Dr. Hilary Beaver
Ophthalmologist
The Methodist Hospital

People with diabetes are more likely to develop eye problems such as cataracts and glaucoma. However, the disease's effect on the retina is the main threat to vision. Damage to the retina, called diabetic retinopathy, is a disease that can cause partial vision loss or complete blindness. According to the National Eye Institute, nearly half of those who have diabetes will develop some degree of diabetic retinopathy during their lifetime.

Retinal problems in diabetics are caused by damage to the tiny blood vessels in the retina. These blood vessels may weaken gradually due to high blood glucose, and this damage is magnified by high blood pressure. Eventually they may break, causing bleeding in the retina or may occlude, withholding essential nutrients and oxygen from the retina.

New blood vessels (neovascularization) may be formed in an attempt to bring new sources of oxygen, but these vessels are abnormal in structure and often break, bleed or contract, creating scar tissue that blocks vision and/or causes retinal detachment.

Risk Factors for Diabetic Retinopathy

Anyone with diabetes is at risk, but the following factors may elevate your risk for developing diabetic retinopathy: "Having diabetes for many years (the longer you have diabetes, the greater your risk) Poor blood sugar control High blood pressure High cholesterol Pregnancy Black, Hispanic or Native American ethnicity Smoking

Warning Signs
Hilary Beaver, M.D., an ophthalmologist at The Methodist Hospital, says often there are no early warning signs of diabetic retinopathy, so it's important to have your eyes checked annually. Contact your eye doctor if you notice any sudden changes in your vision or symptoms such as:

• Blurry or double vision
• Rings, flashing lights or blank spots
• Dark or floating spots
• Pain or pressure in one or both of your eyes
• Trouble seeing things out of the corners of your eyes

Vision loss can be frightening, but there are treatments available. If retinopathy is detected before major damage is done, laser treatment may be used to control the disease. A laser can be used to close off leaking blood vessels of the damaged eye, a procedure that slows the loss of vision. Laser treatments also can be applied to the retina directly to stop the production of new, anomalous blood vessels and the formation of fibrotic, neovascular membranes.

"Vitrectomy may also be used to treat advanced retinopathy," Beaver says. "During this procedure, the blood and scar tissue are removed from the eye, replaced with clean fluid and augmented by laser treatment to help reattach the retina."

The surgery helps slow vision loss, but it is not a cure. Primary prevention through glucose control, and follow-up examinations and treatment are important in managing the disease.

Preventive Steps
Control blood sugar levels. The Diabetes Control and Complications Trial showed that better control of blood sugar levels slows the onset and progression of retinopathy.* Check your blood glucose regularly and talk with your doctor about your target blood sugar levels.

Keep blood pressure and cholesterol under control. Studies have shown that controlling elevated blood pressure and cholesterol can reduce the risk of vision loss.* A healthy diet, regular exercise, maintaining a healthy weight and taking medications as prescribed can help manage blood pressure and cholesterol.

Don't smoke or use tobacco. Smoking increases your risk for various diabetes complications, including diabetic retinopathy. Talk to your doctor about ways to quit.

* Source: National Eye Institute

For more information on ophthalmic services at The Methodist Hospital, call 888-891-4896 or visit methodisthealth.com.