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Diabetic Health Viewed Through the Eyes

By Wallace Goldban, MD

25.8 million Americans – 8 percent of the population – have diabetes and the numbers are growing. Diabetes can cause damage to all parts of the body, and much of that damage can be viewed in the eyes.

What is happening in the eye of a diabetic patient is happening throughout their body; thus, ophthalmologists are at the forefront of diagnosing and treating the disease. Blood vessels in the retina are an indicator of disease-related damage to vital organs. As such, eye screenings for retinal damage are not only important to identify and treat early issues, but also as a prognostic indicator to a person’s overall health and blood sugar control.

It is essential that diabetics have their eyes checked annually. The eye is especially vulnerable to damage from diabetes; 80 percent of diabetics will have some damage after 10 years of living with the disease. The longer a person has diabetes, the higher the chance of diabetic retinopathy, the leading cause of blindness in American adults.

Diabetic retinopathy is caused by changes in the blood vessels of the retina, the light-sensitive tissue at the back of the eye. A healthy retina is necessary for good vision. In some people with diabetic retinopathy, blood vessels may swell and leak fluid. In others, abnormal new blood vessels grow on the surface of the retina. If you have diabetic retinopathy (which usually affects both eyes), you may not notice changes to your vision at first, but over time, diabetic retinopathy can get worse and cause vision loss.

There are two different types of diabetic retinopathy: non-proliferative (with no apparent symptoms) and proliferative. Since this disease is often asymptomatic, early detection is key. Identifying the extent of damage requires a fluorescein angiography where dye is injected into a person’s veins and pictures are taken of the retina to see if there is leakage. Macular edema occurs when the leakage happens in the central portion of the eye and can be debilitating. If left untreated, proliferative retinopathy can occur and new blood vessels form leaking more blood into the eye and causing severe damage.

Early treatment and detection are vital. A thorough examination will include checking your vision to determine if glasses will correct your eyesight, as well as, checking for glaucoma and cataracts which are both more common in diabetics. Your eyes will be dilated to view the blood vessels in the back of the eye.

Traditional treatment for diabetic retinopathy includes laser therapy to stop bleeding and new blood vessels from forming; however, laser treatments can leave scars creating blind spots in your vision. Recent advancements in treatment include injections of steroids or new (anti-VEGF) compounds to achieve the same results without leaving scars. Sometimes if the bleeding is severe, an operation is necessary to remove blood.

Controlling blood sugars is the first step to not only controlling your diabetes, but also enhancing eye health. Other factors that can improve eye health include smoking cessation and controlling blood pressure.

Dr. Wallace Goldban is a board-certified ophthalmologist with over 20 years of experience. He is a graduate of the Albert Einstein College of Medicine and has offices in Palm Springs and Palm Desert. Dr. Goldban can be reached at (760) 320.8497.

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