{"id":17154,"date":"2020-11-27T10:00:04","date_gmt":"2020-11-27T15:00:04","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=17154"},"modified":"2023-10-24T11:58:52","modified_gmt":"2023-10-24T15:58:52","slug":"diabetic-retinopathy","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/diabetic-retinopathy\/","title":{"rendered":"What you need to know about diabetic eye disease"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">How\u2019s your vision? If you have diabetes, you may want to be extra vigilant about the health of your eyes.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Diabetic eye disease is a leading cause of blindness, according to the National Eye Institute (NEI). Among the various types of diabetic eye disease, which include glaucoma, cataracts, and diabetic macular edema, diabetic retinopathy is the most common cause of vision loss among people with diabetes.<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cPeople think of diabetes as affecting their <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/normal-blood-glucose-levels\/\"><span style=\"font-weight: 400;\">blood sugar levels<\/span><\/a><span style=\"font-weight: 400;\">, but they don\u2019t always think of it affecting their eyes,\u201d notes ophthalmologist Rahul Khurana, MD, a clinical spokesperson for the American Academy of Ophthalmology (AAO). But it\u2019s important that they do as <\/span><a href=\"https:\/\/www.nei.nih.gov\/sites\/default\/files\/2019-06\/diabetes-prevent-vision-loss.pdf\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">early detection and timely treatment<\/span><\/a><span style=\"font-weight: 400;\"> can greatly reduce the risk of severe vision loss.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">November is National Diabetes Month and National Diabetic Eye Disease Awareness Month. So, this time of year marks a great opportunity for you to learn more about how diabetes can affect your eye health. You can learn more about conditions like diabetic retinopathy and how you may be able to prevent vision problems or severe vision loss from developing.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">What is diabetic retinopathy?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Diabetic retinopathy is a condition that develops as a result of damage to the tiny blood vessels of the retina, which is the thin layer of tissue at the back of the eye near the optic nerve.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">According to the Centers for Disease Control and Prevention (CDC), diabetic retinopathy is the \u201c<\/span><a href=\"https:\/\/www.cdc.gov\/diabetes\/managing\/diabetes-vision-loss.html\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">most common cause of vision impairment and blindness among working-age adults in the United States<\/span><\/a><span style=\"font-weight: 400;\">.\u201d Nearly <\/span><a href=\"https:\/\/www.cdc.gov\/features\/diabetic-retinopathy\/index.html\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">8 million adults<\/span><\/a><span style=\"font-weight: 400;\"> have diabetic retinopathy, and that number is expected to grow. The World Health Organization also reports that diabetes retinopathy causes nearly <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/news\/diabetes-statistics\/\"><span style=\"font-weight: 400;\">3% of vision loss<\/span><\/a><span style=\"font-weight: 400;\"> worldwide.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u00a0<\/span><span style=\"font-weight: 400;\">In a healthy eye, the retina receives light from the lens of the eye, converts that light into signals and sends those signals to the brain. That\u2019s how you see.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u00a0<\/span><span style=\"font-weight: 400;\">But if you have diabetes and your blood glucose levels tend to be too high, your eyes may pay the price. When blood sugar levels remain elevated over time, they can damage your blood vessels\u2014that includes the tiny blood vessels in your eyes. As a result, those blood vessels may begin to swell or rupture. Some begin to leak fluid into your retina. Your body may respond by trying to grow new blood vessels, but that can cause new problems to develop. Eventually, you may lose the ability to see.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u00a0<\/span><span style=\"font-weight: 400;\">There are two main types of<\/span><a href=\"https:\/\/www.aao.org\/eye-health\/diseases\/what-is-diabetic-retinopathy\" target=\"_blank\" rel=\"noopener noreferrer\"> <span style=\"font-weight: 400;\">diabetic retinopathy<\/span><\/a><span style=\"font-weight: 400;\">: nonproliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR).\u00a0\u00a0<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Nonproliferative diabetic retinopathy<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Nonproliferative diabetic retinopathy is the early stage of this disease. You might not even notice any symptoms during this stage, although some people report some blurriness.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Some experts further divide nonproliferative retinopathy into three stages. Here\u2019s what happens during those stages:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><b>Mild nonproliferative retinopathy: <\/b><span style=\"font-weight: 400;\">During this stage, capillary walls begin to weaken, causing microaneurysms to develop.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Moderate nonproliferative retinopathy: <\/b><span style=\"font-weight: 400;\">The microaneurysms begin to rupture, causing tiny hemorrhages in the retina. The weakened blood vessels also leak or weep fluid into the retina. The leakage can make part of the retina swell. Some of the blood vessels become blocked, reducing the blood supply to the retina.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Severe nonproliferative retinopathy:<\/b><span style=\"font-weight: 400;\"> More ruptures occur, and more blood vessels become blocked, further cutting off the blood supply to the retina.<\/span><\/li>\n<\/ul>\n<h3><span style=\"font-weight: 400;\">Proliferative diabetic retinopathy<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Proliferative diabetic retinopathy is the more advanced form of diabetic retinopathy.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">When you develop this form, your retina begins growing new blood vessels, a process known as neovascularization, according to the AAO. Those new blood vessels tend to be very fragile, so they often break open and bleed into the vitreous, the gel-like substance in the middle of your eye. When this happens, you might notice some small specks or lines floating across your field of vision. These floaters can cloud or block your vision.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">However, that\u2019s not all that can happen if you have PDR. Scar tissue can form on those new blood vessels, which can lead to detachment of the retina. The retina is pulled out of its normal position at the back of your eye, so your retinal cells don\u2019t get their usual supply of oxygen from the blood vessels. The longer it\u2019s left untreated, the more likely that this retinal detachment can lead to permanent vision loss.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">How can you tell if diabetes is affecting your eyes?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">In the early stages of diabetic retinopathy, you might be blissfully unaware that anything is wrong. Your vision might seem totally normal.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">But, you could be in the early stages of diabetic retinopathy without realizing it. That\u2019s why regular comprehensive eye exams are so critical: The only way you would know is for your eye doctor to detect the signs of damage during a dilated eye exam.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cJust because you think you\u2019re fine, don\u2019t risk losing your vision and developing blindness,\u201d<\/span> <span style=\"font-weight: 400;\">warns <\/span><a href=\"https:\/\/www.eyephysiciansoflongbeach.com\/our-doctors\/majid-moarefi-md\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Amir Moarefi, MD, MS<\/span><\/a><span style=\"font-weight: 400;\">, an ophthalmologist in Long Beach, California.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The symptoms of diabetic retinopathy typically start with blurred vision. According to the AAO, other symptoms, as the disease progresses, can include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Floaters or spots in your vision<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">A dark area in your central vision<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Trouble seeing at night<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Colors look faded or washed out<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Vision changes from blurry to clear<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">If left untreated, diabetic retinopathy can also lead to other eye conditions, such as a form of<\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/glaucoma-treatment-and-medications\"> <span style=\"font-weight: 400;\">glaucoma<\/span><\/a><span style=\"font-weight: 400;\"> known as neovascular glaucoma.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Plus, about half of all people with diabetic retinopathy go on to develop a condition diabetic macular edema (DME). With this condition, part of your retina called the macula begins to swell as a result of all the fluid leaking from blood vessels. This can cause blurry vision.\u00a0<\/span><\/p>\n<p><b>RELATED: <\/b><a href=\"https:\/\/www.singlecare.com\/blog\/early-signs-of-diabetes\/\"><b>10 early signs of diabetes and when to see a healthcare provider<\/b><\/a><\/p>\n<h2><span style=\"font-weight: 400;\">Who develops diabetic retinopathy?<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Anyone with diabetes can develop diabetic retinopathy. It doesn\u2019t matter if you have Type 1 diabetes or Type 2 diabetes. But you also must consider how long you\u2019ve had diabetes.<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cThe longer you have diabetes, the higher risk you have of developing diabetic retinopathy over time,\u201d Dr. Khurana says.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">That\u2019s because over time, high blood sugar levels can cause damage to those tiny blood vessels in your eye. The risk is greater if you\u2019ve had trouble managing your blood sugar levels and keeping them within your target range.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">There are also other risk factors for diabetic retinopathy, including:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><b>Race:<\/b><a href=\"https:\/\/care.diabetesjournals.org\/content\/28\/8\/1954\" target=\"_blank\" rel=\"noopener noreferrer\"> <span style=\"font-weight: 400;\">African American and Hispanic people<\/span><\/a><span style=\"font-weight: 400;\"> seem to have a higher risk for developing diabetic retinopathy.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Family history:<\/b><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4125976\/\" target=\"_blank\" rel=\"noopener noreferrer\"> <span style=\"font-weight: 400;\">Research suggests<\/span><\/a><span style=\"font-weight: 400;\"> that a family history of diabetic retinopathy may increase your odds of developing it, too.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Pregnancy:<\/b><span style=\"font-weight: 400;\"> If you develop gestational diabetes when you are pregnant, your chances of developing diabetes later in life increase\u2014and so do your chances of developing diabetic retinopathy.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Other medical conditions:<\/b><span style=\"font-weight: 400;\"> If you have high cholesterol or high blood pressure, you\u2019re at increased risk for developing diabetic retinopathy.<\/span><\/li>\n<\/ul>\n<h2><span style=\"font-weight: 400;\">Can diabetic eye damage be reversed?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Especially in the early stages, diabetic retinopathy is treatable.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cEven if you are losing vision from diabetic retinopathy, we now have a whole new set of options to manage it,\u201d explains Dr. Khurana. \u201cSo, it\u2019s even more important to see your ophthalmologist when you have diabetes.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The diabetic retinopathy treatment options include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><b>Tighter blood sugar control:<\/b><span style=\"font-weight: 400;\"> Prevent the damage from occurring to the blood vessels in your eye, and you may not need additional treatment. You can talk to your endocrinologist if you need help with this task.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Medication:<\/b><span style=\"font-weight: 400;\"> Your eye doctor may suggest medication in the form of steroids or<\/span><a href=\"https:\/\/www.aao.org\/eye-health\/drugs\/anti-vegf-treatments\" target=\"_blank\" rel=\"noopener noreferrer\"> <span style=\"font-weight: 400;\">anti-VGEF treatments<\/span><\/a><span style=\"font-weight: 400;\">. Anti-VGEF treatments are injections of medicine designed to inhibit a protein that your cells produce called vascular endothelial growth factor, which promotes blood vessel growth. The injections can slow or stop abnormal blood vessel growth that may be affecting or reducing your vision. The three main anti-VGEF medications are<\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/avastin\"> <span style=\"font-weight: 400;\">Avastin<\/span><\/a><span style=\"font-weight: 400;\">,<\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/lucentis\"> <span style=\"font-weight: 400;\">Lucentis<\/span><\/a><span style=\"font-weight: 400;\">, and<\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/eylea\"> <span style=\"font-weight: 400;\">Eylea<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Laser surgery: <\/b><span style=\"font-weight: 400;\">If you have more advanced, or proliferative, diabetic retinopathy, you may be a candidate for a type of laser treatment called<\/span><a href=\"https:\/\/www.nei.nih.gov\/learn-about-eye-health\/eye-conditions-and-diseases\/diabetic-retinopathy\/laser-treatment-diabetic-retinopathy\" target=\"_blank\" rel=\"noopener noreferrer\"> <span style=\"font-weight: 400;\">scatter laser surgery<\/span><\/a><span style=\"font-weight: 400;\">, also known as panretinal photocoagulation. Essentially, it removes the peripheral edges of the retina, eliminating some of those blood vessels that are causing vision loss.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Vitrectomy:<\/b><span style=\"font-weight: 400;\"> According to the AAO, this type of surgery may be appropriate for a person with an advanced form of diabetic retinopathy. It involves<\/span><a href=\"https:\/\/www.aao.org\/eye-health\/treatments\/what-is-vitrectomy\" target=\"_blank\" rel=\"noopener noreferrer\"> <span style=\"font-weight: 400;\">removing some of the vitreous gel and leaking blood vessels in the back of the eye<\/span><\/a><span style=\"font-weight: 400;\"> (and sometimes scar tissue). Removing those substances allows light to once again properly focus on the retina so you can see.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">As with any kind of treatment, there are upsides and downsides of the various treatment options for diabetic retinopathy.<\/span><br \/>\n<span style=\"font-weight: 400;\">For example, panretinal photocoagulation can be very effective, Dr. Moarefi says, but you are basically sacrificing your peripheral vision in order to preserve your central vision. And that can affect your ability to carry out some of your activities of daily living, including walking and driving.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">At a certain point, if the diabetic retinopathy has reached an advanced stage, it may not be possible to reverse the damage, Dr. Khurana says. At that point, your eye doctor will emphasize preserving the vision that you still have\u2014and halting any further damage from occurring.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">How can people with diabetes prevent eye problems?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">\u201cThe only way to prevent the damage is to really take it seriously and be proactive with your screening,\u201d Dr. Moarefi explains.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">That means that anyone with diabetes should schedule a comprehensive dilated eye exam <\/span><i><span style=\"font-weight: 400;\">every year<\/span><\/i><span style=\"font-weight: 400;\">, so your eye doctor can assess the health of your retina and look for signs of impending damage. Your doctor will administer eye drops that make your pupils dilate, or widen, to give a better view of the retina.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If your eye doctor suspects you have severe diabetic retinopathy, a diagnostic test called a fluorescein angiogram may also be warranted.<\/span><a href=\"https:\/\/www.aao.org\/eye-health\/treatments\/what-is-fluorescein-angiography\" target=\"_blank\" rel=\"noopener noreferrer\"> <span style=\"font-weight: 400;\">Fluorescein angiography<\/span><\/a><span style=\"font-weight: 400;\"> (FA) involves injecting a colored dye into your veins, then using a camera to take pictures of those blood vessels in the retina when the dye passes through them.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Don\u2019t blow off your eye examination, even if you haven\u2019t noticed any symptoms.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cDedicate that one hour of your year in the beginning to make sure you don\u2019t suffer a lifetime of blindness or visual and physical impairment,\u201d Dr. Moarefi says.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">You can also work to prevent diabetic retinopathy from developing by keeping your blood sugar under good control. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), if you focus on managing your blood sugar levels, you may be able to avoid having chronically elevated levels that can damage those blood vessels in your eyes.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">But there are a couple of other health conditions that you should also pay close attention to managing: your blood pressure and your cholesterol levels. Managing these three conditions, which the NIDDK calls \u201cthe diabetes ABCs\u201d can help you stay healthy and keep your eyes healthy, too.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Even if you get an annual dilated eye exam and are vigilant about keeping your blood sugar levels within your target range, watch out for any changes to your vision. If you start to notice some unusual symptoms, don\u2019t ignore them.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">For example, if you notice a burst of new floaters or flashes of light, this could be a sign of retinal detachment, which can occur in very advanced cases of diabetic retinopathy. It\u2019s a very serious condition that can lead to permanent vision loss if not addressed quickly.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>How\u2019s your vision? If you have diabetes, you may want to be extra vigilant about the health of your eyes. Diabetic eye disease is a leading cause of blindness, according to the National Eye Institute (NEI). Among the various types of diabetic eye disease, which include glaucoma, cataracts, and diabetic macular edema, diabetic retinopathy is [&hellip;]<\/p>\n","protected":false},"author":94,"featured_media":16944,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[8029],"tags":[10298],"coauthors":[9482],"class_list":["post-17154","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-education","tag-diabetes","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Diabetic retinopathy: What you need to know about diabetic eye disease<\/title>\n<meta name=\"description\" content=\"Diabetic eye disease is a leading cause of blindness, but it&#039;s preventable. 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