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Diabetic Retinopathy

Diabetic Retinopathy Doctor in Northville, MI

Taking a Look at Diabetic Retinopathy

How do they diagnose a person with Diabetic Retinopathy?

Usually, the best method to find any variations in the eye is via eye examinations.

Usually the ophthalmologist (an eye Dr.) will be able to diagnose, and even treat the retinopathy before being aware that there are vision issues. They first dilate the pupil, looking in the eye using specialized equipment designed with special lenses.

If the ophthalmologist locates any diabetic retinopathy, they may decide to order color photographs, or a fluorescein angiography to decide if treatment is needed. For this type of test, they inject dye into the arm, and images of the eye are reviewed for any leakage.

What is the treatment?

Generally, the best treatment would be preventing the retinopathy from developing in the first place. This can be helped by keeping your blood sugar within control and lowers the chance of vision loss in the long-term from the diabetic retinopathy. In addition, kidney issues and high blood pressure also need to be treated if they exist.

Medical Treatments: Anti-VEGF injections are used in the eye to help prevent new blood vessels from developing, as well as the subsequent bleeding. The VEGF provides the requirements for growing new blood vessels, and the anti-VEGF can put a stop to the abnormal blood vessels. In certain situations, a steroid may be used.

Laser Surgery: If you have been diagnosed with PDR, macular edema, or neovascular glaucoma, your ophthalmologist may suggest laser surgery.

When it comes to macular edema, they focus the layer towards fixing any damage on, or to the retina next to the macula in order to lower any leakage. The overall goal with this is to help any additional vision loss. Although it’s possible to have some vision improvements, it’s not common for patients with macular edema to return to normal vision. There have been some who see laser spots in their vision, usually near the center. These may fade over time, but may not fade completely.

When it comes to PDR, they focus the laser on every section of the retina, excluding the macula. This treatment is known as panretinal photocoagulation, and it shrinks the abnormal blood vessels, which prevents them from growing again. This can also lower the risks of retinal distortion, or vitreous bleeding.

While laser treatments can have benefits, it’s not a cure, the diabetic retinopathy and multiple laser treatments could be needed. There can also be continued vision loss.

Vitrectomy: If your PDR diagnoses is advanced, you may be suggested to go with this treatment. The vitrectomy is done in an operating room, and it’s considered a microsurgical procedure. The treatment works by removing the vitreous that is filled with blood, and replacing it with clear fluid. The ophthalmologist may chose to give it a few months to see if the blood dissipates on it’s own prior to setting up the vitrectomy.

Usually, vitrectomy will hep prevent future bleeding as it removes the abnormal vessels that were caused from the bleeding. In the event the retina gets detached the vitrectomy surgery is able to repair it as well. However, the surgery should be done in the early stages so the traction retinal detachment, or macular distortion can cause permanent vision loss. Basically, the longer a distorted macula, or one that is out of place goes untreated, the higher the risk of serious vision loss.

The loss of vision is highly preventable.

With today’s medical technology, there are improved treatments for those diagnosed with retinopathy, and there is a lower risk of having severe vision issues. The best way to protect yourself from diabetic retinopathy is still detecting it early.

If you make it a point to control your blood sugar levels, you will have a much lower chance of having loss of vision, so regularly check your blood sugar and blood pressure with your doctor.

When to begin scheduling the examination?

Anyone who has been diagnosed with Type 2 diabetes needs to be examined within five years of the diagnosis, and then each year after. Those with Type 2 diabetes needs to get an examination when diagnosed, and each year after.

If you are pregnant and have been diagnosed with diabetes, you should have an examination within the first trimester, as the retinopathy can quickly progress during the pregnancy.

If you are planning to get eyeglasses, you should keep your blood sugar levels under control for a few days prior to seeing the ophthalmologist, otherwise the glasses may work then, but not so well later once your sugar is under control.

Even in the event that you do not have retinopathy, a quick change in blood sugar can also cause vision problems.

If you experience the following, you should have your vision checked quickly:

  • Affects a single, or both of your eyes.
  • Issues last longer than a few days.
  • Isn’t connected with changes in blood sugar.

When being diagnosed with diabetes, you need to get your eyes checked:

  • In the first five years of being diagnosed if under the age of 29.
  • Within several months if you’re over the age of 30.

Having diabetes could affect your vision

In the case you’ve got diabetes mellitus, this means your body isn’t storing and using sugar the way it should. Having blood sugar levels that are high can cause damage within the blood vessels within the retina. This is the nerve in the back of the eye which helps images get sent to the brain, and senses light. Diabetic retinopathy is the term used to refer to damage within the retinal vessels.

Diabetic retinopathy types

There are two different types of diabetic retinopathy, proliferative diabetic retinopathy (PDR) and nonproliferative diabetic retinopathy (NPDR).

NPDR is referred to as background retinopathy, which is just the early stages of diabetic retinopathy. This is the stage where small blood vessels in the retina begin to show leakage, either of fluid or blood. This causes swelling in the retina, or forms deposits known as exudates.

Those who have been diagnosed with diabetes also tend to have NPDR, but it can be mild and may cause vision issues. When a persons vision begins to get affected, this is from the macular edema, or the macular ischemia, and could even be both.

Macular edema happens when the macula begins to get thicker or swells up. This is a little section in the middle of the retina which gives us the ability to clearly view details. This swelling is from leakage of blood vessels. It is also the most common reason for diabetics to loss there vision. The loss of vision could vary from mild to severe, but the peripheral vision will still function.

Mascular ischemia happens when the small blood vessels, referred to as capillaries decide they want to close. This causes blurred vision as the macula isn’t getting the blood supply it needs to work.

PDR is when the abnormal vessels known as neovascularization starts to grow on the optic nerve, or the retina. It’s the closing of many blood vessels withing the retina that causes the PDR to develop because it cuts off the blood flow needed to work properly. Due of this, the retina’s response is to create new vessels as it’s trying to get the blood flow needed.

However, the new vessels are not providing the needed blood flow, and grow abnormally. In addition, there tends to be scar tissue with the new vessels which can cause detachment from the retina or wrinkling to occur.

PDR can actually cause more vision issues than NPDR as it’s able to affect both the central, as well as the peripheral vision.

The following are ways that vision loss can occur with Proliferative diabetic retinopathy:

Vitreous hemorrhage: This can cause the new vessels to begin leaking blood in the vitreous, which is a clear gel type liquid filling the eye. If the hemorrhage is tiny, then a person many experience what’s know as “floaters”. However, if the leak is big enough it can cause total vision loss.

It can take various amounts of time to reabsorb blood depending on how much blood was leaked, from days to years. Vitrectomy surgery could be suggested if the blood doesn’t clear the eye in a certain time.

The vitreous hemorrhage by it’s self won’t lead to vision loss that is permanent, once the blood has been reabsorbed the vision can be back to normal, long as the macula was not damaged.

Traction retinal detachment: With PDR, car tissue that’s connected with neovascularization could wrinkle or shrink. This can cause the retina to move out of place. The wrinkling of the macular can lead to distorted vision, and if detachment occurs it can cause even more vision loss that’s more severe.

Neovascular glaucoma: On occasion, the large scale closing of retinal vessels can cause more new and abnormal vessels to begin growing on the iris, which is the part of the eye with color, as well as within the drainage channels. This can work as a dam, blocking the natural fluid flow from the eye, causing a build up of pressure within the eye and the result is neovascular glaucoma. This is an eye diseases that damages the optic nerve and is considered severe.