Diabetic
RetinopathyIntroduction: Diabetic retinopathy is
one of the major causes of blindness in both eyes. It is painless and it is found
in those diabetics who had their condition for a long time and where diabetes
control was not always achieved. It is important for diabetics to know that this
eye condition can be prevented. This is achieved through a combination of
at least yearly eye examinations by an eye specialist with blood sugar monitoring
by the patient and ordering a hemoglobin A1C every few months by the regular physician. Signs,
Symptoms and Diagnostic Tests: When
diabetes is not closely controlled, certain changes happen to the blood vessels
in the body that can be visualized by the eye-specialist through eye examinations.
The specialist will detect enlarged veins and small red dots in the retina, which
starts the process of the diabetic retinopathy. The specialist will then
see leakage of protein (exudate) and blood into the retina. This
is called nonproliferative
retinopathy. When the process continues over the years with poorly
controlled diabetes new pathological blood vessels form, a process that is called
"neovascularization". These vessels grow on the surface of the vitreous
body and can involve the vitreous cavity. This is called proliferative
retinopathy, a process which is indicating more advanced changes
from diabetic neuropathy. The last link shows you more details and explains with
pictures of bleedings into the vitreous body and formation of fibrous tissue why
the vision of a patient with uncontrolled diabetes deteriorates. As the proliferative
retinopathy forms scarring, this can cause retinal detachment resulting in sudden
visual loss. Treatment: Treatment of diabetic retinopathy
depends on whether it is in an early or later stage and whether and how much neovascularization
has taken place. The most important things to do for the patient and physician
alike are to achieve blood sugar control and to lower
high blood pressure effectively, if this is also present. Anybody
who might still be skeptical about how effective the control of blood sugar is
in preventing diabetic neuropathy should read the Diabetes
Control and Complications Trial. This
text explains that mature onset diabetes when closely controlled with multiple
insulin injections per day can reduce the rate of diabetic neuropathy by 76% and
can slow down the progression of existing mild retinopathy by 54%. Any sudden
change of vision, black spots or flashing lights in one or both eyes need the
prompt attention of an eye specialist. There are a number of procedures that the
eye specialist can utilize. Here is an
ophthalmological site where a few clinical cases are reviewed with
lots of images.
|
