Diabetic Retinopathy

Diabetic retinopathy is a complication of diabetes that affects the eyes. It’s caused by damage to the blood vessels of the light-sensitive tissue at the back of the eye (retina).

At first, diabetic retinopathy may cause no symptoms or only mild vision problems. Eventually, however, diabetic retinopathy can result in blindness.

Diabetic retinopathy can develop in anyone who has type 1 diabetes or type 2 diabetes. The longer you have diabetes, and the less controlled your blood sugar is, the more likely you are to develop diabetic retinopathy.

To protect your vision, take prevention seriously. Start by carefully controlling your blood sugar level and scheduling yearly eye exams.

Diabetic retinopathy

How do I know if I have Diabetic Retinopathy?

It’s possible to have diabetic retinopathy and not know it. In fact, it’s uncommon to have symptoms in the early stages of diabetic retinopathy.

As the condition progresses, diabetic retinopathy symptoms may include:

• Spots or dark strings floating in your vision (floaters)
• Blurred vision
• Fluctuating vision
• Dark or empty areas in your vision
• Vision loss
• Difficulty with color perception
• Diabetic retinopathy usually affects both eyes.

Diabetic retinopathy may be classified as early or advanced, depending on your signs and symptoms.

Early diabetic retinopathy. This type of diabetic retinopathy is called nonproliferative diabetic retinopathy (NPDR). It’s called that because at this point, new blood vessels aren’t growing (proliferating). NPDR can be described as mild, moderate or severe. When you have NPDR, the walls of the blood vessels in your retina weaken. Tiny bulges (called microaneurysms) protrude from the vessel walls, sometimes leaking or oozing fluid and blood into the retina. As the condition progresses, the smaller vessels may close and the larger retinal vessels may begin to dilate and become irregular in diameter. Nerve fibers in the retina may begin to swell. Sometimes the central part of the retina (macula) begins to swell, too. This is known as macular edema.

Advanced diabetic retinopathy. Proliferative diabetic retinopathy (PDR) is the most severe type of diabetic retinopathy. It’s called proliferative because at this stage, new blood vessels begin to grow in the retina. These new blood vessels are abnormal. They may grow or leak into the clear, jelly-like substance that fills the center of your eye (vitreous). Eventually, scar tissue stimulated by the growth of new blood vessels may cause the retina to detach from the back of your eye. If the new blood vessels interfere with the normal flow of fluid out of the eye, pressure may build up in the eyeball, causing glaucoma. This can damage the nerve that carries images from your eye to your brain (optic nerve).

Testing
shutterstock_171182246Diabetic retinopathy can be diagnosed through a comprehensive eye examination. Testing, with special emphasis on evaluation of the retina and macula, may include:

• Patient history to determine vision difficulties experienced by the patient, presence of diabetes, and other general health concerns that may be affecting vision
• Visual acuity testing
• Dilated eye exam
• An opthalmoscopy and slit lamp exam
• A gonioscopy, OCT (optical coherence tomography)and/or a tonometry

We will explain the exact purpose of these tests to you at your exam.


Careful management of your diabetes is the best way to prevent vision loss. If you have diabetes, please come see us for a yearly dilated eye exam — even if your vision seems fine — because it’s important to detect diabetic retinopathy in the early stages. If you become pregnant,we may recommend additional eye exams throughout your pregnancy, because pregnancy can sometimes worsen diabetic retinopathy.

Lastly, please contact us right away if you experience sudden vision changes or your vision becomes blurry, spotty or hazy.


Early detection and treatment can help prevent vision loss.

√ People with type 1 diabetes who are age 10 and older should have a dilated eye exam within 5 years after diabetes is diagnosed and then every year.
√ People with type 2 diabetes should have an exam as soon as diabetes is diagnosed and then every year.


How do we treat Diabetic Retinopathy?

Good control of diabetes with intensive management and control of blood sugar will delay, and possibly prevent, both the development and progression of diabetic retinopathy.

Patients with diabetic retinopathy frequently need to have special photographs of the retina taken. This series of photos is called fluorescein angiography.

The type of retinopathy, as well as the patient’s general health and eye structure, will determine the kind of treatment needed and the type of anesthesia utilized, but these are common surgery options:

• Laser photocoagulation
• Vitrectomy surgery
• Pharmacotherapy

Your retina specialist at Pepose Vision will explain your treatment options in detail.


Good news!  Pepose Vision is the first in Missouri to offer Iluvien

A new treatment has been approved by the FDA for treatment of diabetic macular edema (DME). ILUVIEN is an eye implant that automatically releases treatment for 36 months. Typically, patients being treated for DME require frequent, even monthly, injections into the eye. The real breakthrough with ILUVIEN is that a single injection lasts for 3 years.

Pepose Vision participated in the clinical studies to help introduce Iluvien and is the first in Missouri to offer it.

Please contact us to schedule an appointment to learn more.


Exciting Diabetic Retinopathy Clinical Studies at Pepose Vision.

This is an excellent opportunity to try tomorrow’s technology today.

In addition to a wide range of advanced vision services, Pepose Vision Institute is also a ophthalmological research center. We perform important clinical studies on new treatments for a variety of vision issues, including Diabetic Retinopathy.

Our studies offer our patients a chance to experience the latest breakthroughs in the treatment of Diabetic Retinopathy. And to play an important role in helping to potentially develop treatments for millions of people that experience this condition.

To learn more about our studies, please click here.


Diabetic Retinopathy is the leading cause of blindness in the United States for persons aged 65 or less.

Much of the vision loss is preventable with early diagnosis and appropriate treatment.


What's your next step?

If you have diabetes or are experiencing any of the symptoms we've discussed on this page, please come see us right away. Our experienced doctors will use advanced diagnostics to determine exactly how to help you see your very best, patiently answer your questions and carefully explain all your options, including our clinical studies.

Contact us