What is Diabetic Retinopathy?

Diabetes mellitus causes high blood sugar to circulate in the body. The blood with high blood sugar content is very thick and acts like sludge. Very small, fragile blood vessels in the kidneys, heart, and eyes can become damaged and leaky from progressive damage and become very poor at delivering the required nutrients that the body needs, including oxygen. When the retinal tissue is deprived of oxygen, because the small vessels are not working properly, it "cries out" for help. First, there are signs of small blood spots where blood has leaked out of small, damaged blood vessels. Some areas of the retina can become starved of oxygen to the point of dying, and cause small white spots called "cotton wool spots" that are visible on examination of the retina. These changes are called "background or non-proliferative" diabetic retinopathy. These changes are a warning sign that things are getting worse and the diabetes must be controlled before more devastating problems arise.

Non-proliferative Diabetic Retinopathy (NPDR)

Non-proliferative Diabetic Retinopathy (NPDR) patients may lose vision from "macular edema". This is a swelling of the macula, the central retina that gives us our reading vision. This swelling happens when the small blood vessels leak because they have become damaged from chronic high blood sugar. A retina specialist generally treats diabetic macular edema with laser and/or injected medications. If you are diagnosed with diabetic macular edema, you will promptly be referred to a retina specialist for evaluation and treatment.

Proliferative Diabetic Retinopathy (PDR)

Proliferative Diabetic Retinopathy (PDR) develops when diabetic retinopathy gets worse, and the retina is crying out for oxygen. New blood vessels may start forming or proliferating inside the eye, on the retina in a desperate attempt to get more oxygen. Unfortunately, these new blood vessels can cause a lot of problems, including bleeding inside the eye, retinal detachments, and a type of glaucoma (called neovascular glaucoma). Once new blood vessels start forming, you will need to be referred to a retina specialist to review options for treatment, which may include laser, anti-VEGF injections to stop the growth of new blood fragile vessels, and/or possibly surgery.

Is this treatment available at GEM Clinic?

Anti-VEGF injections and laser for diabetic retinopathy are performed by a retina specialist. These treatments are not available at GEM Clinic. However, GEM Clinic doctors are experienced in the medical and surgical management of neovascular glaucoma, which can develop from retinal problems like diabetic retinopathy. Depending on your condition, you may need to maintain follow-up appointments with both your retina specialist and your glaucoma specialist at GEM Clinic to ensure that your disease is well-controlled.

What can I do to help treat my diabetic eye disease?

By working together as a team, you as the patient being the key part of this team, every effort will be made to control your diabetic eye disease. Ultimately, the best form of treatment for any disease is prevention. For diabetic problems, maintaining normal blood sugar levels with regular monitoring and medication, and following a proper diabetic diet are very important ways of preventing the disease from getting worse. Regular exercise and weight loss are also important ways of controlling adult diabetes (type II). If you are also a smoker, quitting smoking is strongly advised and integral to optimizing the circulation of oxygen throughout your body.

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