Diabetes and Blindness

The National Eye Institute estimates that about 45 percent of adults that have been diagnosed with diabetes have diabetic retinopathy to some extent. Blood sugar levels, as you know, are a main factor in what causes diabetes. As you age and have diabetes, the chances increase that you will suffer from this eye disease, especially if you have had it for more than ten years.

Diabetes and blindness cannot always be detected at first. There are two stages to diabetic retinopathy – early and advanced.

Early diabetic retinopathy -- In the early stages, you may not notice any difference in your vision. My great aunt had no idea anything was happening with her eyes for a very long time. This stage of diabetes and blindness occurs when the eye’s blood vessels start to weaken. They can develop swelling, and fluids leak into the retina. Some of the blood vessels that feed the retina may become blocked. This signals the eye to grow more blood vessels. Some of these may bleed, blurring the vision and leave specks. I remember my great aunt making comments about seeing "black things" in her vision.

As these new bloods vessels grow and multiply (proliferate) they can also begin bleeding and leaking. Some of the fluids can leak into the macula, or central, straight-line vision part of the eye which enables seeing detail and sharpness. The macula then swells, blurring vision. This is called macula edema. In the early stages of macular edema, you may still not notice any vision changes. During early diabetic retinopathy, the eye nerves can also swell.

Advanced diabetic retinopathy -- During this more serious stage of diabetes and blindness, lack of oxygen to the retina occurs, causing even more new blood vessels to grow and leak. At this point the vessels are weak and abnormal. As they proliferate and bleed, they can destroy the retina. The leakage can also move into the gel of the eye, called the vitreous humor. All of this can cause increased pressure in the eye, as in glaucoma, and damage the optic nerves. The optic nerves are what transmit images to your brain. Once damaged, it is irreversible. In advanced stages, scarring can take place, even detaching the retina from the back of the eye. In the advanced stages if not treated, permanent blindness can occur. My great aunt's blindness was not total, but enough so her life was forever changed.

Symptoms of Diabetic Retinopathy

• When bleeding and fluid leakage occur, you will notice little spots of blood in your vision. These are a type of floater. They can temporarily clear up. See your doctor right away before they get worse.
• Increase in floaters as leakage occurs into the vitreous humor. This can sometimes clear up.
• Night blindness – this especially shows up as poor night vision while driving.

• If left untreated, bleeding can become more serious and hemorrhage, sometimes over night. You will notice blurred vision.
• You may start to lose vision and black areas that block out the image you are seeing will occur in your range of vision. See the Before and After pictures to the right.

I spoke with my Dad's retina specialist about treatment for diabetic retinopathy. Nowadays there are more advanced options for treating diabetes and blindness -- something not available to my great aunt. Diabetes and blindness can be treated, if diabetic retinopathy is detected early. As mentioned above, in the early stages you may not know you have a problem. It must be detected through an eye exam. Surgery may be recommended, depending on findings. In later stages with proliferative diabetic retinopathy where there is bleeding and leakage, you will need surgery. Surgery is not a “cure,” but delays the progress of the disease. You may need further treatment if it worsens. Research is underway for medicines to stop growth of blood vessels in the first place. Some methods of diabetic retinopathy treatment are mentioned below.

Focal Laser Treatment – This is more minor surgery done in the doctor’s office in one day. The laser burns those vessels that are leaking and seals them off. You will notice small spots from the laser burns for days or weeks. Vision will be blurry for a day or two after surgery.

Vitrectomy -- With this surgery, an incision is made and the leaking blood vessels and any scar tissue are removed. Further procedures may be done to prevent the retina from detaching. Introducing a small gas bubble into the eye is the usual method. If this is done, you may be instructed by your doctor to lay face down until the gas bubble disappears – this may take days. Since this is more serious surgery, it may be done in a hospital with general anesthesia. Sometimes laser surgery is also done. You may be required to stay overnight. After surgery, you will be given drops to use for as many weeks as the doctor decides, depending on your circumstances.

Scatter laser Treatment -- The purpose of the laser surgery is to diminish the size of the growing blood vessels. They can sometimes then disappear. Several (scattered) laser burns are used. Although it is also done in the doctor’s office, more than one session is usually required. Again, your vision will be blurry for a couple days afterwards.

Your doctor will advise you as to the complications and effects of the surgery, including possible loss of some vision.

The bottom line with diabetes and blindness is to get regular eye exams and carefully control your diabetes, blood pressure, cholesterol, weight, and smoking habits. You are not necessarily going to fall victim to blindness just because you have diabetes. Taking preventative steps can make the difference.

Return from Diabetes and Blindness,
back to Causes of Blindness

copyright 2009-2011, OneSong, LLC
See Menu bar for our Copyright Notice, Disclaimer, and Privacy Policy

SBI!