Almost 26 million people in the United States live with some form of diabetes. This serious metabolic disease is characterized by high blood sugar, and results from poorly regulated insulin production or impaired insulin response. It can have serious implications for numerous systems within the body, including the eyes. Early detection and treatment is the best defense against diabetic eye disease.

Diabetic retinopathy is caused by damage to the small retinal blood vessels from elevated sugar (glucose) levels in the bloodstream. The retinal blood vessels damaged by chronic high blood sugar levels may begin to leak fluid (diabetic macula edema) or cause small hemorrhages in the early stages. In more advanced stages, the retinal blood vessels become clogged leading to inadequate oxygen levels in the retina known as ischemia.

The retina then sends out signals to grow new abnormal blood vessels called neovascularization. These abnormal blood vessels have a tendency to bleed (vitreous hemorrhage), which may lead to a sudden onset of floaters. Abnormal blood vessels can also cause scar tissue which pulls on the retina can can lead to retinal detachment in severe cases. Sometimes, neovascularization grows in the front of the eye on the iris which can lead to a very severe form of glaucoma.

As diabetic retinopathy progresses, symptoms include blurred vision that will suddenly clear up or a sudden increase in eye floaters. Eventually, you could experience macular edema (a thickening of the central portion of the retina), retinal detachment, or a buildup of pressure within the eye (glaucoma). The key to successful treatment of diabetic retinopathy is early detection so it can be treated at earlier stages rather than later stages. Often vision loss from diabetic retinopathy can be prevented with appropriate and timely treatment.

Early intervention is vital to treating this eye condition to prevent irreversible damage, including blindness. Our office offers both surgical and non-surgical retina treatments.

Using advanced imaging, Dr. Lalin can identify microaneurysms, which indicate the earliest stages of diabetic retinopathy. Diabetic macular edema, one of the most common symptoms of diabetic eye disease, can be treated with medications such as steroids, Avastin®, Ozurdex, or laser therapy. 

Diabetic Macular Edema

• • Laser Treatment: We cauterize the macula to reduce fluid leakage.
  • Injections: Some eyes do not respond adequately to laser treatment and we use steroid medications or newer anti-VEGF drugs like Avastin, Eylea, and Lucentis. These intravitreal treatments must often be repeated to control the macular edema.
  • Surgery: Persistent macula edema that does not respond to laser treatment or injections may sometimes require out-patient surgery to remove scar tissue

Proliferative Diabetic Retinopathy

• • Laser Treatment: The primary treatment is laser photocoagulation where we cauterize areas in the peripheral retina. This helps to decrease the oxygen demands of the retina which causes retinal and disc neovascularization to resolve or decrease. Laser procedures and intravitreal injections are typically performed here in our office.
  • Surgery: Some eyes which develop bleeding or a retinal detachments require a surgical procedure called a vitrectomy which is performed in our ambulatory surgery center.

Early detection is critical for effective treatment of diabetic retinopathy. Successful management of the disease also hinges on a strong effort to control blood sugar levels. Although it won’t prevent diabetic eye problems, controlled glucose levels can slow the development and progression of diabetic eye disease.

Our team can discuss how your diet directly impacts your symptoms. We also recommend you meet with a dietician or nutritionist trained in diabetes management.