DOCTOR'S VIEW ARCHIVE
Diabetes & Eye Disease...See No Evil
Medical Editor: William C. Shiel Jr., MD, FACP, FACR
If you knew that something as simple as an annual visit to an eye specialist (Ophthalmologist) could help prevent you from going blind, would you keep your yearly appointment? Likewise, if you knew that controlling your blood sugar levels in diabetes could slow down the progression of eye disease, would you think twice before having a second cookie?
Diabetes (both type 1 and type 2) is complicated by eye disease (damage to the retina, called retinopathy) in over 60% of patients. The retina is the portion of the eye that detects light and its function is essential for vision. Diabetes is one of the leading causes of blindness in the United States.
In general, diabetes-related eye disease progresses in an orderly fashion, with a strong relationship to the length of time a patient has had diabetes. In type 1 diabetes, retinopathy usually doesn't develop until after the first 5 years. By the next 20 years, nearly all patients with type 1 diabetes have significant eye disease. In type 2 diabetes, up to 21% of patients already have eye involvement at the time they are diagnosed with diabetes. Diabetic retinopathy is characterized by the formation of new blood vessels in the back of the eye (neovascularization). These vessels are weak and can tear, resulting in bleeding in the back of the eye. Scarring can lead to detachment of the retina, and the condition can be complicated by central vision impairment known as macular edema (swelling of the macula).