Dr. Hoffman says...
Koby Karp Doctors Eye Institute specializes in the treatment of Diabetic Eye Disease. Whether you are experiencing symptoms or getting information for a relative or a friend, we have provided a great deal of information here to answer some of your questions.
Focusing on Diabetic Eye Disease
November is National Diabetes Awareness month. Koby Karp Doctors Eye Institute reminds you that any time is the right opportunity to stress the importance of eye care for diabetic patients. Visual impairment due to diabetes can be devastating, although most of the eye complications of long term hyperglycemia (high blood sugar) can be controlled and stabilized if discovered and treated in time.
Long term elevation of blood glucose damages the linings of blood vessels. This can lead to retina damage and blindness. The retina is the critical nerve tissue along the back wall of the eye which is responsible for converting light into nerve impulses that the brain can understand. Similar to the kidney, the small arteries of the retina can be affected by hyperglycemia and may begin to dilate and leak. Swelling of the retina can lead to distorted or significantly blurred central vision, while gradual closure of these small arteries can cause further damage to the retina due to lack of oxygen. The eye responds by forming new blood vessels which can break and bleed within the eye, and in late stages can pull the retina causing a retinal detachment and blindness.
At all stages of Diabetic Retinopathy, there are some options for treatment, but most treatments will stabilize the process and keep it from worsening. Early detection and treatment of diabetic retinopathy are therefore crucial to maintain good vision for patients with diabetes. Patients can have little or no symptoms with significant diabetic retinopathy.
When the blood glucose is quite high, some patients will notice a blurring of vision in both eyes or difficulty with near focus which fluctuates as the glucose level changes. This is due to swelling in the lens of the eye rather than retinopathy. The lens will develop early opacity in some diabetics. This is called a cataract and can be treated with cataract removal and lens implant surgery. At Koby Karp Doctors Eye Institute, we perform small incision, no stitch cataract removal for more rapid recovery of vision. If significant swelling in the center of the retina occurs, patients may have distorted or crooked vision. This "macular edema" can be treated with laser in some cases to limit the loss of vision. New blood vessels can also be treated with a laser procedure to prevent hemorrhage into the vitreous jelly of the eye and the advanced complications of diabetic retinopathy such as retinal detachment, scarring and glaucoma. These types of treatments have been extremely important in the prevention of blindness among diabetic patients but for best long term vision results, early detection and treatment are critical.
At Doctors Eye Institute, upon referral for diabetic eye examination, we perform an initial complete eye examination with dilation of the pupils for careful retina evaluation. In the absence of diabetic retinal problems, similar yearly examinations follow. If there is some evidence of diabetic retinopathy, we may reduce the follow up period to follow more closely. Recommendations for treatment are made when the retinal changes reach certain stages to prevent vision loss. Adhering to a regimen of follow up examinations, with timely treatment when indicated, patients with diabetes can minimize their chances of losing vision to diabetic retinopathy.