Retinal Conditions

What is diabetic retinopathy?

Diabetic retinopathy is a disease that results from diabetes. It can damage blood vessels inside the retina and result in vision loss. The disease usually affects both eyes. Any patient with type 1 or type 2 diabetes is at risk. There are two types of diabetic retinopathy: nonproliferative (or background) and proliferative. Many diabetics have the milder nonproliferative type that usually does not affect vision. The proliferative type is more severe and occurs when new blood vessels grow on the surface of the retina. It often results in the sudden onset of floaters when the abnormal vessels bleed into the vitreous cavity of the eye.

What causes diabetic retinopathy?

Diabetes, which produces high blood sugar levels in the body, can damage the blood vessels in the retina. At the most advanced stage of diabetic retinopathy, new blood vessels may develop. These blood vessels are fragile and easily bleed. This condition may result in severe vision loss or even blindness.

A condition called macular edema can also cause visual loss in patients who are diabetic. The eye’s macula, which provides central vision and allows one to see fine details, can become swollen when fluid leaks into it. This results in blurred vision.

Can diabetic retinopathy be treated?

The good news is that early detection and advancements in treatments can help reduce vision loss caused by diabetes. There are different treatments for different conditions. Nonproliferative diabetic retinopathy is managed by decreasing a patient’s blood sugar levels. The laser procedure for proliferative retinopathy, called pan-retinal or scatter laser, shrinks the newly formed abnormal blood vessels. Multiple laser treatments may be required. 

Diabetic macular edema is treated by laser, Avastin® or steroid injections. For patients experiencing an excessive amount of bleeding in the vitreous cavity, a procedure is performed that removes the vitreous gel clouded by the blood and replaces it with a salt solution. 

The key to preventing vision loss is early detection. People with diabetes should see an ophthalmologist at least once a year, especially if any change in vision, such as blurred vision or a sudden increase in floaters, is detected.

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Flashes and floaters are common as one ages. They typically appear as flashes of light or as specks or squiggly lines that float across the field of vision.

Sudden flashes of light can be caused by a migraine, which may or may not be followed by a headache.

Many people rarely notice floaters, but they may seem more prominent when looking at a white wall. Sometimes the eyes can follow or even catch up with them. Although these objects appear to be in the front of the eye, they are actually little clumps of gel floating inside the eye that cast shadows on the retina.

Flashes and floaters are generally harmless, but should they suddenly appear, it is important to seek the services of a specialist in order to rule out a serious cause such as a retinal tear or detachment.

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What is macular degeneration?

Macular degeneration is the leading cause of severe vision loss in Americans over the age of 65. Macular degeneration causes a deterioration or breakdown of the macula, the small area of the retina that allows one to see fine details clearly. When the macula deteriorates, the central vision becomes blurred, hindering the ability to read or drive. This disease is not painful and many people who are diagnosed, especially in the early stages, are able to lead productive lives.

People with a family history of macular degeneration are at greater risk of developing the disease. Macular degeneration is divided into two forms. The “dry” form is the most common and accounts for about 90 percent of all macular degeneration cases. The “wet” form, also called the exudative or neovascular form, accounts for the other 10 percent. It is the more severe form and can be associated with more rapid and severe vision loss.

What causes macular degeneration?

Macular degeneration is the result of aging and genetics. Smoking, obesity and gender may also contribute to the disease. Dry macular degeneration is usually gradual in its onset and causes thinning and atrophy of the macular tissues.

Wet macular degeneration develops when new blood vessels grow underneath the surface of the retina. These new vessels can bleed or leak fluid, resulting in a blur of the central vision. Vision loss may occur slowly or quickly. Straight lines that appear wavy or new blind spots in vision may be an early indication of wet macular degeneration. For those experiencing these vision changes, it is important to schedule an appointment with one of our specialists immediately.

Can macular degeneration be treated?

For those diagnosed with macular degeneration, the good news is that there are now medications available to slow vision loss and help maintain an active lifestyle. Treatment for wet macular degeneration, the more serious form of this disease, has undergone major advancements. For most people, treatment now entails monthly injections of medications called anti-vascular endothelial growth factors, or “anti-VEGF” drugs. Avastin®, Lucentis®, and Eylea® are the commonly used medications. Most patients who adhere to a monthly schedule can stabilize their vision and many can experience an improvement in vision.

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