November is Diabetes Awareness Month

Did you know that diabetic retinopathy is the current leading cause of blindness in adults in the U.S.? The condition is serious, but the fortunate news for patients is that with proper screening, a majority of devastating vision loss is preventable. We encourage patients with diabetes to make regular annual visits to an eye care professional a priority, particularly as they age. Spending an hour or less at your doctor’s office once a year could mean the difference between potentially losing all vision and effective treatment that prevents such a loss.

What is diabetic retinopathy?

Diabetic retinopathy is a condition that occurs in the retina that generally results from chronically elevated blood glucose levels. Glycosylation of these blood vessels can lead to breakdown of blood vessel walls, leakage and swelling and ultimately decreased vision. In addition, unstable new blood vessels can form that can break and bleed, which can also lead to decreased vision.

Diabetic retinopathy, although the leading cause of blindness in patients under the age of 55 in the US, is largely preventable with proper screening and treatment.

On top FA/FP moderate NPDR, bottom FA/FP severe PDR with NVD, NVE, and ischemia. (Fluorescein Angiogram/Fundus Photo).

How is diabetic retinopathy diagnosed?

Up to 60% of diabetic patients are not properly screened for diabetic retinopathy. Proper screening can consist of yearly visits to an eye care professional or, more recently, telemedicine screening visits in a primary care setting. Through local telemedicine partnerships, Austin Retina is pleased to have seen up to 80% compliance rates, ultimately saving the sight of thousands.

Once any diabetic retinopathy is detected on initial screening, other testing modalities such as optical coherence tomography (OCT) and fluorescein angiogram imaging are employed. OCT is an excellent tool used to detect subtle changes in macular thickness, which often occurs in early diabetic maculopathy. Optos fluorescein angiogram wide-angle imaging is critical in analyzing the peripheral retina for ischemia and neovascularization, both of which can be easily missed by direct examination or routine photography.

OCT (optical coherence tomography) – Image of a patient with diabetic retinopathy.

How is diabetic retinopathy treated?

The two critical variables for control of diabetic retinopathy are blood pressure and blood glucose.

Controlling blood glucose (hemoglobin A1C less than 7%) limits the destruction that can occur from glycosylation of small blood vessels in the retina. In most cases, this can be achieved through diet and exercise. Controlling blood pressure decreases the amount of leakage and swelling that can occur from these already damaged blood vessels.

The newest treatments for diabetic retinopathy involve the use of medications that can be effective not only in stabilizing the condition but also in restoring vision. These medications are injected into the eye through an office-based procedure called an intravitreal injection. This relatively painless injection through the white part of the eye is performed after the eye is thoroughly anesthetized with topical eye drops. Additionally, medications such as Eylea, Lucentis, and Avastin have the potential to improve vision by reducing the amount of macular edema caused by diabetic retinopathy.

Do you have questions? Please contact Austin Retina directly so we can assist. You can request an appointment online here or call our office at 800-252-8259 during normal business hours.

What Is a Diabetic Eye Exam?

Diabetes is a disease that impairs the body’s ability to produce the insulin hormone and leads to elevated levels of glucose (sugar) in the blood. Chronically elevated blood sugar levels can increase your risk for an array of eye problems including blurry vision, cataracts, glaucoma and diabetic retinopathy.

Often, diabetes damages the small blood vessels in your retina, or the back of the eye. This condition is called diabetic retinopathy, the most common cause of vision loss among people with diabetes. Diabetic retinopathy develops when blood vessels in the eye are exposed to high blood glucose levels for a prolonged period of time. This weakens the walls of the blood vessels in the eyes. The longer a person has had diabetes and the greater his/her exposure to high blood glucose, the higher his/her risk of having this condition.

“Diabetic eye disease, when caught in time, is no longer a blinding condition. Nowadays, with early detection and prompt treatment, we can prevent vision loss and in some cases, are able to reverse some of the diabetic changes in the retina. But what we like to do, at Austin Retina, is help educate our patients on what diabetes is and how it affects their vision,” explains Dr. Robert W. Wong. “By working together with the primary care physician, endocrinologist and the patient themselves, we find strategies to improve blood sugar and blood pressure control. These two risk factors, among others, are things our patients have the ability to control. And with guidance, our goal is to keep them seeing well and living healthier lives.”

If you have been diagnosed with diabetes, it is important to get regular eye exams, so your doctor can detect problems like diabetic retinopathy early, preserve your eye health and protect your vision.

What is a diabetic eye exam?

Anyone with diabetes is encouraged to get regular eye exams. This allows your ophthalmologist to look for changes in the blood vessels of the retina that may indicate diabetic retinopathy. Here is what you can expect during a diabetic eye exam:

  • Your ophthalmologist will ask you about your medical and vision history.
  • Next, you will read an eye chart.
  • The doctor will then examine the retina in the back or your eye using an instrument called an ophthalmoscope.
  • Often, your doctor will administer drops to dilate your pupils and use a special light called a slit lamp to view the retina.
  • A test called fluorescein angiography may be used to reveal changes in the structure and function of the retinal blood vessels. For this test, your doctor will inject a fluorescent yellow dye into one of your veins and photograph your retina as the dye outlines the blood vessels.
  • During a diabetic eye exam, your doctor will also check your eyes for cataracts and glaucoma.

If you’ve been diagnosed with diabetic retinopathy, the experienced eye care specialists at Austin Retina Associates can help. We are skilled in the treatment of diabetic retinopathy in Austin. Call at 800-252-8259 to schedule an initial consultation.