Diabetic Eye Disease

The mother of a friend of mine has diabetes, should she be concerned with possible eye-related problems?

Yes, your friend’s mother should have an ophthalmologic examination because she is at a higher risk for problems due to her diabetes.

Why is it important that a child receive a dilated examination once a year if the child is diagnosed with juvenile diabetes?

The American Academy of Ophthalmology recommends a yearly eye exam beginning five years after the diagnosis of diabetes. Diabetic retinopathy almost never occurs before puberty and it is not common for older teenagers to need treatment. However, yearly exams are extremely important in order to prevent serious loss of vision in those that do need treatment.

Is there a cause and effect relationship between adult onset diabetes and macular degeneration?

There is no known relationship between type 2 diabetes and macular degeneration.

I have had laser treatments for diabetic retinopathy. One eye still has neovascularization. What additional treatments are there?

Laser surgery usually causes neovascularization to shrink, but often it does not disappear. If it is not bleeding, growing or causing distorted vision, it probably does not need any further treatment. If the remaining neovascularization does cause vision problems, more laser or vitrectomy surgery may be recommended.

Is it possible to be suffering from diabetic retinopathy but not have any other outward symptoms of diabetes? My daughter has been diagnosed with a “cone-rod dystrophy.” Can this be mistaken for diabetic retinopathy?

Cone-rod dystrophy would not be mistaken for diabetic retinopathy. The two conditions are very different. Once in a while, diabetic retinopathy is found in someone who does not know they have had diabetes for years. The American Diabetes Association estimates there are 8 million Americans who have undiagnosed diabetes.

Is there a cure for partial sight loss as a consequence of diabetic retinopathy?

It depends on the cause of the vision loss. For example, laser surgery for macular edema will prevent further visual loss more often than it will improve vision. If the macula is not damaged and vision is blurred because of vitreous hemorrhage, sight may return to normal after the blood clears.

What diet would you recommend for people having diabetic retinopathy?

There are no special dietary supplements recommended for diabetic retinopathy. It is very important to follow your regular diabetic diet.

Can diabetic retinopathy be treated with surgery, e.g. replacing part of the retina/macula?

Vitrectomy surgery can remove blood and scar tissue from the eye in people with severe proliferative diabetic retinopathy. Unfortunately, doctors cannot yet replace the retina/macula.

Can you tell me if the damage done from diabetic retinopathy can be healed or reconstructed so the vision loss is not permanent?

It is important to know that the results of the Diabetes Control and Complications Trial (DCCT) study showed that good control of blood sugars decreased the development of diabetic retinopathy by 75% in patients with no diabetic retinopathy at the start of the study. If diabetic retinopathy was present at the start of the study, there was a decrease in the rate of progression by 50% compared to those who did not control their blood sugars well.

Once diabetic retinopathy occurs, if it progresses to a certain point, then laser treatment decreases the chances of visual loss. Finally, if severe visual loss occurs, sometimes vitrectomy (a surgical procedure) can restore vision in some cases.  Overall, if patients are followed carefully, blindness can be avoided in 90% of patients with diabetic retinopathy.

I am interested in learning more about diabetic retinopathy. Could you tell me how many Americans each year are diagnosed with diabetic retinopathy? Are there any breakthroughs in diagnosis or treatment that I should know about?

There are an estimated 65,000 new cases of proliferative diabetic retinopathy and 75,000 new cases of diabetic macular edema each year. In addition, there are 8,000 new cases of blindness caused by complications of diabetes reported yearly.

Studies have shown that timely laser surgery can reduce the risk of visual loss from proliferative diabetic retinopathy by 90%, and can reduce the risk of moderate visual loss from diabetic macular edema by 50%.

The most important recent study has been the Diabetes Control and Complications Trial which showed that compared to patients with poor sugar control, in patients without diabetic retinopathy, tight control decreased the rate of progression by 75%. If diabetic retinopathy was present, tight control decreased the rate of progression by 50%. Once diabetic retinopathy reached certain thresholds, then laser treatment can decrease the progression of visual loss as well. There are ongoing studies into the causes of development of abnormal blood vessels in the eye in diabetes as well as what causes the loss of normal blood vessels in diabetes.

Disclaimer: The responses provided through this service are not intended to replace consultation with an ophthalmologist. This question and answer service is intended for general educational purposes only and the responses represent the approach of the responding physician given the facts presented, not necessarily the only or best method or procedure in every case.