Diabetes leads to vision loss by causing damage to the retina, which is the nerve tissue located at the back of the eye. 99% of people who have had diabetes for more than 15 years have some damage to the retina. Diabetes causes blood vessels that supply the retina with oxygen to become leaky and cause swelling within the retina, leading to damage and blindness (diabetic retinopathy). Diabetes also causes blood vessels in the retina to bleed and even stop working, leading to vision loss.
Patients can often have completely normal vision while having severe damage occur to the retina. Without proper examinations and treatment, patients can go blind very quickly, sometimes with little or no warning. By using proper treatments, we have an 80% chance of preventing blindness from diabetes.
Laser was the original treatment for leaking and bleeding blood vessels in the retina, and is still used as treatment in almost all patients with diabetic eye disease. Laser treatment is simply shining a light beam into the eye causing leaky blood vessels to quit leaking and bleeding blood vessels to begin to shrink, making them less likely to bleed.
In many cases, the best result for bleeding, scar tissue formation, and leaking blood vessels is achieved with medicine injections that temporarily stop the signal that drives diabetic retinopathy. Many studies have shown the benefit of injecting medication into the eye to decrease retinal damage and preserve vision, and numerous national clinical trials have shown these injections can slow down the progression of diabetic retinopathy and save vision in diabetics.
Surgery can be performed in the operating room for patients that have severe bleeding, scar tissue formation, and leaking blood vessels that will not respond adequately to injections and laser treatments. Patients must understand that we have a great ability to treat three out of four types of problems that occur with diabetic eye disease (diabetic retinopathy).
Patients with very mild diabetic retinopathy need to be seen twice a year, and patients with moderate to severe diabetic retinopathy may need treatment as often as every month while their retinopathy is active. It is crucial that diabetic patients keep their appointments. All too often we see patients that fail to keep their appointments, who eventually return one to two years later and are permanently blind. An examination can show diabetic vessels with the potential to leak and bleed before patients actually have any vision loss. By identifying these vessels before they actually leak and bleed, we have a much better chance of preventing patients from going blind.