Diabetic Retinopathy (Eye Damage)

Diabetic Retinopathy (Eye Damage)

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    A answered
    The eye examination consists of multiple parts, many of which are quantifiable. When vision is tested, it is useful for documenting eye health status and any changes. Vision is usually tested,one eye at a time, for distance and for near. Often it is done without glasses (prescription) and then repeated with glasses. If a patient doesn't have glasses or has reduced vision, a pin?hole device can be used as an estimate of the best potential visual acuity. The next step in an eye exam is utilizing lenses in order to establish best?corrected visual acuity. For instance, you cannot really decide how bad a cataract is without knowing the individual best correction.
    The external eye exam consists of the evaluating pupil reactions, eye muscle movements, lids, and color of the iris. The next part of the exam employs a microscopic instrument called slit lamp. By varying the size beam and the magnification, the eye doctor can stereoscopically view the insides of the eye and diagnose almost all ocular conditions. This is why individuals need to see an ophthalmologist or optometrist in order to diagnose any serious eye problem. The intraocular pressure is measured at this time; this is an important test as part of the evaluation of glaucoma. Primary care doctors and emergency room physicians are usually able to recognize and treat pink eye and other common eye conditions but are unable to get a good look inside the eye without more testing.
    Usually the final part of the eye exam is an evaluation of the retina with either a hand held or head mounted light and lenses. Many systemic conditions, such as diabetes or hypertension, which can affect the eye can be identified through a slit lamp and retina exam. There are other tests that are useful to measure and manage eye disease such as the following: visual fields,color vision, prism measurements of eye deviations, tear tests for dry eyes, and checker board grids for macular degeneration.
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    The following are guidelines for dilated eye exams if you have diabetes:
    • If you are between 10 and 29 years old and have had diabetes for at least 5 years, you should have an annual dilated eye exam.
    • If you are 30 or older, you should have an annual dilated eye exam, no matter how short a time you have had diabetes. More frequent exams may be needed if you have eye disease.
    • If you have any changes in your vision.
    • You should have a dilated eye exam if you are pregnant or planning to get pregnant.
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    If you are an adult, have a thorough eye exam at the time of diabetes diagnosis and yearly thereafter.
    If you are over 10 and have had diabetes for at least 3 years, you also need a comprehensive exam once a year.
     • After the initial exam, see an eye doctor familiar with retinopathy and other diabetes complications of the eyes once a year for a dilated exam.
     • Call your diabetes care provider if you notice changes in your vision, but don’t panic. Highs and lows in your blood glucose level may cause temporary blurring in your vision.
     • Keep your blood glucose levels close to normal. You will help prevent damage to the small blood vessels that run through your retina.
     • Have regular blood pressure checks, and work to keep your blood pressure on target.
     • Discuss your exercise program with your eye doctor. Some activities can raise the pressure inside your eyes and lead to bleeding in the retina.
     • If you have retinopathy, avoid taking birth control pills because they may affect the clotting of your blood or increase your blood pressure.
     • Get early treatment for eye problems! Early intervention, such as laser treatment for retinopathy, cuts the risk of blindness by 90 percent.
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    A , Pharmacy, answered
    It's important for people with diabetes to see an eye specialist once a year to check for eye complications that diabetes can cause. High blood sugar, as well as high blood pressure, can damage your eyes in several ways. It can hurt your retina, the vitreous (a jelly-like fluid that fills the back of the eye), the lens, and the optic nerve, which sends vision signals to your brain. Your retinas have tiny blood vessels, and having high blood sugar over a long period of time can damage these sensitive vessels. Regular visits to an eye care professional can pick up early signs of these complications when they are most treatable.
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    If you have diabetes, see your eye care professional if:
    • Your vision becomes blurry
    • You have trouble reading signs or books
    • You see double
    • One or both of your eyes hurt
    • Your eyes get red and stay that way
    • You feel pressure in your eye
    • You see spots or floaters
    • Straight lines do not look straight
    • You can't see things at the side as you used to
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    For adults with type 1 diabetes: You need to have a dilated eye exam within five years of being diagnosed and every year after that.

    For adults with type 2 diabetes: You need to have a dilated exam soon after you have found out you have diabetes. About 1 in 5 people with type 2 diabetes have some eye problems when they find out they have diabetes. That's why it's important to have an eye exam soon after you find out you have diabetes.

    After the first eye exam, all adults with diabetes need a dilated eye exam every year. Exams may be needed more often if you have eye problems. 
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    A , Ophthalmology, answered
    Focal photocoagulation, a laser treatment for diabetic retinopathy, enables an ophthalmologist to identify individual blood vessels and seal them off with the laser. This method is often used to treat macular edema (blurring of central vision). The doctor uses a laser to make 20 to 50 tiny burns to seal the leaking blood vessels, which slows the leakage and promotes fluid resorption -- effectively reducing the amount of fluid in the retina (the innermost layer of the eye). Local anesthetics prevent any discomfort during the procedure, and the surgery is usually completed in a single session. If macular edema affects both eyes, only one is operated on at a time. A second session -- usually a week or so later -- will be needed for the second eye. The procedure can cut the risk of further vision loss in half, and in a small number of people, it actually restores vision.
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    The diabetic retinopathy exam involves a thorough eye exam, including a dilated retinal exam with both slit lamp biomicroscopy and indirect ophthalmoscopy. These methods of examining the retina with special microscopes and lenses in the office allow the ophthalmologist to see the retina in great detail in order to assess the potential changes that diabetic retinopathy causes.

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    High blood glucose and high blood pressure (BP) from diabetes can hurt four parts of your eye:

    Retina: The retina is the lining at the back of the eye. The retina's job is to sense light coming into the eye.Vitreous: The vitreous is a jellylike fluid that fills the back of the eye.Lens: The lens is at the front of the eye and focuses light on the retina.Optic nerve: The optic nerve is the eye's main nerve to the brain.

    This answer is based on source information from the National Diabetes Information Clearinghouse (NDIC).

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    Diabetic retinopathy has four stages:

    Mild nonproliferative retinopathy: At this earliest stage, microaneurysms occur. They are small areas of balloonlike swelling in the retina's tiny blood vessels. Moderate nonproliferative retinopathy: As the disease progresses, some blood vessels that nourish the retina are blocked. Severe nonproliferative retinopathy: Many more blood vessels are blocked, depriving several areas of the retina of their blood supply. These areas of the retina send signals to the body to grow new blood vessels for nourishment. Proliferative retinopathy: At this advanced stage, the signals sent by the retina for nourishment trigger the growth of new blood vessels. This condition is called proliferative retinopathy. These new blood vessels are abnormal and fragile. They grow along the retina and along the surface of the clear, vitreous gel that fills the inside of the eye. By themselves, these blood vessels do not cause symptoms or vision loss. However, they have thin, fragile walls. If they leak blood, severe vision loss and even blindness can result.

    This answer is based on source information from National Eye Institute.