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Tips and Solutions for Diabetic Retinopathy and Low Vision


May 6, 2009

Diabetic retinopathy is the most common diabetic eye disease and a leading cause of severe vision loss and even blindness in American adults. It is caused by changes in the blood vessels of the retina.

"I think I'm the only blind principal in Los Angeles," stated Connie Gibson after she developed diabetic retinopathy, which later led to sudden vision loss after complications from laser surgery. Now age 59, Gibson is currently legally blind, but has been able to move forward with her life. She continues working and living an active lifestyle despite her disability.

Vision-threatening diabetic retinopathy affects one in every 12 people with diabetes who are 40 or older. According to the National Eye Institute, it is one of the most common eye diseases among Americans age 40 and over that leads to some form of visual impairment like low vision, along with age-related macular degeneration, glaucoma, and cataracts.

What is diabetic retinopathy?

Diabetic retinopathy is the most common diabetic eye disease and a leading cause of severe vision loss and even blindness in American adults. It is caused by changes in the blood vessels of the retina.

In some people with diabetic retinopathy, blood vessels may swell and leak fluid. In others, abnormal new blood vessels grow on the surface of the retina. The retina is the light-sensitive tissue at the back of the eye. A healthy retina is necessary for good vision.

With diabetic retinopathy, at first you may not notice changes to your vision. But over time, diabetic retinopathy can get worse and cause vision loss, affecting both eyes.

What are the four stages of diabetic retinopathy?

  1. Mild Nonproliferative Retinopathy. At this earliest stage, microaneurysms occur. They are small areas of balloon-like swelling in the retina's tiny blood vessels.
  2. Moderate Nonproliferative Retinopathy. Some blood vessels that nourish the retina become blocked.
  3. Severe Nonproliferative Retinopathy. Many more blood vessels are blocked, depriving several areas of the retina with their blood supply. These areas send signals to the body to grow new blood vessels for nourishment.
  4. Proliferative Retinopathy. At this advanced stage, the signals sent by the retina for nourishment trigger the growth of new eye blood vessels. These new blood vessels are abnormal and fragile. By themselves, they do not cause symptoms or vision loss. However, they have thin, fragile walls that can leak, causing severe vision loss and even blindness.

Who is at risk for diabetic retinopathy?

All people with diabetes-both type 1 and type 2-are at risk. That's why everyone with diabetes should get a comprehensive dilated eye exam at least once a year. The longer someone has diabetes, the more likely it is that he or she will get diabetic retinopathy. Between 40 to 45 percent of Americans diagnosed with diabetes have some stage of diabetic retinopathy. If you have diabetic retinopathy, your doctor can recommend treatment to help prevent its progression.

In addition, diabetic retinopathy may be a problem during pregnancy. To protect vision, every pregnant woman with diabetes should have a comprehensive dilated eye exam as soon as possible. Your doctor may recommend additional exams during your pregnancy.

What can I do if I have already lost some vision from diabetic retinopathy?

There are solutions! If you have lost some sight from diabetic retinopathy, ask your eye care professional about low vision services and devices that may help you make the most of your remaining vision, and even a referral to a low vision specialist. Many community organizations and agencies offer information about low vision counseling, training, and other special services for people with visual impairments. A nearby school of medicine or optometry may provide low vision services.

Companies such as Optelec US Inc., and its subsidiary sister companies ShopLowVision.com and LowVision.com, provide eye care professionals and consumers with an all-inclusive and always accessible source for low vision products and educational needs.

What can I do to protect my vision?

If you have diabetes, it is important to get a comprehensive dilated eye exam at least once a year. If you have diabetic retinopathy, you may need more frequent exams. People with proliferative retinopathy can reduce their risk of blindness by 95 percent with timely treatment and appropriate follow-up care. However appropriate treatment will not cure diabetic retinopathy.

Does diabetic retinopathy have any symptoms?

Often there are no symptoms in the early stages of the disease, nor is there any pain. Because of that, it is important that those with diabetes don't wait for symptoms before having their eyes checked.

How is diabetic retinopathy treated?

During the first three stages of diabetic retinopathy, no treatment is needed unless you have macular edema. To prevent progression of diabetic retinopathy, people with diabetes should control their levels of blood sugar, blood pressure, and blood cholesterol.

Proliferative retinopathy is treated with scatter laser surgery. Two or more sessions usually are required to complete treatment. Although you may notice some loss of your side vision and slight reduction in your color and night vision, scatter laser treatment can save the rest of your sight. If the bleeding is severe, you may need a surgical procedure called a vitrectomy, in which blood is removed from the center of your eye.

Gibson said two things have helped her to continue working and functioning despite her disability: the helpful staff at her elementary school and technology that has allowed her to continue to read. Her investigation of available vision aids led her to a company called Optelec, which offers solutions ranging from desktop electronic video magnifiers and USB video magnifiers to hand-held portable and compact video magnifiers- all designed to improve the quality of life and mobility for its users.

"It [Optelec low vision aid] allows you to be independent, and that's what you want when your vision is impaired," she says. "I would tell anyone with impaired vision to get a low vision aid, whether it's for reading or for a hobby. Why give up something you love?"

Sources: Optelec US Inc., and National Eye Institute, National Institutes of Health (NEI/NIH)

For more information, call 800-335-7970 and visit www.optelec.com and www.lowvision.com


Categories: Beginners, Blood Sugar, Diabetes, Diabetes, Eye Care (Retinopathy), Reversing Complications, Type 2 Issues



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Comments

Posted by Anonymous on 6 May 2009

In its early stages, diabetic retinopathy is reversable. I've had type 1 for 30 years. When my opthamologist detected early retinopathy, he asked me what my latest A1c was. When I told him that it was above 7, he pulled no punches. He said, "You MUST get your A1c below 7 if you want to save your sight."

With that wake-up call, I redoubled my efforts to control my blood sugar. Wearing a pump and using Symlin have helped me considerably. For the past 6 years I have kept my A1cs below 7, usually around 6.4. My retinopathy has healed. On my latest trip to a retina specialist, he said that for anyone who has spent 30 years with type 1, my eyes are as good as they get. And my own opthamologist told me that if he didn't know that I was type 1, he wouldn't be able to tell it by looking at my eyes.

The lesson to be learned is that you don't have to give up hope. If your doctor says that you have mild retinopathy, don't give up! Work on getting your blood sugar under control and reverse the deterioration. You don't have to succumb, you can triumph!

Posted by Anonymous on 11 May 2009

I am 58 years old have had Type 1 diabetes for 16 years and was concerned about possible damage of my vision by retinopathy. I began visiting the opthalmologist annually several years after I was diagnosed w/ the disease. I definitely kept abreast of technology particularly as it concerned controlling blood sugar to aid in staving off complications. I have been able to maintain an A1c below 7 for quite sometime using a pump.
Fortunatly for me, I have had clean bills of eye health. My next annual exam is coming up in about 3 weeks, so hopefully, knock on wood!

Posted by Anonymous on 12 May 2009

I am a 32 year old type 2 with proliferative retinopathy. Officially diagnosed 2 years ago, I was shocked when all of a sudden one day I could see nothing but blood in my left eye. I was in the process of getting all my different check-ups done, but had not had an eye appointment yet. I was refered to a wonderful retinal specialist who was very blunt and to the point. It was hard to hear, but was merely the truth. He said clearly I have been diabetic for a long time to develop these complications. Long story short, I have had surgery on both eyes to remove blood and blood vessels. I was an abnormal patient due to my young age, but he also said that helped in my recovery. PLEASE, maintain good blood sugar control. For now, I am lucky to be able to see almost as well as I could prior to my surgeries and for now, things look good comparatively, but it is a very serious condition and one that I don't wish on anyone.

Posted by Anonymous on 12 May 2009

I have been diabetic for about 50 years, and had been able to avoid retinopathy in myself. My wife is taught Chinese medicine in China, and we run a holistic health clinic with a partner who is a board certified ophthalmologist, Robert Abel, MD. I developed some herbal treatments for retinopathy, and have had good success, in some cases in reversing it , and Dr Abel has confirmed this. I actually wrote an article on this, but I am not sure if it is allowed to post here, so I won't do that, but if you google my name you can find it.

Alan Tillotson, Ph.D.

Posted by Anonymous on 17 May 2009

I have mild retinopathy that has improved with the use of bilberry, a supplement made with this berry found in the UK. It is a super antioxidant similar to the US blueberry. My Eye Dr. sees improvement. It won't hurt you so give it a try after researching it for yourself.


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