Diabetic Retinopathy: More than meets the eye
1/16/2023 by Katie King, APRN, C.N.P., M.S.N.
People who have been diagnosed with diabetes are at greater risk for eye disease and vision impairment due to a condition known as diabetic retinopathy. Diabetic retinopathy is the leading cause of blindness among adults in the U.S. In the initial stages of diabetic retinopathy, many people do not have any symptoms. Early recognition is vital because, if left untreated, it can progress to permanent vision changes and even blindness.
What is it?
Diabetic retinopathy occurs when high blood sugars damage the small blood vessels supplying blood flow to the retina. The retina is a layer of tissue along the back of the eye. It converts light to electrical signals. The electrical signals are transmitted to the brain via the optic nerve. The damage caused by elevated levels of blood sugar can disrupt these electrical signals to the brain, gradually resulting in vision loss.
How to prevent diabetic retinopathy
- Watch your blood sugar levels.
- Keep your blood pressure under control.
- Monitor your cholesterol levels.
- Get regular exercise — at least 150 minutes per week of moderate intensity activity.
- Eat a healthy well-balanced diet. Aim for 5-6 servings of fruits and vegetables, avoid concentrated sweets, limit processed foods and saturated fats.
When to start screening?
People diagnosed with Type 1 diabetes should start formal diabetic eye examinations within five years of diagnosis. Individuals who are diagnosed with Type 2 diabetes, also referred to as adult-onset diabetes, should start screening at the time of diagnosis to ensure there are no signs of early diabetic retinopathy. After initial screening, patients with diabetes should have annual screening provided by an ophthalmologist or optometrist. Testing should include a comprehensive eye examination and dilation of the pupil. Photoscreening is another option that is available in most primary care settings. Photos of the retina are taken and reviewed by an optometrist or ophthalmologist for signs of retinopathy.
Women with diabetes who are considering pregnancy should be screened before they become pregnant. After their pregnancy, the patient's health care team will determine how long screening should continue.
How is diabetic retinopathy treated?
Panretinal photocoagulation is a laser treatment that helps to reduce damage to the retinal blood vessels by stopping leaking vessels and destroying new growth of vessels.
Alternatively, medications can be injected into the eye to treat leaky blood vessels.
Diabetic retinopathy is a common and preventable form of vision loss. If you have diabetes, keep your vision healthy this year by making healthy food choices, exercising regularly and ensuring your blood sugars are in range. And most importantly, make sure you get your annual screening exam for retinopathy. Let your primary care team know if you are struggling with any of these issues. We are here to help and want you to see into the future.
Katie King, APRN, C.N.P., M.S.N., is a nurse practitioner in Family Medicine at Mayo Family Clinic Southeast in Rochester. She has an interest in preventive care services and agrees with Ben Franklin that “An ounce of prevention is worth of pound of cure.” She enjoys being outside with her family and exercising with forward motion in the forms of cycling, jogging, walking and hiking.