Eye Surgeons Miranda

Diabetic retinopathy

Diabetes mellitus can cause damage to your retina, which could eventually lead to blindness. It affects up to 80 percent of all patients who have had diabetes for 10 years or more. Despite these overwhelming statistics, research suggests that at least 90 percent of new cases could be reduced through proper and vigilant treatment and monitoring of the eyes.

Diabetes Prevalence

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Prevalence - The Blue Mountains Eye Study found that one third of people with diabetes had diabetic eye damage (retinopathy), and that included 16 percent of those with previously undiagnosed diabetes. At the moment, diabetes is this country's fastest growing chronic disease with 75 Australians developing diabetes every day and some 890,000 Australians currently diagnosed with the disease. However, the total number of Australians with diabetes and pre-diabetes is estimated at 3.2 million. Those are pretty significant numbers.

Diabetic Retinopathy Susceptibility

Those most at risk - As its name implies, all people with diabetes mellitus are at risk, both those with type 1 and type 2 diabetes. The longer you've had diabetes, the higher the risk of developing some ocular problem. Because expecting women with diabetes may be more susceptible, we recommend that all pregnant diabetics have dilated-eye examinations each trimester to protect their vision.

Diabetic Retinopathy Warning Signs

Warning signs - Diabetic retinopathy often gives no early warning signs. Even macular oedema, which can cause more rapid vision loss, may go undetected for some time. In most cases, however, if you have macular oedema, you're likely to have blurred, distorted or patchy vision that can't be corrected with prescription glasses. Other symptoms include problems with recognising people, reading, watching television and driving a car. You may also be overly sensitivite to glare and have difficulty seeing at night.

With extreme fluctuations in blood sugar the vision will improve then worsen during the day. As new blood vessels form at the back of the eye, they can bleed and threaten vision. The first time this happens, it may not be very severe, leaving just a few specks of blood, or spots, floating in your visual field. Although the spots often go away, they are likely to be followed within a few days or weeks by a much greater leakage of blood, which blurs vision. In extreme cases, a person will only be able to tell light from dark in that eye. It may take the blood anywhere from a few days to months or even years to clear from the inside of the eye, and in some cases the blood will not clear. These types of large hemorrhages tend to happen more than once, often during sleep.

Diabetic Retinopathy Prevention

Preventative measures - There are several steps you can take to help prevent diabetic retinopathy. Long-term studies show that controlling blood sugar levels reduces the risk of the disease's development and progression. Long-term studies also suggest that high blood pressure and cholesterol can increase the chances of retinopathy progressing to the severe form and making macular oedema more likely to occur.

Have your eyes examined here every year. If we find you are at low risk for vision problems, we may recommend follow-up exams every one to two years. While screening for diabetic retinopathy and other eye problems will not prevent diabetic eye disease, it can help you avoid vision loss through early detection and treatment. If you have changes in your vision such as those mentioned above, please call us straightaway for an appointment. In most cases, the sooner the problem can be treated, the more effective the treatment will be.

Diabetic Retinopathy Treatment

Treatment - The best way of addressing diabetic retinopathy is to monitor it vigilantly and achieve euglycemia. Having said that, there are three major treatments for diabetic retinopathy, which are very effective in reducing vision loss from this disease. They are laser surgery, vitrectomy and injection of steroid-based or anti-VEGF medications into the eye.

While laser remains the foundation of long-term treatment, it does cause a loss of retinal tissue. That's why we employ the other two approaches in specific situations. We find vitrectomy particularly useful in severe cases where the vitreous is full of blood, or the retina is detaching due to contracting scar tissue.

Injections are very useful in treating macular oedema that isn't amenable to further laser or to gain control of rapidly progressive disease even as laser treatment is being completed. In some patients it results in a marked increase of vision, especially if there is an oedema of the macula.

Diabetic Retinopathy Prognosis

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Prognosis - When diabetic retinopathy is diagnosed and monitored closely from the early stages, the outlook is good. Regular ophthalmic examination increases the likelihood of catching complications early and treating them promptly, thereby improving the prognosis. Because controlling your diabetes, blood pressure and cholesterol are so crucial, we work closely with your general practitioner or endocrinologist to achieve optimal control. For instance, we are able to detect blood vessel damage that may be occurring in your brain or kidneys by actually seeing it in your retinal vessels. Because we train as general doctors before specialising, we know the significance of such discoveries. Thus, we're not only looking after the health of you eyes, but the rest of you as well.