Retinopathy in Greenbelt & Bowie, MD

Diabetic retinopathy is a complication of Type 1 and Type 2 diabetes and is a leading cause of blindness in adults 18 – 65 years old. It occurs when diabetes damages the tiny blood vessels inside the retina, the light-sensitive tissue at the back of the eye. In the early stages of diabetic retinopathy, you may not notice changes to your vision. However, diabetic retinopathy can be progressive and is generally exacerbated by poor control of blood sugar. There are four stages of diabetic retinopathy: 

• Mild Non-proliferative Retinopathy
  At this stage, dilation of small vessels occurs, causing thin-walled areas of "pouching" that are prone to leakage.
• Moderate Non-proliferative Retinopathy
  As disease progression continues, vessels become blocked and begin to leak.
• Severe Non-proliferative Retinopathy
  Increased blockage and leakage leads to deprivation of blood supply downstream. Swelling occurs, and signals are released that encourage new blood vessel growth.
• Proliferative Retinopathy
  At this advanced stage, the retina begins to grow incompetent, wispy vessels. These vessels are abnormal and fragile. They grow along the surface of the retina and into the clear, vitreous cavity in the back of the eye.

In and of themselves, these compromised vessels do not cause symptoms or vision loss. However, they have very weak walls, and if or when they leak blood, severe vision loss and even blindness can result. Diabetic retinopathy is progressive but gradual; most patients do not have any symptoms in the early stages. This is why it is extremely important that diabetic patients are diligent about having eye exams once a year.

At Solomon Eye Physicians & Surgeons, we routinely diagnose patients with diabetic retinopathy and can help patients in the early stages manage the condition. However, if your diabetic retinopathy is advanced, we will refer you to a trusted retina specialist who can provide further treatment.

Diabetic retinopathy often has no symptoms or warning signs until it has reached the proliferative stage. It is imperative that diabetic patients do not wait for symptoms and have comprehensive dilated eye exams at least once a year. The symptoms of proliferative retinopathy can include: 

• New floaters, which are actually tiny flecks of blood in your vision
• Reduced ability to see color
• Reduced vision acuity
• Distorted or blurred vision

Hemorrhages in the eye related to diabetic retinopathy tend to happen progressively, often while sleeping. Occasionally, the initial spots may clear without treatment. However, bleeding can reoccur and cause severely blurred vision. If left untreated, proliferative retinopathy can cause severe vision loss and even blindness.

The major cause of diabetic retinopathy is uncontrolled blood sugar. Spikes in blood sugar damage the retinal blood vessels, causing them to swell, become blocked, and eventually bleed.

All people with diabetes, both early onset and adult onset, are at risk. That’s why everyone with diabetes should get a comprehensive dilated eye exam at least once a year. Between 40 – 50 percent of Americans diagnosed with diabetes have some stage of diabetic retinopathy. If you have diabetic retinopathy, your primary physician can recommend treatment to help prevent its progression.

During pregnancy, diabetic retinopathy may be a problem for women with diabetes. 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 pregnancy.

Diabetic retinopathy can be detected during a comprehensive eye exam that includes:

• Visual acuity test – eye chart
• Dilated eye exam – Drops are used to widen the pupil, and a thorough examination of the retina and optic nerve is performed. Signs include: leaking blood vessels, retinal swelling, fatty deposits on the retina, damage to the retinal nerve fiber layer, and any changes to the tiny vasculature of the retina.
• Fluorescein angiography – A special dye is injected into your arm, and pictures are taken as the dye passes through the vessels of the retina. This allows for easy identification of leaking vessels.

At Solomon Eye Physicians & Surgeons, we see and diagnose diabetic retinopathy quite frequently. The most important factors in treating the condition are always strict blood sugar control and following the instructions of your primary physician. Other treatments can vary, depending on the progression of your condition and can include corticosteroid injections, laser procedures, or a vitrectomy. If we diagnose you with advanced or progressive diabetic retinopathy, we will refer you to a retina specialist to ensure you receive optimal care.

For anyone diagnosed with Type 1 or Type 2 diabetes, diabetic retinopathy is a potential issue. Carefully monitoring and managing your blood sugar and being diligent with yearly comprehensive eye exams are the top two keys for avoiding damage to the retina and permanent vision loss. Contact Solomon Eye Physicians & Surgeons in Greenbelt or Bowie, MD to schedule a comprehensive eye exam, which always includes diabetic eye evaluations, to ensure the earliest possible detection of any problems.