Diabetic Retinopathy

Diabetic retinopathy, also known as diabetic eye disease, is caused by a complication of diabetes (both type 1 and type 2). Persistently high blood sugar levels cause damage to the blood vessels in the retina and can, if left untreated, cause blindness. The length of time you’ve had diabetes and how the maintenance of the condition are both significant factors in the progression of this eye disease. Thankfully, there is much that can be done to monitor, slow, and treat diabetic retinopathy. Controlling your blood sugar levels, blood pressure, and cholesterol is very important, as is to partner with a diabetic eye care specialist (diabetic retinopathy ophthalmologist) to regularly assess your eyes and carry out appropriate treatment.

Before Diabetic Retinopathy Treatment

The appearance of floating spots or bleeding from abnormal retinal blood vessels.

After Diabetic Retinopathy Treatment

Floating spots are no longer present, bleeding stops, and vision becomes clear.

How Do I Know if I Need the Help of a Diabetic Eye Doctor?


Quite simply, if you have diabetes or are at risk of it (often termed pre-diabetes) then you need to use the services of a diabetic eye doctor. Good management of the condition is the key to keeping optimal vision throughout your lifetime. Only by undergoing regular checks from an ophthalmologist experienced in the monitoring and treatment of diabetic retinopathy will you be able to undergo early intervention should further complications arise.

While anyone who has diabetes is at risk of developing diabetic retinopathy, there are additional factors that increase its likelihood or speed of progression. These are:

Smoking

Hypertension (high blood pressure)

High cholesterol

Poorly controlled blood sugar

Certain ethnicities—Hispanic, Native American, and African-American

During pregnancy 

In addition, the longer you have diabetes, the greater your chances of developing diabetic retinopathy.The complications of diabetic eye disease are many, and diabetic eye specialists are highly trained to spot the earliest symptoms during regular eye checks. The retina is the light-sensitive layer of cells at the back of the eye, transferring light into electrical signals and transmitting it via the optic nerve to the brain. To work efficiently, the retina needs a constant source of oxygen-rich blood, which it receives via a network of tiny blood vessels. When the blood sugar is uncontrolled over long periods this weakens and damages these blood vessels. Left untreated this can, in severe cases, lead to permanent loss of vision. There are two stages of diabetic eye disease—early diabetic retinopathy and advanced diabetic retinopathy. In the early stage, it’s unlikely that you’ll notice any obvious symptoms. However, the anatomical changes that are occurring within the eye will be picked up during a regular diabetic eye screen from your ophthalmologist. If you experience any of the following symptoms you should see your diabetic eye specialist immediately:

 New floaters (shapes floating in your field of vision)

Blurred or patchy vision

Eye pain

Redness

Any worsening of vision

Sudden vision loss

What Happens During Diabetic Retinopathy Surgery?


Surgery for diabetic retinopathy isn’t usually carried out during the early stages of the disease. However, should your eye screening detect that the condition is worsening, a diabetic eye surgeon has several options available to provide effective treatment.

These include injections, laser treatment, and eye surgery: 

To understand what happens during diabetic retinopathy surgery it’s necessary to understand a little more about the disease. During the first stage, or early-stage (nonproliferative diabetic retinopathy, or NPDR) the blood vessels that supply the retina become weakened. Small bulges appear that can leak blood. The vessels dilate (widen), some become blocked, and the nerve fibers can swell. The macula (the central area of the retina) can also become filled with fluid—this is called macula edema.

The second, more advanced stage (proliferative diabetic retinopathy, PDR) leads to the damaged blood vessels becoming closed off completely. New vessels grow to compensate but these are abnormal in size and shape. They bleed easily and leak into the vitreous (the clear jelly within the eye). Scar tissue forms and, if not treated, can cause the retina to detach from the back of the eye. Pressure can increase within the eye, damaging the optic nerve. This can lead to glaucoma.

Treatments used to treat worsening diabetic retinopathy include: 

Laser treatment: There are different types of laser treatment. The first is called photocoagulation, or focal laser treatment. It stops or reduces the leakage of blood vessels by sealing them with a laser burn. The second type is panretinal photocoagulation, or scatter laser treatment. This uses a laser to shrink the abnormal blood vessels, so preventing them from leaking. This treatment is carried out over multiple sessions. All laser treatments are generally carried out under local anesthetic and take around 30-40 minutes per session.

Eye injections: These are used to treat severe diabetic maculopathy, a condition where the central part of the retina becomes damaged. The injections, called VEGF inhibitors (vascular endothelial growth factor) or anti-VEGF help prevent the growth of new, abnormal blood vessels and swelling in the eye. The treatment is quick and usually pain-free. It will initially be carried out once a month until vision stabilizes. After this, they may be more infrequent or stopped altogether. In some cases, if VEGF treatment fails to have an effect, steroid medications may be injected instead.

Eye surgery: Known as vitreoretinal surgery, this is carried out when a large amount of blood has leaked into the eye or if extensive scar tissue has, or is likely to, cause retinal detachment. It involves making a small incision and removing some of the vitreous from the eye. It’s carried out under local anesthetic with sedation, so is pain-free and you’ll be unaware of it being carried out.

How Does WBEC Provide the Best Diabetic Retinopathy Treatment?


The West Boca Eye Center is led by Brent Bellotte MD., a ground-breaking clinician who’s dedicated his professional life to the field of advanced ophthalmology and surgical treatments. Bellotte has and continues to play a pivotal role in the development of treatments, being recognized as being one of the leading eye doctors within the US and across the globe. 

His specialist areas lie in the treatment of cataract surgery, glaucoma treatment, laser vision correction, and diabetic retinopathy treatment. The clinic offers a second-to-none environment of academic grade, meaning that whatever is deemed necessary to best treat your diabetic retinopathy is carried out in a single location.

Routine diabetic retinopathy eye checks include:

A dilated eye exam: The eyes will be checked for abnormal vessels, scarring, growth of new blood vessels, bleeding into the vitreous, swelling, blood, or fatty deposits in the retina, retinal detachment or the likelihood of it occurring, and any abnormalities to the optic nerve.

Measuring the pressure within the eye

Looking for evidence of cataracts

A vision test

Additional tests, if necessary, that are carried out on-site include:

Fluorescein angiography: A dye is injected into the arm and pictures taken of the inside of your eyes as it flows through the blood vessels. This shows exactly where vessels are leaking, blocked, or broken down.

Optical coherence tomography: This provides cross-section images of the retina to see if any fluid has leaked into the tissue.

As with treatment within all medical fields, that of diabetic retinopathy continues to evolve. Brent Bellotte MD. is at the forefront of this research, meaning that when new, cutting-edge treatments become available the WBEC is one of the first in the country to be able to offer them to their patients.

Learn More

More information is available using our educational video library. Inform yourself about an illness through powerful visuals that are easy to understand. We will show you exactly how this illness affects your eye and how to treat it properly.

What is Diabetic Eye Disorder?

Diabetic retinopathy is an eye problem that affects the retina: a light-sensitive tissue at the back of the eye. This disorder is caused by diabetes which damages the blood vessels located within the retina, in turn, causing vision problems, in severe cases, blindness.

What are the symptoms?

Blurriness, dark areas of vision, and difficulty perceiving colors.

How is it treated?

Visit West Boca Eye Center to identify what the best solution for your condition may be.

How to tell if diabetes is affecting your eyes

While it’s essential to have regular eye checks (annually, at least) if you’ve been diagnosed or at risk of diabetes, the following symptoms may become apparent as the condition progresses. If you suffer any of the following you need to see a diabetic eye specialist immediately.

The appearance of dark spots or strings that float within your field of vision—commonly called floaters

Blurred or hazy vision

Empty areas in your field of vision

Eye pain and/or redness

Any impairment in your color recognition

Gradually worsening vision

Sudden vision loss

What are the eye complications of diabetes?

Complications that can occur within the eye as a result of having diabetes include:

Vitreous hemorrhage: The tiny blood vessels within the eye can leak, causing blood to enter the vitreous of the eye (the jelly-like substance that fills the eyeball). Small amounts of blood can cause floaters—large amounts can be very serious and cause a total blockage of vision. There are treatments available to effectively treat vitreous hemorrhage, and most impairment of vision is transient. Once the blood has cleared, vision can often return to its previous state (unless the retina has been damaged).

Retinal detachment: Scar tissue is formed when abnormal blood vessels form within the eye. This can, if left uncontrolled, cause the retina to detach from the back of the eye. It can be a partial or complete detachment. Symptoms include seeing flashes of light, increasing impairment of vision, floaters, or a sudden loss of vision.

Glaucoma: The growth of new blood vessels within the eye can cause the pressure within the cavity to increase—a condition known as glaucoma. This compresses and damages the optic nerve, the pathway by which images from the eye are transferred to the brain.

Complete vision loss: Left uncontrolled, either diabetic retinopathy, glaucoma, or a combination can lead to blindness.

Do I need to find a diabetic eye exam near me?

All diabetics need to include regular eye checks with a diabetic eye care specialist. This should be, at a minimum, every year. Those with more advanced diabetic retinopathy will need more frequent visits. This makes finding a provider of a diabetic eye exam near me a popular option. 

However, location shouldn’t be the driving force behind your decision. Far better to find a diabetic eye doctor with whom you feel comfortable and who offers a full range of the latest treatment options should you need them, even if you need to travel to see them.

What is diabetic retinopathy?

The condition is a complication of diabetes, whereby uncontrolled high blood sugar levels cause damage to the back of the eye. If it’s not monitored (and treated when necessary) it can lead to blindness.

What are the diabetic retinopathy symptoms?

During the early stages of diabetic retinopathy, there are often no symptoms. As the condition progresses you may notice some or all of the following:

Blurred vision

A decrease in the clarity of color

Spots or floaters

Pain and/or red eyes

Patchy vision

Worsening vision

Sudden vision loss

What are the diabetic retinopathy treatment options?

While the condition can’t be prevented, many lifestyle choices will reduce the progression. This is the first line of defense and includes:

Strict control of your blood sugar

Reducing your blood pressure and cholesterol to normal levels (with the help of your diet and medication from your doctor)

Regular diabetic eye exams

Lifestyle changes, to include eating a healthy diet, maintaining an appropriate weight, taking regular exercise, reducing alcohol intake, and stopping smoking.

Other treatment options are carried out should the condition progress. These include: 

Laser treatment

Eye injections

Eye surgery

What are the diabetic retinopathy stages?

There are two stages of diabetic retinopathy:

Stage one—early-stage or nonproliferative diabetic retinopathy (NPDR): This is where the walls of the blood vessels become weaker and may leak a little. However, no new blood vessels or scarring has yet occurred. You’re likely to be asymptomatic during this stage, but the condition requires annual monitoring from your diabetic eye doctor.

Stage two—proliferative diabetic retinopathy (PDR):. As the condition advances, the tiny blood vessels become blocked and break down. This causes new, abnormal, ones to form. These are significantly weaker and can bleed into the vitreous humor of the eye. Scar tissue is formed and this can cause the retina to become detached. In some cases, the new blood vessels cause the pressure within the eye to rise (glaucoma) and cause damage to the optic nerve.