Diabetes

Diabetes is a disease caused by having too much sugar in the blood. Patients with diabetes are treated with insulin or pills in order to control the blood sugar levels. Without proper treatment, after a few years, the retina can be affected. We call it Diabetic Retinopathy.

Diabetic Retinopathy

Chronically elevated blood glucose levels cause damage to the retinal vessels. This leads to an insufficient oxygen supply to the different retinal layers The lack of oxygen supply to the retina leads to the formation of new and abnormal blood vessels, a process called “neovascularisation” which can lead to a vision loss, even blindness in some patients.

Patients with long-standing diabetes, especially those with a poor control of their sugar, those suffering from high blood pressure or hyperlipidemia, smokers and also pregnant women are particularly at risk. A tight control of blood sugar, blood pressure and blood lipids achieved by a proper diet, regular physical activity and medications can prevent or slow the progression of diabetic retinopathy.

Even if you already have diabetic retinopathy, proper treatment and follow-up can maintain the vision in a good state for many patients. That is the reason why is so important for diabetics to be controlled by their family physician or endocrinologist and to regularly be seen by an ophthalmologist (EyeMD).

Early diagnosis and prevention of diabetic retinopathy is needed because visual symptoms usually don't appear until changes in the retina are well underway. When vision becomes affected, you might notice blurred vision, floaters (perceived as spots floating in your visual field), dark areas on the visual field or poor night vision. If you are diabetic, ask your doctor when an exam with the EyeMD will be necessary or if one can be arranged.

Diabetic macular edema

The macula is the central part of the retina. With this part of the retina, you can read, recognize faces and perform activities that require very fine vision. Macular edema can be one consequence of diabetes.

Being examined

Before any treatment is proposed, a detailed exam of the retina will be done. This will help to determine what can be done and what are the chances of improving your vision.

During your visit, we perform several diagnostic tests to know how the diabetes affects your eyes:

First we check your vision and your glasses to know what you are able to see. Next we check you eye pressure and examine the different layers of the inside of the eye using a slit lamp and an ophthalmoscope. Complementary exams using an OCT (Optical Coherence Tomography), angiography, ultrasound or other tests may be required depending on your specific condition. These are explained elsewhere on our website.

Treating Diabetic Retinopathy

After the complete examination of your case we will select the correct treatment for you and give you an idea of the chances of success. Treatments that we can performed in our office in Lausanne are:

• Laser photocoagulation. A bright light is used to treat areas around the abnormal vessels or to prevent them from developing. This is a non-invasive technique done at a slit lamp.
• Intravitreal injections. Medications can be injected into the eye to prevent vessels from growing, or to get rid of excess fluid building up in the retina or the macula. These injections are sometimes combined with laser photocoagulation, or used prior to surgery.
• Surgery. Surgery is sometimes necessary to take care of bleeding inside the eye, abnormal vessels or other complications of diabetes in the eye.

For more information about diabetes and its eye complications visit DiabetesEyeCheck.org