DIABETIC RETINOPATHY

Patients with diabetes (type 1 or 2) are at risk for developing diabetic retinopathy, a condition in which elevated blood sugar levels damage the blood vessels in the back of the eye. This can result in bleeding, decreased blood supply to the retina, and in severe cases can lead to neovascularization (growth of fragile blood vessels) and macular edema. Complications of diabetic retinopathy include retinal detachments, vitreous hemorrhages and loss of vision. Recent research discovered that over 50% of individuals with diabetes have or will have diabetic retinopathy, with a higher prevalence in males versus females.

Diabetic retinopathy can be diagnosed with a dilated fundus exam or retinal imaging. The major classifications of diabetic retinopathy include:

• Non-proliferative Diabetic Retinopathy (NPDR) – The less severe form of diabetic retinopathy, which is classified by the presence of microaneurysms, cotton wool spots, dot blot hemorrhages or intraretinal microvascular abnormalities. NPDR can usually be managed by getting blood sugar levels under control.
• Proliferative Diabetic Retinopathy (PDR) – The progression from NPDR to the formation of new, fragile, leaky blood vessels. PDR is the advanced stage of diabetic retinopathy often requiring intraocular injections by a retinal specialist.

Macular Edema can develop in both NPDR and PDR. This is a severe complication which results in the swelling of the macula (part of the eye responsible for the central vision) and decreased vision.

Symptoms of diabetic retinopathy include:

• Sudden blurred vision
• Increased number of floaters
• Fluctuation in vision
• Flashes of light
• Blind spots in vision
• Double vision

Risk factors for developing Diabetic retinopathy include:

• Duration of uncontrolled diabetes
• Family history of diabetes
• High A1C/BS levels
• High cholesterol levels
• High blood pressure
• Kidney disease
• Poor dietary control
• Smoking

Treatment options for diabetic retinopathy include:

• Lowering blood sugar levels with treatment administered by an endocrinologist or PCP, as well as changes in diet and lifestyle
• Intraocular injections or surgery may be required in severe cases

At Eye Theory, we strongly recommend routine diabetic eye exams for diabetic patients. Early detection is key to managing diabetic retinopathy and protecting your vision. If you have diabetes or unexplained vision changes, schedule an appointment at Eye Theory to be evaluated by our doctors.

MACULAR DEGENERATION

Age-related Macular degeneration (ARMD) is the leading cause of vision loss in America. The macula is the part of the eye responsible for your central vision. Macular degeneration occurs when protein deposits called drusen (lipids, proteins and extracellular material) build up in the macula and damage the cells.

There are two stages of macular degeneration:

• Dry AMD (80% of cases) – the less severe form of macular degeneration, which is characterized by the presence of drusen deposits in the macula.
• Wet AMD (20% of cases) – the more severe form of macular degeneration, resulting in neovascularization, bleeding, atrophy and central vision loss.

Risk factors for macular degeneration include:

• Age - Higher risk in ages 55 and older
• Race - Caucasians are at greatest risk
• Eye color - Lighter colored eyes are at higher risk
• Smoking - Doubles the risk of developing AMD
• Genetics - Higher risk if you have a family history

Symptoms of macular degeneration include:

• Gradual loss of central vision
• Blind spots in vision
• Distorted vision

Macular degeneration can be diagnosed with the following tests:

• Dilated fundus exam or retinal photography
• Dark adaptation testing
• Slit lamp examination
• Optical coherence tomography
• Amsler grid
• Visual field test

Unfortunately, there is currently no cure for macular degeneration but there are treatment options to slow down the progression of AMD and manage the complications. Current treatment options for AMD include:

• Supplements such as lutein, zeaxanthin, vitamin C, vitamin E and zinc
• Anti-VEGF injections
• Low-vision devices
• Smoking cessation
• Blue-light protective lenses
• Low-level light therapy 

Like most diseases, early detection is the key to managing macular degeneration. At Eye Theory, we screen for macular degeneration during our comprehensive eye exams. If you have macular degeneration or vision loss, schedule an appointment at Eye Theory to be evaluated by our doctors.

RETINAL DETACHMENT

A retinal detachment is a serious ocular complication in which the retinal tissue partially or completely detaches from the eye. Retinal detachments can lead to temporary or permanent blindness if not treated urgently. There are many different types of retinal detachments (rhegmatogenous, tractional, and exudative), holes and tears – all of which require immediate medical attention.

Symptoms of retinal detachment include:

• Sudden increase in floaters
• Flashes of light
• Blurred vision
• Curtain-like “veil” appearing over vision
• Darkening or missing areas of vision

Retinal detachments can be diagnosed using:

• Optical coherence tomography
• Dilated fundus examination
• Ultrasound
• Retinal imaging

Causes of retinal detachment include:

• Previous history of retinal detachment
• Family history of retinal detachment
• Extreme nearsightedness
• History of eye surgery
• Trauma (blunt or penetrating)
• History of retinal diseases including diabetic retinopathy, uveitis, hypertensive retinopathy, high myopia, lattice degeneration, and many more

Time is of the essence when it comes to retinal detachments. The longer the retina is detached, the worse the prognosis in terms of restoring vision. Treatment options for retinal detachment include:

• Laser barrier to seal holes or tears to prevent an impending detachment
• Pneumatic retinopexy – injection of an expanding gas bubble into the eye to return the detached retina back to its original position
• Scleral buckle – placing a silicone band around the outside of the eye to push the retina back into place
• Cryopexy – using a “freezing probe” to create scar tissue around the tear or hole and seal its position
• In severe cases, a vitrectomy to remove adhesions or scar tissue pulling on the retina

If you are experiencing any of the symptoms of a retinal detachment such as flashes of light or sudden loss of vision, it is important to visit your eye doctor immediately. At Eye Theory, our doctors are highly skilled and trained to diagnose and co-manage retinal detachments. We team up with leading retinal specialists to ensure our patients receive the highest quality of care.