Diabetic retinopathy causes blindness in people with type 1 and type 2 diabetes. But if you know how to protect your diabetic eyes, it will not happen to you.
Going blind used to be an inevitable complication after many years with diabetes. Today about one in three type 2 diabetics have retinopathy to some degree.
But like so many other diabetic problems, you may not notice anything is wrong with your eyes until serious symptoms show up.
At first diabetic retinopathy symptoms are minor. Only an opthalmologist would be able to see what is happening, because the changes are microscopic.
The first signs you might notice are blurring of your vision and floaters. The trouble is that by that time retinopathy has already damaged your eyes.
Your retina is the area at the back of your eye where your optic nerve comes in. Your rods and cones are there along with bundles of a thousand tiny capillaries. Those veins and arteries keeps your eyes alive and healthy.
In diabetes we have too much glucose roaming in our blood. Why? For type 1 diabetics it is lack of insulin. For type 2 diabetics it is insulin resistance. Either way, the hormone imbalances of diabetes lead to high blood sugar.
The result is neuropathy, damage to the tiny blood vessels and the nerves around them. Since your retina is full of these capillaries it shows that damage very soon.
That is diabetic retinopathy in simple terms. Your capillaries are damaged by high blood sugar. They weaken, causing your body to make more and more capillaries, but the new ones are even weaker.
They begin to leak fluid into your eyes. This is what causes blurred vision and floaters, those little specks that float across your field of vision. Those are classic symptoms.
As you become aware of them, you will realize that you need more than an optometrist. You need an ophthalmologist, an M.D. who can treat retinopathy.
Your doctor probably told you to find an ophthalmologist when you were diagnosed with diabetes. He knew that diabetic retinopathy treatment should begin before the symptoms are noticeable to you.
If the disease is left alone, you may experience dark spots in your vision, poor night vision, inability to see colors, glaucoma and retinal detachment. Eventually you will become blind.
Whether you are a type 1 or type 2 diabetic the results are the same. If you have poor blood sugar control, high blood pressure and high cholesterol you are at high risk for retinopathy. Smoking doubles the risk too.
The risks become greater during pregnancy. You need to know that genetics adds to your risks as well, because black and Hispanic diabetics have more early retinopathy.
Taking care of your eyes will begin as soon as you go to your ophthalmologist. A good eye doctor will dilate your eyes at every visit and do other tests to check for problems in the retina.
There is laser surgery available now that was not around a few years ago. I have first-hand experience with it. Here is how it went.
After cataract surgery I continued to see my opthalmologist. He spent a lot of time at each visit using bright lights and magnifiers to study my retina. I didn't know what he was looking for.
On one visit he said I had tiny microaneurysms beginning to form in one eye. He explained that these were spots where the capillaries were starting to leak, not a lot, but enough to need intervention.
He asked if my vision was okay, and I told him yes. Cataract surgery had given me back sharp vision, and nothing had changed.
He said I would need laser treatment. It sounded scary, but he said it was not anything like the cataract surgery. The treatment would be done at his office, not at a hospital, and it would not involve needles or anesthesia, or even lying down.
The laser treatment room was dark. I sat at one of the machines, set my chin on the chin rest and looked at a small light. The laser therapist told me to sit very still.
I held my breath while she hit the little capillaries in my eye with a tiny laser. She was coagulating the spots that were leaking. It was done before I had time to run out of breath.
The doctor told me that for a few days I would have blind spots where the laser did its work, and he was right. It was a few days before the blind spots were completely gone. But my diabetic retinopathy had been treated.
The ophthalmologist has to dilate your eyes at your yearly visits. This is because he uses bright lights, and your pupils close up in bright light.
He numbs your eyes, dilates the pupils and paralyzes them so they will not close. Then he can make a thorough exam of the entire inside of your eye.
Of course your eyes won't go back to normal for several hours afterward. You may want someone with you at the eye doctor's office so you don't have to drive home.
Take your sunglasses with you. If you forget them, the ophthalmologist's office has throwaway sunglasses you can use.
Your ophthalmologist also does vision tests and measures the pressure in your eyes to check for glaucoma. Make sure you get those yearly tests.
He will find problems before you know about them. That
will save your eyes. Are you afraid of the cost? Medicare, Medicaid and insurance companies pay for ophthalmology visits.
Keep your blood sugar under tight control. That is the best thing you can do to guard against diabetic retinopathy.
It will help every other complication of diabetes too. Make sure you test your blood sugar often so you know how you are doing.
Get your hemoglobin A1C done every three months as the American Diabetic Association recommends.
Yearly visits to an ophthalmologist are a must. No one else can detect early diabetic retinopathy symptoms, and catching the problems early means the disease has no chance to progress.
And don't ignore hazy or blurred vision or sudden changes in visual fields. Go to your ophthalmologist as soon as you can.
Take your medications for diabetes, high blood pressure and high cholesterol, everything your doctor has recommended, and don't stop.
And there is something else you can do. Learn about antioxidants and their benefits in preventing and repairing all kinds of diabetic neuropathy. There is proof they slow down the effects of diabetic retinopathy.
But please watch out for the guys who try to sell you expensive supplements. Do your homework and you'll find most of what you need at the grocery store.
The day you find out you have type 2 diabetes, that's the time to find a good ophthalmologist. It is possible that you've been diabetic for a while without knowing it.
Start protecting your eyes now, and learn how to avoid the other diabetic complications too. That way diabetic retinopathy might never be a problem for you.
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