Top 10 things to know about diabetic retinopathy
- Diabetic retinopathy is the most common cause of vision loss under age 60.
- Vision loss is almost completely preventable
- It’s better to have 5 good years of control at the beginning than at the end.
- Patients who know their Hemoglobin A1c test results tend to have better Hemoglobin A1c results long-term.
- It takes about 2 years of great sugar control to begin to reduce the risk of vision loss. Be serious early.
- Laser Therapy can reduce vision loss by 50%, but laser therapy with good long term sugar control reduces risk by 95%
- One month of high sugars won’t blind you. It takes months or years of terrible sugar control to get retinopathy.
- Most Tampa patients with the disease cannot tell us their Hemoglobin A1c results.
- There are at least 5 medicines that can be placed in the eye to improve vision. Many insurances don’t cover all the options.
- Micropulse Lasers can avoid some of the side effects of traditional lasers and buy some freedom from chronic eye medication dependence.
Dr. Mahootchi has a special interest in diabetic retinopathy. He is a type 1 diabetic for over 35 years. He was enrolled in the landmark diabetic control and complications trial (DCCT) out of college. Dr. Mahootchi has one of only 4 yellow micropulse lasers in Florida and was the first in Tampa Bay to use it for diabetic retinopathy. He lectures around the world and at society meetings about its use.
What You Should Know About Diabetic Retinopathy
Diabetic Retinopathy is the most common cause of permanent vision loss under age 60. It’s the result of long-term bad sugar control and is largely preventable. Early exams, treatment, and patient involvement in controlling their own sugar are key to avoiding problems. What is Diabetic Retinopathy? It damages the retina in two main ways.
Poorly controlled diabetes can damage the small blood vessels in the retina. This can lead to DME (diabetic macular edema), which is leakage of fluid into the macula. It also causes new blood vessels to grow, break and bleed. This fills the eye with blood and makes it hard to see. This second way is called proliferative retinopathy.
How do I know I have diabetic retinopathy?
Often patients don’t know. The disease can have no symptoms until almost too late. Think of rolling off a cliff. It doesn’t actually hurt until you fall off.
Regular exams from the time of diagnosis are the best way to avoid problems.
- Blurry vision
- Fluctuating vision – sometimes blurry, sometimes clear
- Dark or dim areas in your field of vision
- Decreased night vision
- Decreased clarity of colors or images
- New or increasing floaters
Diabetic retinopathy usually affects both eyes, but sometimes one eye may be worse than the other. Fluctuating blood sugar levels could also affect your vision
What Causes Diabetic Retinopathy?
Over a period of time, high blood sugar can lead to the blood vessel damage described above. When this happens, those vessels can leak blood and fluid over the retina. This can cause distorted vision. Think of how a camera would make poor pictures if there were water droplets on the film.
Eventually, again with long-term poor sugar control, new blood vessels will form in the retina. However, these will often become malformed, causing bleeding and scarring, and even retinal detachment. All this is preventable.
The Treatment of Diabetic Retinopathy
The treatment of diabetic retinopathy continues to improve! From the non-destructive Iridex micropulse lasers to 3 designer medicines (Avastin, Eylea, and Lucentis) placed in the eye to long-lasting drug-releasing implants for long-term control (like Ozurdex and Iluvein), we are lucky to have so many options.
Different treatments are individualized for each patient to help restore vision and independence. As with cancer treatment and infections, often using two different treatments yields better results.
Once you have significant retinopathy, it’s probably too late to reverse it by good sugar control alone. The disease can blind you or cause permanent vision loss during the two years or more that it takes to reverse risk. Even if your sugar control was instantly perfect, the fluid in the eye damages the retina. Think of it like this: if your house flooded, you could let a carpet dry over a few weeks, but it would likely be ruined. It takes medicine and a change in long-term sugar control.
It’s important to make sure the retina is well treated long before cataract surgery. When we do surgery, we take extra steps to ensure the retina stays safe.
Many ask if the medicines placed in the eye are comfortable. There are many different ways to place medicine in the eye. We take special numbing measures to keep you comfortable.
Dr. Mahootchi has been a Type 1 diabetic for over 35 years and has a special interest and perspective in preventing vision loss from diabetes.
Other diabetic eye issues.
Diabetics usually get cataracts 10 years earlier than non-diabetics. We are one of the highest-rated cataract practices in the Tampa and Wesley Chapel areas. The treatment not only clears the vision but can get you out of glasses. Tampa patients enjoy many advantages with our cataract surgery
Diabetic neuropathy can affect the cornea (called diabetic keratopathy). Unfrozen Autologous Serum can work miracles. Learn more here.
Cranial nerve palsies that cause double vision are often a common presentation of diabetic neuropathy. The nerves affected are coming straight from the brain and not the spinal cord. Diabetic Third, Fourth and Sixth nerve palsy is another one of our specialties
Finally, some of the diabetic treatments can raise eye pressure. As we are very experienced with glaucoma, we can help you avoid multiple drops or multiple different doctor specialist visits with our Tampa Bay practice.
Getting Diabetic Retinopathy Help- in Tampa, Wesley Chapel, Lakeland, and Plant City
If you are diabetic, a diabetic retinopathy screening with us can truly save your vision.
The exam is covered under most insurance. If you are not insured, rest assured that the exam is not expensive. We won’t do unnecessary testing that doesn’t change how your condition is managed. We communicate with your primary care or diabetic specialist.
Not all eye exams are the same. Frankly, the type exam done in a retail setting is focused on selling glasses. Many are done without dilation, which prevents seeing diabetic swelling in 3 dimensions. The worst of insurances are trying to count these types of exams as good enough for diabetes. Don’t fall for it. You need a dilated exam with an expert who is going to take the time to review more than just a picture of your eye.
Avoid loss of sight and make an appointment with the Eye Clinic of Florida. Dr. Mahootchi is board certified by the American Board of Ophthalmology.
***Hemoglobin A1c is the “drug test” of sugar control. We can test your sugar right now, but the number may have nothing to do with how the sugar varies from high to low throughout months of living. The Hemoglobin A1c test measures how much sugar is stuck to the outside of your red blood cells. Since they live a few months, think of the Hemoglobin A1c as measuring how thick the syrup is that the blood cells swim in.
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