Diabetes is a condition in which blood sugar levels are higher than normal. Diabetes may be type I or Infantile Diabetes, in which the patient's organism is not capable of producing the hormone insulin in sufficient quantities: or type II or Adult Diabetes in which despite normal levels of insulin production, this hormone is not effective.
Diabetes can lead to various eye problems: blurred vision, greater risks of suffering from glaucoma or cataracts, paralysis of eye muscles, etc.
However, the most import effect it can have on the eye is on the retina, which is the part of the eye responsible for focussing the images it perceives. This disorder is what is known as diabetic retinopathy, and it may lead to blindness.
The diabetic retinopathy can be of two types:
No proliferating retinopathy. Is the most initial phase. Along the years the high levels of sugar in blood go damaging the blood vessels of the retina. As they become very fragile, small hemorrhages in the shape of a point are form. In this first stage, diabetic retinopathy is unlikely to have symptoms, since the small hemorrhages in the back of the eye do not hurt, and the vision is usually preserved. At times, the vessels are more fragile, and allow fluids to escape from the interior of the blood capillaries which, if placed on the macula, cause visual deterioration, affecting mainly central and near vision.
Proliferating retinopathya. As the illness advances, the alterations of the retinal circulation increase, in consequence there are areas of the retina that don’t receive an adequate blood supply.New blood vessels are organized and try to go towards these areas. This process is called neovascularization.These new vessels are very fragile and can break very easily, leading to large bleedings inside the eye that causes a sudden loss of the person’s sight.
The best protection against diabetic retinopathy lies in an early diagnose.
After twenty years of suffering from diabetes it is highly probable that a patient may suffer diabetic retinopathy. This is why all diabetics should undergo periodic check-ups with their ophthalmologist, which include examinations of the back of the eye to avoid to avoid any risk.
One of the most important tests used in its diagnosis is the fluorescein angiograph. This test consists of injecting an intravenous contrast into the patient. When the contrast reaches the patient's eye, the ophthalmologist takes photographs so that he can detect which are the areas whose blood vessels are leaking the contrast and those areas the contrast does not reach properly because they have an insufficient blood supply.
Treatments will differ depending on the type of diabetic retinopathy:
Drug treatments. These are useful for improving the retinal blood supply and for reducing the fragility of the blood vessels. Their efficiency is, however, very limited.Laser Photocoagulation. This consists of sealing those points through which fluids escape to the retina. It is normally completed in several sessions and is very useful when a diabetic retinopathy is still at a non-proliferative stage or at an early proliferative stage.Vitrectomy. This is a surgical technique that is used above all in those patients with important bleeding inside their eye. It serves to clear this blood from the eye.
Nevertheless, the diabetic must accompany these measures by strictly controlling his blood-sugar levels, given that this is the real cause of the problem.
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