Diabetes Retinopathy FAQ

Because there are so many diabetics in the United States, diabetic retinopathy is the leading cause of new cases of blindness among people aged 20 to 74 years. Approximately 5 to 10 percent of the general U.S. population has diabetes mellitus.

Most diabetic women can have a baby without an increase in retinopathy. In some patients, however, the retinopathy might worsen enough to require laser photocoagulation. In a few cases, vision might remain decreased. It is recommended that all patients be frequently monitored during pregnancy. Generally, this means a baseline examination and visits at least every three months.

Some studies have shown the patients with high blood pressure are more likely to have retinopathy. However, since high blood pressure alone can damage the eyes, heart, kidneys and brain, patients should keep their blood pressure under control and have it monitored regularly.

Patients with proliferative retinopathy might have normal vision but are still at high risk for imminent loss of vision due to hemorrhage or retinal detachment. Laser photocoagulation in these patients has been proven to be effective by the Diabetic Retinopathy Study.

Each case is different. In patients with advanced diabetic retinopathy, laser photocoagulation treatment is not as effective as it is in patients with early retinopathy. In many patients, the progression of retinopathy is delayed. But in others, the disease progresses despite the laser treatment or, by coincidence, at the same time as the treatment.

Studies have shown that most patients with proliferative retinopathy have hemorrhages at night while they sleep. There is no convincing evidence that exercise increases the number of hemorrhages. Moreover, exercise is important not only for general well-being, but also for controlling blood sugar levels. Each patient should continue routine exercise unless he or she notices hemorrhages frequently during exercise.

Yes. Patients with blurred vision from diabetic eye disease are very likely to have kidney disease and/or high blood pressure. They should be checked regularly by their primary healthcare practitioner.

If the retina is damaged, stronger glasses cannot return vision to normal. They do provide greater magnification, but they also force a patient to hold reading material closer to the face. Most patients who have a moderate degree of vision loss opt for a hand-held magnifier in addition to normal reading glasses, allowing for a more comfortable reading distance.

Some patients might be helped greatly by low vision aids. These are special magnifying devices that enable patients to make the best use of their remaining eyesight by enlarging objects.

For certain patients, telescopic devices might improve distance vision. These aids are available through your own ophthalmologist or through Wills Eye Hospital’s Low Vision Service.

There is no evidence that limiting the use of your eyes, avoiding television or bright light, taking vitamins or using sunglasses or any other devices can prevent diabetic retinopathy or its progression.

Currently, there is no evidence that diabetics who take aspirin are at greater risk of frequent eye hemorrhages. This was studied in the Early Treatment Diabetic Retinopathy Study.

Research into the basic mechanisms of retinopathy is ongoing. Doctors and scientists continue to study how the retina and choroid work and what changes occur during the aging process.

Research is also under way on means to control new blood vessel growth and blood vessel leakage.

There is financial aid for people whose best-corrected vision with glasses is 20/200 or worse in both eyes, or whose visual field is restricted to 10 degrees or less. They might be eligible for an additional income tax deduction as well as other financial and rehabilitative benefits to help them cope with vision loss.

A retinal detachment is a very serious problem that almost always causes blindness unless treated. The appearance of flashing lights, floating objects, in the affected eye may indicate a retinal tear and/or detachment. A curtain over a part of the vision is a sight of detached retina.

As one gets older, the vitreous, the clear gel-like substance that fills the inside of the eye, tends to shrink slightly and take on a more watery consistency. As this occurs the vitreous separates from the retina and may tear it.

Retinal tears increase the chance of developing a retinal detachment. Fluid vitreous, passing through the tear, seperates the retina from the back of the eye like wallpaper peeling off a wall. Laser surgery or cryotherapy (freezing) are often used to seal retinal tears to attempt to prevent detachment.

If the retina is detached, it must be repaired. There are four ways to do this:

1. Pneumatic retinopexy involves injecting a special gas bubble into the eye that pushes on the retina to seal the tear.
2. The scleral buckle procedure requires the fluid to be drained from under the retina before a flexible piece of silicone is sewn on the outer eye wall to give support to the tear while it heals.
3. Vitrectomy surgery removes the vitreous gel from the eye, replacing it with a gas bubble, which is slowly replaced by the body's fluids.
4. A combination fo some of the above.