Questions and answers on Macular Degeneration (Diabetic Eye Disease)

What is diabetic retinopathy ? Diabetic retinopathy is the main cause of blindness in people younger than 60. It affects the vessels at the background of the eye, which leak fluid and also bleed. If the macula is compromised (the central sensitive area of the eye), there is drop of vision. Few diabetics also develop abnormal vessels inside the eye (new vessels), which are fragile and can bleed, causing sudden drop of vision. Finally, sometimes normal vessels can be so affected that blood circulation inside the eye is disrupted and due to cell death, drop of vision is irreversible.

Do all diabetics have diabetic retinopathy ? All diabetics are at risk of developing diabetic retinopathy and the risk is increased proportionally to the duration of the disease. Eventually all diabetics will develop some degree of diabetic retinopathy. That is the case for both diabetics type 1 and type 2. It is very important to understand that severe diabetic retinopathy can affect even people with optimal diabetic control, though the chances are much higher in those with poor diabetic control.

What are the symptoms of diabetic retinopathy ? In early stages there are unfortunately no symptoms from the eyes, even in patients with severe damage at the background of the eye. When the bleeding and the leakage extend to the central area, there is drop of vision. In cases of bleeding from abnormal vessels, vision can drop suddenly, since the inside of the eye fills with blood. Diabetic retinopathy does not cause pain.

Is there any treatment for diabetic retinopathy ? Fortunately, laser treatment at the background of the eye provides arrest of even improvement of the disease. Laser seals the leaking and bleeding vessels. In cases of abnormal vessel formation, laser treatment extends in a large area of the background of the eye (but not in the area of central vision) and that usually causes the abnormal vessels to regress and avoids bleeding inside the eye.

What must all diabetics do ? It is mandatory that all diabetics must check the background of the eye (fundoscopy) at least once a year, irrespective of the type of diabetes, duration of the disease and diabetic control (even if it is optimal). This examination shows the presence and the severity of diabetic eye disease and the need for laser treatment. Usually the background of the eye is photographed for future follow up. It is very important to prevent serious damage at the background of the eye before significant and irreversible loss of vision happens. That can only be done with proper diagnosis and treatment.

Dr George Kampougeris has acquired extensive experience in follow up and treatment of diabetic retinopathy during his subspecialty training in the United Kingdom. He has performed over 5000 laser procedures in diabetic eyes.