Center for Sight

Comprehensive Eye Care Center

Eye Exams for Diabetic Eye Disease, Problems & Retinopathy

Diabetic eye disease and diabetic eye problems, such as diabetic retinopathy and diabetic macular edema, are areas of specialization for the eye doctors at Center for Sight in Fall River. Diabetic Retinopathy is the most frequent cause of new cases of blindness among adults aged 20-74 years old. However, with early diagnosis and treatment, progression of the disease and its associated vision loss can at a minimum be slowed, and in many cases vision loss from diabetic retinopathy can be prevented.

Diabetes is actually a disease of the small blood vessels throughout the body. When diabetes damages these small blood vessels it will impair the normal circulation of blood in certain organs and tissues. It is common for patients with diabetes to suffer from difficulty with the circulation in their legs, kidneys, heart, brain and eyes-especially the very small blood vessels of the eye found in the retina. When diabetes causes damage to the small blood vessels in the retina, it is called Diabetic Retinopathy. Diabetic Retinopathy tends to appear and progress in the stages as follows:

Mild Nonproliferative Retinopathy is the earliest stage of Diabetic Retinopathy. It is characterized by the presence of “dot” and “blotch” hemorrhages and “microanuerysms” in the Retina during your eye examination. Microanuerysms are areas of balloon like swelling of the tiny blood vessels in the Retina caused by the weakening of their structure. Mild Nonproliferative Retinopathy can be present without any change in your vision. Mild Nonproliferative Retinopathy usually does not require treatment unless it progresses or if it is accompanied by Diabetic Macular Edema. If you have Mild Nonproliferative Retinopathy, your doctor will make specific recommendations about how often you will need to be reexamined.

Moderate Nonproliferative Retinopathy is slightly more severe stage where some of the small blood vessels in the retina may become blocked causing a decrease in the supply of nutrients and oxygen to certain areas of the Retina. The best way to diagnose blockage of the small blood vessels in the retina is by having a diagnostic test called an Intravenous Fluorescein Angiogram (IVF).

Severe Nonproliferative Retinopathy is characterized by many of small blood vessels in the retina becoming blocked, depriving it of nourishment and oxygen resulting in a condition “Retinal Ischemia” which leads to the growth of new fragile retinal blood vessels in order to reestablish the supply of oxygen.

Proliferative Retinopathy has a significant risk of vision loss because the new fragile blood vessels-called neovascularization-tend to break easily and hemorrhage into the Vitreous leading to scarring and ultimately to retinal detachment with profound vision loss, even blindness.

Diabetic Macular Edema is a common complication of diabetic eye disease and may occur on its own or with Diabetic Retinopathy. Normally, the small blood vessels in the retina do not leak but diabetic eye disease may cause them to leak by weakening the inner lining of the blood vessels so that they become porous, resulting in swelling of the Macula-which is the center of vision. This swelling is a condition called Diabetic Macular Edema. Diabetic Macular Edema can occur in any stage of Diabetic Retinopathy. 

 The most effective and accurate ways to observe and diagnose Diabetic Macular Edema are to perform Optical Coherence Tomography (OCT) and Intravenous Fluorescein Angiography (IVF). It is possible to have Diabetic Macular Edema and not have vision loss. Dr. Kelly will review the results of your testing with you and make recommendations as to whether laser photocoagulation or perhaps Vascular Endothelial Growth Factor (VEGF) Inhibitor injections such as Lucentis® or Eyelea® offer the best course of treatment to prevent vision loss in these instances. Today, for most patients, VEGF inhibitor intravitreal injections such as Lucentis® or Eylea®, which are less destructive and safer than laser treatments, are considered as primary therapy for the management of vision-threatening complications of diabetic retinopathy such as diabetic macular edema (DME).