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Diabetes Puts You At Greater Risk for Eye Diseases Like Diabetic Retinopathy & Glaucoma.

People living with diabetes should have their eyes examined annually to monitor for the development of eye diseases. Most eye diseases develop unnoticed until they have already caused permanent vision loss. Eye exams ensure you detect developing diseases proactively.

Diabetes can have a profound impact on your eyes, especially if you struggle managing your blood sugar levels. The Canadian Association of Optometrists (CAO) recommends annual eye exams for people living with diabetes, and Alberta Health provides annual financial coverage for the health exam as well.

Staying on top of your eye health is vital. It is the difference between many more years of great vision quality and the irreversible loss of vision. As dramatic as it may sound, most eye diseases initially form without symptoms. For people with diabetes, the eye exam goes into more depth to check for signs of diseases like diabetic retinopathy and diabetic macular edema (DME).

Your diabetic eye exam uses dilation and more extensive testing to provide greater insight into your retinal health; you may not be comfortable driving after the exam.

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Annual Dilated Eye Exams Are Important

From start to finish, an eye exam takes under an hour to complete. Request an appointment to schedule your comprehensive dilated eye exam.

Diabetic retinopathy and diabetic macular edema are additional concerns for people living with diabetes. Nearly 80% of people living with diabetes for more than 20 years will develop some form of diabetic eye disease. Of them, nearly 50% will be unaware.

Diabetic Retinopathy – Diabetic retinopathy is a serious eye disease that can lead to total blindness (in advanced stages). It has multiple stages, and initially develops without symptoms.

  • Mild nonproliferative retinopathy – Your vision is likely unaffected and there is no pain. Under examination, small balloon-like blood vessels on the retina are swollen and may leak fluid into the retina.
  • Moderate nonproliferative retinopathy – Some blood vessels on the retina lose their ability to transport blood. This causes visible changes to the retina and contributes to the development of DME.
  • Severe nonproliferative retinopathy – The retina is now blood-starved due to many blood vessels being blocked. At this point, the blood vessels and surrounding areas secrete growth factors that will promote the growth of new blood vessels.
  • Proliferative diabetic retinopathy – The final stage of retinopathy, new but weak blood vessels are growing to replace the ones that have died. Because of their weakness, these new blood vessels causes adhesions to develop with the vitreous ( a gel-like substance that helps the eye maintain a round shape), which can then contract and cause a detachment.

Panretinal photocoagulation can be used to shrink blood vessels. During this surgery, between 1,000 and 2,000 burns are made with a laser.

This treatment can be effective for preserving central vision, but often it comes at the expense of peripheral and night vision.

DME is the build-up of fluid on the retina. About half of all people with diabetic retinopathy will also develop DME. DME can form at any stage of retinopathy’s development, though is more likely to occur in the retinopathy’s advanced stages.

During an eye exam, several tests are performed that can be used to detect for retinopathy or DME, including advanced retinal imaging and OCT imaging equipment. In a dilated eye exam, these tests are performed in addition to the eye being dilated for better viewing of the back of the eye.

There are three main treatments for DME. They may be used alone or as a combination.

  • Anti-VEGF injection therapy – This therapy blocks a protein called endothelial growth factor (VEGF). Blocking VEGF can reverse blood vessel growth, decrease fluid on the retina, and decrease scar tissue formation.

    Treatment lasts for years, with treatment frequency decreasing over time.

  • Focal/grid macular laser surgery – A fine laser is used to burn the retina where blood vessels are growing in areas of edema. This slows the leakage of fluid and reduces retinal swelling.
  • Corticosteroids – Injected or topical corticosteroids can be used to treat DME. However, long-term use has been linked to increased eye pressure (an indicator of glaucoma) and cataract development.

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