Diabetes causes damage to the blood vessels in the retina, resulting in diabetic retinopathy. People with diabetes are at an increased risk of developing this condition, which is among the top causes of vision loss worldwide. Despite the fact that vision loss resulting from diabetes is preventable, diabetic retinopathy is the leading cause of legal blindness in Americans ages 20-74.

How common is diabetes in New York?

Nationwide the CDC reports that 37.3 million or 11.3% of the US population has diabetes and another 96 million or 38% of the adult population has pre-diabetes. Surprisingly 23% of adults with diabetes are currently undiagnosed and not receiving any medical care to manage their condition. According to the New York State Department of Health there are currently over 1.6 million New Yorkers with Diabetes. Bronx county had the highest prevalence of diabetes at 16% of the population.

How common is diabetic retinopathy in New York?

A recent study by the CDC showed that out of the national population that has diabetes, 38% of African Americans, 34% of Hispanic Americans, and 26% of white Americans have diabetic retinopathy. The New York State Department of Health estimates that one in three people with diabetes, and half of people with diabetes aged 45-65 years, have some stage of diabetic retinopathy.

What is a diabetic eye exam?

A patient with diabetes should have bi-annual eye exams using advanced imaging to monitor their eye health and ensure that their diabetes is not progressing to diabetic retinopathy. For diabetic patients we will use a specialized device that takes high resolution images of the retina, this helps your eye doctors monitor any potential complications. Furthermore we run a highly specialized test called electroretinography, this will show cellular damage before any permanent damage has been done. With these tests and other standardized tests, we can report back to your general practitioner whether your diabetes is being managed effectively.

What is diabetes?

There are two types of diabetes; type 1 is a genetic disorder that often manifests itself early in life, and type 2 occurs over time due to diet and lifestyle choices.

Generally, food that we eat is broken down into glucose and then travels through the bloodstream. In response to high blood sugar levels, the pancreas releases insulin, an essential hormone that converts sugar into energy for your cells. When someone has diabetes their body either does not create enough insulin or does not react properly to insulin.

Types of diabetic retinopathy

Diabetic retinopathy is also sometimes called diabetic eye disease, and it is a result of uncontrolled blood sugar in type 1 and type 2 diabetics. When a person’s diabetes turns into diabetic retinopathy, their retina will incur damage due to the abnormal blood flow from their uncontrolled diabetes. The longer a person has diabetes and the less controlled their blood sugar is, the more likely they are to have diabetic retinopathy.

Diabetic retinopathy can be classified into two types. Nonproliferative and proliferative diabetic retinopathy.

Nonproliferative Diabetic Retinopathy

There are three stages of nonproliferative diabetic retinopathy: mild, moderate, and severe.

As far as non-proliferative diabetic retinopathy is concerned, optometrists typically monitor these patients, make sure that their patients are properly complying with all diabetic medications, and schedule follow-up appointments with their primary care physician and endocrinologist. To keep their blood sugar levels in check, it's crucial to practice a healthy diet and lifestyle. Patient’s awareness of their hemoglobin levels and blood sugar levels is crucial, as the more aware they are, the better able they will be to take proper precaution should any of those levels start to rise.

Proliferative Diabetic Retinopathy

Another type of diabetic retinopathy is proliferative, in which new leaky blood vessels begin to form. When it becomes proliferative diabetic retinopathy, blood can leak into the retina, causing significant vision loss and in most cases the resulting loss of vision is permanent.

Diabetic retinopathy: What are the symptoms?

When this condition is in its early stages, there may not be any symptoms. Symptoms of diabetic retinopathy may include:

• Blurred vision
• Floating spots or lines in your field of vision
• Reduced color vision
• Blind spots
• Loss of vision

What are diabetic retinopathy’s risk factors?

The risk of diabetic retinopathy increases for people with type 1 or type 2 diabetes, as well as for those with certain medical conditions. Diabetes increases a person's risk of diabetic retinopathy over time. The worse a person's blood sugar is controlled, the greater the chance of diabetic retinopathy affecting their eyes.

Among the other risk factors are:

• Those who are Hispanic and African-American are at a greater risk
• Conditions such as high blood pressure or high cholesterol
• Pregnancy
• Smoking

How can diabetic retinopathy be prevented?

Diabetic retinopathy is not always preventable, but there are certain proactive measures that could be taken to lower your chance of developing this condition. It's advisable to take your prescribed medication for diabetes and to do what you can to maintain good control of your blood sugar and blood pressure. In addition, regular eye exams and early detection of changes due to this condition can really help prevent serious loss of vision. We recommend scheduling an eye exam with an optometrist that has an OCT and ERG. These two advanced technologies provide your eye doctor with more information in real time to prevent progression of diabetic retinopathy.

Try to be aware of any changes in your vision and please contact us right away if you notice any sudden differences such as spotty or blurry vision.

It is strongly recommended to quit smoking in order to prevent damage to your vision due to diabetic retinopathy.