Diabetic Retinopathy – FAQs
The following diabetic retinopathy questions have been answered by an American Academy of Ophthalmology member.
QUESTION #1:
Why is it important that a child receive a dilated examination once a year if the child is diagnosed with juvenile diabetes? Approximately how many children under age with juvenile diabetes are treated for eye- related problems?
ANSWER:
The American Academy of Ophthalmology recommends a yearly eye exam beginning five years after the diagnosis of diabetes. Diabetic retinopathy almost never occurs before puberty and it is not common for older teenagers to need treatment. However, yearly exams are extremely important in order to prevent serious loss of vision in those that do need treatment.
QUESTION #2:
Is there a cause and effect relationship between adult onset diabetes and macular degeneration? Will careful control of the diabetes lessen the progress of macular degeneration?
ANSWER:
There is no known relationship between type 2 diabetes and macular degeneration.
QUESTION #3
I have had a partial vitrectomy performed on both of my eyes. My right eye has started hemorrhaging again, just four months after surgery. The doctor believes there is an area of traction causing this. He advises that a second vitrectomy would make cataracts more likely later on. Why is this? And if we don’t intervene, isn’t more scar tissue likely to build up due to the bleeding?
ANSWER
Vitrectomy usually prevents further vitreous hemorrhage. If the eye does continue to bleed, a second operation may be helpful. Vitrectomy accelerates cataract formation, especially over age 50. We don’t know why cataracts develop more quickly after vitrectomy. The bleeding will not necessarily cause more scar tissue to develop. Your ophthalmologist will advise you on your particular risks.
QUESTION #4
I would like to know if it is reasonable to perform a PRK on a 30-year-old patient with myopia of 3.5 diopters. His eye fundus shows a background diabetic retinopathy with a few microaneurysms.
ANSWER
The PRK will not have any effect on diabetic retinopathy. It is reasonable to proceed.
QUESTION #5
I have had laser treatments for diabetic retinopathy. One eye still has neovascularization. What additional treatments are there?
ANSWER
Laser surgery usually causes neovascularization to shrink, but often it does not disappear. If it is not bleeding, growing or causing distorted vision, it probably does not need any further treatment. If the remaining neovascularization does cause vision problems, more laser or vitrectomy surgery may be recommended.
QUESTION #6
Is it possible to be suffering from diabetic retinopathy but not have any other outward symptoms of diabetes? Would this disease be easily diagnosed when the patient has undergone intense eye exams or can this be easily mistaken for other eye diseases? My daughter has been diagnosed with a “cone-rod dystrophy.” Can this be mistaken for diabetic retinopathy?
ANSWER
Cone-rod dystrophy would not be mistaken for diabetic retinopathy. The two conditions are very different. Once in a while, diabetic retinopathy is found in someone who does not know they have had diabetes for years. The American Diabetes Association estimates there are 8 million Americans who have undiagnosed diabetes.
QUESTION #7
My middle-aged mother had laser treatments for diabetic retinopathy. Since then, she says she doesn’t see as well at night and is bothered by the glare of headlights. She says it is a small price to pay for keeping her sight. Is this a normal consequence of laser therapy?
ANSWER
People with proliferative diabetic retinopathy often have difficulty with night vision caused by a decrease in blood flow to the area of the retina that sees at night. Panretinal laser, used to treat proliferative retinopathy, may make night vision worse. Laser surgery for macular edema is not likely to affect night vision. Macular edema or cataract are more likely to cause glare than laser surgery. By the way, I agree that decreased night vision is a small price to pay for keeping eyesight.
QUESTION #8
- Is there a cure for partial sight loss as a consequence of diabetic retinopathy ?
- What diet would you recommend for people having diabetic retinopathy (zinc rich, etc.)?
- Can diabetic retinopathy be counter-arrested by surgery, e.g. replacing part of the retina/macula?
ANSWER
- It depends on the cause of the vision loss. For example, laser surgery for macular edema will prevent further visual loss more often than it will improve vision. If the macula is not damaged and vision is blurred because of vitreous hemorrhage, sight may return to normal after the blood clears.
- There are no special dietary supplements recommended for diabetic retinopathy. It is very important to follow your regular diabetic diet.
- Vitrectomy surgery can remove blood and scar tissue from the eye in people with severe proliferative diabetic retinopathy. Unfortunately, doctors cannot yet replace the retina/macula.
QUESTION #9
I was diagnosed with minimal retinopathy this week by my ophthalmologist. I have had the disease for under five years. Most of my A1c tests have been at the high side of normal or a little over. I have started taking rezulin and this has given me even better control with the same small doses of insulin. So, my question: Once retinopathy has started, can better control reduce or eliminate it?
ANSWER
Strict control of blood sugar definitely reduces the risk of visual loss from diabetic retinopathy. However, it is very unusual for retinopathy to disappear completely.
Disclaimer: The responses provided through this service are not intended to replace consultation with an ophthalmologist. This question and answer service is intended for general educational purposes only and the responses represent the approach of the responding physician given the facts presented, not necessarily the only or best method or procedure in every case. Please refer to the Academy’s full disclaimer.
