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Diabetic Retinopathy

More than 17 million Americans have diabetes, a disease that can hurt your eyes, kidneys, nerves and heart. Diabetes is the leading cause of blindness in the United States, causing up to 24,000 people to lose their vision every year.

Diabetes disproportionately affects seniors. Half of all cases occur in people older than 55 years of age. And 20 percent of all seniors older than 65 years – seven million Americans – have diabetes.

The good news is that with careful management, ill effects can be minimized.

About diabetes

In diabetes, the body does not properly create or use insulin, a hormone that helps your body convert food into energy. In Type I diabetes, sometimes called juvenile diabetes, the body does not produce insulin. This form of diabetes accounts for up to 10 percent of all cases. Individuals with Type I diabetes must monitor their blood sugar levels and inject insulin into their bodies in order to properly digest the energy that comes from food.

People with Type II diabetes, or adult-onset diabetes, make up almost 90 percent of all cases. Individuals with this form of the disease can produce insulin, but their bodies do not readily use it. While body cells become starved for energy, digested sugar builds up in the blood stream. This buildup of sugar in the blood is what causes the damage to your retina, heart and other organs.

While there is no cure for Type II diabetes, it can be treated with a combination of diet, exercise and medicine.

Diabetic retinopathy

The greatest threat to vision from diabetes is diabetic retinopathy. It causes small blood vessels that line your retina to weaken from excessive blood sugar, eventually rupturing, blurring your vision and causing swelling. The retina is the light-sensitive nerve tissue that lines the back of your eye, transmitting visual information to your brain. If diabetic retinopathy is untreated, about half of all cases will result in blindness.

People with diabetes are twice as likely as the general population to get cataracts and glaucoma.

Preventing diabetic retinopathy

The most important thing any diabetic can do is properly manage their blood sugar. The most extensive study to date about diabetes and vision found that people who properly manage their blood sugar were able to reduce their risk of vision loss by 75 percent over a nine-year period.

It is important for all diabetics to have an annual dilated eye exam. Dilation allows your eye doctor to look for signs of damaged blood vessels.

There are other ways to reduce the risk from diabetic retinopathy. Studies show that it is important to manage high blood pressure, keep cholesterol low through a combination of diet and exercise, and avoid smoking.

Treatment options

While no treatment can cure diabetic retinopathy, there are treatment options that an ophthalmologist can employ to reduce vision loss. Laser surgery may be used to either shrink or destroy leaking or abnormal blood vessels on the retina. Another treatment option is a vitrectomy, which removes cloudy vitreous fluid and replaces it with a clear saline solution.