Digital Retinal Camera

Diabetic Retinopathy

Diabetic retinopathy is damage to the eye's retina that occurs with long-term diabetes. Symptoms of diabetic retinopathy include:

Blindness
Blurred vision
Floaters
Shadows or missing areas of vision

Many people with early diabetic retinopathy have no symptoms before major bleeding occurs in the eye. This is why everyone with diabetes should have regular eye exams. Treatment usually does not reverse damage that has already occurred, but it will keep the disease from getting worse. Drugs are being developed that keep abnormal blood vessels from growing in patients with proliferative diabetic retinopathy.

Laser surgery or photocoagulation may be used to keep vessels from leaking or to get rid of abnormal fragile vessels. A surgical procedure called vitrectomy is used when there is bleeding (hemorrhage) into the eye. It may also be used to repair retinal detachment.

Diabetic retinopathy is caused by damage to blood vessels of the retina, the light-sensitive inner layer of the eye. There are two types: non-proliferative or proliferative.

Non-proliferative diabetic retinopathy is the early stage of the disease and is less severe. Blood vessels in the eye start to leak fluid into the retina, which leads to blurred vision.

Proliferative retinopathy is the more advanced form of the disease, and more severe. New blood vessels start to grow in the eye. These new vessels are fragile and can bleed (hemorrhage), which may cause vision loss and scarring of the retina.

Diabetic retinopathy is the leading cause of blindness in working-age Americans. People with both Type 1 and Type 2 diabetes are at risk for this condition. Having more severe diabetes for a longer period of time increases the chance of getting retinopathy. Retinopathy is also more likely to occur earlier and be more severe if your diabetes is poorly controlled. Almost everyone who has had diabetes for more than 30 years will show signs of diabetic retinopathy.

Tight control of blood sugar, blood pressure, and cholesterol is very important for preventing diabetic retinopathy. People with diabetes should begin having eye examinations as follows:

Children older than 10 years who have had diabetes for 3 - 5 years or more
Adults with type 2 diabetes soon after diagnosis
Adolescents and adults with type 1 diabetes within 5 years of diagnosis

After the first exam, most patients should have a yearly eye exam. If you are beginning a new exercise program or are planning to get pregnant, have your eyes examined. Avoid resistance or high-impact exercises, which can strain already weakened blood vessels in the eyes.

Glaucoma

Glaucoma is a group of eye disorders leading to progressive damage to the optic nerve, and is characterized by loss of nerve tissue resulting in loss of vision. The optic nerve is a bundle of about one million individual nerve fibers and transmits the visual signals from the eye to the brain. The most common form of glaucoma, primary open-angle glaucoma, is associated with an increase in the fluid pressure inside the eye. This increase in pressure may cause progressive damage to the optic nerve and loss of nerve fibers. Vision loss may result. Advanced glaucoma may even cause blindness. Not everyone with high eye pressure will develop glaucoma, and many people with normal eye pressure will develop glaucoma. When the pressure inside an eye is too high for that particular optic nerve, whatever that pressure measurement may be, glaucoma will develop.

Glaucoma is the second leading cause of blindness in the U.S. It most often occurs in people over age 40, although a congenital or infantile form of glaucoma exists. People with a family history of glaucoma, African Americans over the age of 40, and Hispanics over the age of 60 are at an increased risk of developing glaucoma. Other risk factors include thinner corneas, chronic eye inflammation, and using medications that increase the pressure in the eyes.

The most common form of glaucoma, primary open-angle glaucoma, develops slowly and usually without any symptoms. Many people do not become aware they have the condition until significant vision loss has occurred. It initially affects peripheral or side vision, but can advance to central vision loss. If left untreated, glaucoma can lead to significant loss of vision in both eyes, and may even lead to blindness.

A less common type of glaucoma, acute angle closure glaucoma, usually occurs abruptly due to a rapid increase of pressure in the eye. Its symptoms may include severe eye pain, nausea, redness in the eye, seeing colored rings around lights, and blurred vision. This condition is an ocular emergency, and medical attention should be sought immediately, as severe vision loss can occur quickly.

Glaucoma cannot currently be prevented, but if diagnosed and treated early it can usually be controlled. Medication or surgery can slow or prevent further vision loss. However, vision already lost to glaucoma cannot be restored. That is why the American Optometric Association recommends an annual dilated eye examination for people at risk for glaucoma as a preventive eye care measure. Depending on your specific condition, your doctor may recommend more frequent examinations.

Macular Degeneration

Macular degeneration is an eye disorder that makes it difficult to see fine details. The condition affects the macula, the part of the retina responsible for central vision. At first you may not have symptoms. As the disease progresses, your central vision can be affected.

The most common symptom in dry AMD is blurred vision. As the disease progresses, you may need more light to read or perform everyday tasks. The blurred spot in the center of vision gradually gets larger and darker. In the later stages, you may not be able to recognize faces until people are close to you.

AMD typically does not affect side (peripheral) vision. This is very important, because it means you will never have complete vision loss from this disease.

The most common early symptom of wet macular degeneration is that straight lines appear distorted and wavy. You may also notice a small dark spot in the center of your vision that gradually gets larger.

No treatment exists for dry macular degeneration. However, a combination of antioxidants and zinc may slow the progression of the disease. Smokers should not use this treatment. The recommended supplements contain:

500 milligrams of vitamin C
400 International Units of beta-carotene
80 milligrams of zinc
2 milligrams of copper

Although there is no cure for wet AMD, treatments may include:

Laser surgery (laser photocoagulation) -- a small beam of light destroys the abnormal blood vessels.
Photodynamic therapy -- a light activates a drug that is injected into your body to destroy leaking blood vessels.
Special medications that slow the formation of new blood vessels in the eye (anti-angiogenesis (anti-VEGF) therapy) -- drugs such as bevacizumab (Avastin) and ranibizumab (Lucentis) are injected into the eye to stabilize or improve vision.

Low-vision aids (such as special lenses) and therapy can help improve your vision and quality.

Diet and Nutrition

There’s no substitute for the quality of life good vision offers. Adding certain nutrients to your diet every day – either through foods or supplements – can help save your vision. Researchers have linked eye-friendly nutrients such as lutein/zeaxanthin, vitamin C, vitamin E and zinc to reducing the risk of certain eye diseases, including macular degeneration and cataract formation. In the last 20 years, eye health research has linked diet and nutrition with a decreased risk of age-related macular degeneration (AMD).

Lutein & Zeaxanthin: Lutein and zeaxanthin are important nutrients found in green leafy vegetables, as well as other foods, such as eggs. Many studies have shown that lutein and zeaxanthin reduce the risk of chronic eye diseases, including age-related macular degeneration and cataracts.
Vitamin C: Vitamin C (ascorbic acid) is an antioxidant found in fruits and vegetables. Scientific evidence suggests vitamin C lowers the risk of developing cataracts, and when taken in combination with other essential nutrients, can slow the progression of age-related macular degeneration and visual acuity loss.
Vitamin E: Vitamin E in its most biologically active form is a powerful antioxidant found in nuts, fortified cereals and sweet potatoes. It is thought to protect cells of the eyes from damage caused by unstable molecules called free radicals which break down healthy tissue.
Essential Fatty Acids: Fats are a necessary part of the human diet. They maintain the integrity of the nervous system, fuel cells and boost the immune system. Two omega-3 fatty acids have been shown to be important for proper visual development and retinal function.
Zinc: Zinc is an essential trace mineral or ‘helper molecule.’ It plays a vital role in bringing vitamin A from the liver to the retina in order to produce melanin, a protective pigment in the eyes. Zinc is highly concentrated in the eye, mostly in the retina and choroid, the vascular tissue layer lying under the retina.

Spots and Floaters

Spots (often called floaters) are small, semi-transparent or cloudy specks or particles within the vitreous, which is the clear, jelly-like fluid that fills the inside of your eyes. They appear as specks of various shapes and sizes, threadlike strands or cobwebs. Because they are within your eyes, they move as your eyes move and seem to dart away when you try to look at them directly.

Spots are often caused by small flecks of protein or other matter trapped during the formation of your eyes before birth. They can also result from deterioration of the vitreous fluid, due to aging; or from certain eye diseases or injuries.

Most spots are not harmful and rarely limit vision. But, spots can be indications of more serious problems, and you should see your optometrist for a comprehensive examination when you notice sudden changes or see increases in them. By looking in your eyes with special instruments, your optometrist can examine the health of your eyes and determine if what you are seeing is harmless or the symptom of a more serious problem that requires treatment.

Hypertension

Hypertension is the term used to describe high blood pressure.

Blood pressure readings are measured in millimeters of mercury (mmHg) and usually given as two numbers. For example, 120 over 80 (written as 120/80 mmHg).

The top number is your systolic pressure, the pressure created when your heart beats. It is considered high if it is consistently over 140.
The bottom number is your diastolic pressure, the pressure inside blood vessels when the heart is at rest. It is considered high if it is consistently over 90.

Either or both of these numbers may be too high.

Pre-hypertension is when your systolic blood pressure is between 120 and 139 or your diastolic blood pressure is between 80 and 89 on multiple readings. If you have pre-hypertension, you are more likely to develop high blood pressure.