Diabetes and Eye Health
Diabetes is a common metabolic disorder characterized by persistent hyperglycemia of varying severity due to insulin deficiency or decreased effectiveness of insulin. Diabetes is divided into Type 1 and Type 2. Diabetic Retinopathy (DR) is more common in type 1 diabetes (40%) than in type 2 diabetes (20%) and is the most common cause of low vision between the ages of 20 and 65.
1.Why Does Diabetes Cause Eye Hemmorages?
2.What Are Eye Complaints In Diabetic Patients?
3.What Are The Stages Of Diabetic Retinopathy?
4.Which Examinations And Tests Are Used In The Diagnosis And Follow-up Of Diabetic Eye Symptoms?
5.How Is Diabetic Retinopathy Treated?
6.Which Drugs Are Used In Intraocular Injections In Diabetic Retinopathy?
7.What Is Argon Laser Therapy?
WHY DOES DIABETES CAUSE EYE HEMORRHAGES?
Constantly high blood sugar in diabetes disrupts the capillary structure in the retinal layer of the eye, as in all body organs. Bleeding in the retinal layer causes low vision and reduces the quality of vision. At the beginning of the disease, mild eye symptoms do not cause complaints. As the symptoms progress, complaints of blurred vision begin. Early diagnosis and treatment is very important in diabetic retinopathy. Treatment should be performed before the critical level, i.e. ischemia occurs.
WHAT ARE EYE COMPLAINTS IN DIABETIC PATIENTS?
In the early stages of the disease, there may be no complaints or temporary visual impairment. As the disease progresses, eye complaints increase. These complaints include
- Blurred vision
- Floaters in the eye, spider web-shaped images
- No increase in vision with glasses
- Difficult vision when driving, reading a book.
- Light sensitivity
- Sudden loss of vision in heavy bleeding
WHAT ARE THE STAGES OF DIABETIC RETINOPATHY?
Diabetic Retinopathy has three main stages. It progresses from a lower stage to a higher stage with the duration and severity of the diabetes. These stages are as follows.
First Stage (Background Diabetic Retinopathy): There are small hemorrhages (microaneurysms) at several points in the eye. Sometimes there may be transient eye complaints. No treatment is needed at this stage. Eye examinations are required every six months or once a year. If diabetes is not under control, the eye passes to the second stage after a certain period of time.
Second Stage (Preproliferative Diabetic Retinopathy): Bleeding in the eye has increased. Macular edema has occurred and most importantly ischemia has occurred in the retina. In this stage, vision decreases. Floaters can be seen in front of the eye. Treatment is necessary. Argon laser treatment is applied.
Third Stage (Proliferative Diabetic Retinopathy): There are diffuse hemorrhages in the retinal layer, lipid deposits in the retinal layer called hard exudate, edema in the visual center and retinal ischemia due to lack of oxygen in the peripheral retina. In addition, the most important characteristic of this stage is the formation of new weak vessels. Very intensive treatment is required at this stage. If argon laser treatment has not been started, it should be started and completed immediately, and if there are areas that have been started but not completed, these areas should be lasered. In addition to laser, intraocular injections should be performed for the visual center and new vessel formations.
WHAT EXAMINATIONS AND TESTS ARE USED IN THE DIAGNOSIS AND FOLLOW-UP OF DIABETIC EYE SYMPTOMS?
Ophthalmoscopy: During the eye examination, bleeding, macular edema and new vascular formations can be seen by looking directly at the bottom of the eye (behind the eye).
Fundus Flurosein Angiography: Intravenous flurosein dye (10 cc) is used to visualize the retinal vessels and the retinal layer. Before argon laser treatment, it helps to decide on the areas to be treated with laser. Detailed information about the back of the eye is obtained with special photographs taken in the early, middle and late stages.
OCT Angiographies have recently come into use. In these, it is not necessary to administer flurosein into the body intravenously. Images are created by analyzing the blood flow in the vessels.
Optical Coherence Tomography (OCT): It is a non-invasive procedure. It mostly provides information about the signs of diabetes in the central retina (macular edema).
HOW IS DIABETIC RETINOPATHY TREATED?
In the first stage of the disease, only follow-up is performed. No treatment is needed. In the second stage, argon laser treatment is applied. In the third stage, intraocular injections are performed in addition to argon laser treatment.
WHICH DRUGS ARE USED IN INTRAOCULAR INJECTIONS IN DIABETIC RETINOPATHY?
Anti-Vascular Endothelial Growth Factor (VEGF) Inhibitors: They are the most common group of drugs given intraocularly. They help prevent abnormal growth of retinal vessels. These drugs are used to treat conditions such as age-related macular degeneration (AMD), diabetic retinopathy and retinal vascular occlusion.
Corticosteroids: Corticosteroids injected into the eye reduce inflammation in the eye and prevent edema formation. It is especially used in the treatment of conditions such as intraocular inflammation (uveitis) or macular edema.
Steroid Implants: In some cases, steroid implants can be placed in the eye to provide a long-lasting effect. These implants provide a gradual release of medication over a long period of time and can control inflammation in the eye.
WHAT IS ARGON LASER TREATMENT?
Argon laser is a type of laser that produces a high-energy light beam. This laser beam is used to treat deoxygenated and dysfunctional retinal areas in the eye, allowing more oxygen to reach healthy retinal areas. Small vascular dilatations are closed and leaks from these areas to the retina are prevented. The treatment is usually completed in 3-4 sessions. The eye is numbed to prevent pain.
The website content has been created for informational purposes. It does not constitute a diagnosis or treatment recommendation. An ophthalmologist should be consulted for definitive diagnosis and treatment.
