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Diabetic Eye Specialists

Diabetes is a chronic condition that affects how the body processes blood glucose (also referred to as blood sugar), which is the primary source of energy that our body uses to perform all functions. When we eat food, the food is broken down into sugar, which is dispersed throughout the body via the bloodstream. Blood glucose is regulated by the anabolic hormone insulin, which is responsible for making sure that the proteins, carbohydrates, and fats from the foods we consume are being properly metabolized and distributed throughout the body’s cells.

In diabetes, the production of insulin is disrupted in some way – the body either doesn’t produce enough insulin or is unable to effectively use the insulin that is being produced. When this happens, glucose remains in the bloodstream for a prolonged period of time, causing damage to blood vessels throughout the body.

If left untreated and unmanaged, diabetes can cause a myriad of health problems, including serious vision issues. Diabetic eye diseases are most commonly caused by damage incurred within the retinal vascular system. In severe cases, patients with diabetic eye diseases can experience permanent vision loss. However, many diabetes-related conditions are easier to manage and treat when detected in their earliest stages. As such, if you have been diagnosed with Type 1 or Type 2 diabetes, it’s crucial that you see a diabetic eye specialist.

What conditions do diabetic eye specialists treat?

A diabetic eye specialist is usually a retina specialist who is an ophthalmologist with extra training in retinal diseases which includes eye diseases associated with diabetes. There are many diseases that patients with diabetes are susceptible to.

Diabetic Retinopathy

Diabetic retinopathy is one of the main eye diseases that patients with diabetes can develop. It is a progressive eye disease that is characterized by the presence of weakened, fragile, and damaged blood vessels in the retina. The earliest form of this condition is known as background diabetic retinopathy. At this stage, the damaged blood vessels can develop microaneurysms, which are small outpouchings of blood that bulge against the walls of the retinal blood vessels. When broken, microaneurysms can bleed into the retinal tissues.

In the earliest stages of diabetic retinopathy, patients may not experience any noticeable symptoms. As the disease progresses, it can transition into what is known as proliferative diabetic retinopathy. At this advanced stage, blood vessel damage begins to impede circulation. In an attempt to rectify the loss of normal circulation, the retina begins to form abnormal blood vessels through a process called neovascularization. Unlike regular, healthy blood vessels, these new abnormal blood vessels are extremely fragile, weak, and prone to breakage. When they break, these abnormal blood vessels can cause bleeding inside the eye and scar tissue formation that can lead to sight-threatening tractional retinal detachments. Learn more about diabetic retinopathy.

Diabetic Macular Edema

Diabetic macular edema is a complication of diabetic retinopathy. It occurs when the abnormal blood vessels leak fluid into the central portion of the retina known as the macula. As the fluid accumulates, the macula begins to swell. Diabetic macular edema typically decreases your central reading vision and if not treated properly can lead to permanent central vision loss.

Glaucoma

Glaucoma is an eye condition defined by damage to the optic nerve caused by excessive pressure within the eye. It is one of the most common causes of permanent vision loss in older adults. There are different types of glaucoma, with the two main types being open-angle and angle-closure glaucoma. The condition can cause a wide variety of symptoms, including:

• Eye pain
• Blurred vision
• Halos around lights
• Headaches
• Blind spots in central or peripheral vision

Patients with diabetes are twice as likely to develop glaucoma.

Cataracts

Cataracts are a common eye condition in which the ocular lens becomes cloudy. In a healthy eye, the lens acts very much like a camera lens; light passes through it and is refracted towards the back of the eye where the retina captures and converts the light into neural impulses. For light to pass through, the lens must be clear like glass. Cataracts typically develop slowly over time and can impair vision in several ways, including blurriness, dulled color perception, double vision, light sensitivity, and poor night vision.

Cataracts are most commonly caused by aging. Patients with diabetes are much more likely to develop cataracts.

Other Conditions

In addition to the above conditions, diabetes can also increase a patient’s risk for developing other retinal conditions, including:

• Wet age-related macular degeneration (AMD), a disease in which the macula deteriorates and abnormal neovascularization occurs
• Retinal vein and artery occlusions, a group of conditions that cause issues in the retinal vascular system
• Retinal detachment, a serious condition in which the retina is pulled out of place.

When should I see a diabetic eye specialist?

Although diabetic eye disease can be very serious, in many cases it can be managed if diagnosed early. Patients with diabetic eye conditions who are proactive about their vision health have a good chance of maintaining and preserving their vision for many years to come.

If you have been diagnosed with Type 1 or Type 2 diabetes, you should plan on having a thorough exam from a diabetic eye specialist annually. For patients with Type 1 diabetes, it’s recommended to schedule your first exam within the first five years of being diagnosed. For patients with Type 2 diabetes, the recommendation is to schedule an exam with a diabetic eye specialist as soon as you have been diagnosed whether or not you have any symptoms. Similarly, pregnant women who have diabetes should schedule a diabetic eye exam as soon as they become pregnant.

It’s important to not procrastinate when it comes to preventative care for diabetic eye diseases, even if you’re not experiencing any symptoms. There are certain early signs of diabetic eye diseases that can only be detected through a thorough diabetic eye exam. If you are experiencing any of the following symptoms, you should schedule an appointment with a diabetic eye specialist as soon as possible:

• Blurred vision
• Visual distortions (e.g. straight lines appearing wavy or broken)
• Colors appearing dull or faded
• Darkened areas in central vision
• Frequent vision changes
• Floaters (dark or translucent specks, spots, strings, and cobweb shapes in your vision)
• Flashes of light

If you experience a sudden increase in floaters or flashes of light in your vision, call your doctor right away. A sudden proliferation of these symptoms can indicate that the retina is torn or is about to detach. Retinal detachment is an emergency that can lead to permanent vision loss and needs to be evaluated immediately.

Diabetic Eye Exams

A diabetic eye exam is a comprehensive diagnostic process in which a diabetic eye specialist examines the retina, the retinal vascular system, and vitreous humor for signs of diabetic eye diseases.

• The exam begins with your doctor taking an inventory of your medical history and vision health.
• Next, the doctor will ask you to read an eye chart to assess your visual acuity.
• The doctor will administer eye drops to dilate your pupils. Eye dilation widens the pupil, making it easier for your doctor to see inside of your eye and your retina. Using a slit lamp, which is a microscope with a bright light, and an ophthalmoscope, your doctor will examine your retina.
• Your doctor may also perform an optical coherence tomography (OCT) test, which is a non-invasive imaging procedure that captures cross-sectional images of your retina using low-coherence light.
• Another common imaging technique that is frequently used during diabetic eye exams is fluorescein angiography. In this exam, a light-sensitive dye is injected into the patient via IV. When the dye arrives in the retinal vascular system, your doctor will shine a special blue light on the retina to highlight the dye. Images of the vascular system are captured using a high-definition camera. This test helps diabetic eye specialists detect damage in the retinal vessels.
• Fundus photography may also be performed during a diabetic eye exam. Fundus photography uses a microscope attached to a camera to capture high-definition images of the retina, macula, and optic nerve.
• During the exam, the diabetic eye specialist will also check your eyes for signs of glaucoma and cataracts.

A diabetic eye exam generally takes about 1-2 hours from start to finish but can take longer depending on which retinal imaging exams are performed. Learn more about retinal diagnostic testing.

Treatment for Diabetic Eye Diseases

There are several treatment options available for diabetic eye diseases. Treatment generally depends on the exact condition and severity. Some treatment options include:

• Preventative medicine and managing blood sugar levels: In some cases, patients with diabetes can stave off the effects of diabetic eye diseases by diligently monitoring and managing their blood sugar levels. To maintain healthy blood sugar levels, patients should engage in physical activity daily and consume a diabetic-friendly diet consisting of high-fiber carbohydrates (vegetables, low-glycemic fruits, whole grains, legumes), heart-healthy proteins (fish, poultry), and healthy fats (avocados, olive oil, nuts). Patients should also keep track of their blood sugar levels using a blood sugar meter.
• Anti-vascular endothelial growth factor (anti-VEGF) injections: One of the most serious effects of diabetic eye disease is abnormal neovascularization, in which irregular blood vessels form in the retina. Anti-VEGF medications such as Avastin, Eylea, and Lucentis are sometimes used to stop these abnormal blood vessels from forming and causing more damage. They can also treat diabetic macular edema. These medications are administered directly into the eye via injection. Learn more about anti-VEGF retinal injections.
• Steroid injections: Corticosteroids are sometimes used to treat retinal swelling caused by diabetic macular edema. Like anti-VEGF medications, steroids are injected directly into the eye.
• Laser photocoagulation: Laser photocoagulation is a surgical procedure that uses a laser to cauterize leaking blood vessels. It can also be used to create scar tissue that seals off retinal tears or holds a detached retina in place.
• Vitrectomy surgery: Vitrectomy is a surgical procedure that involves removing the vitreous gel that fills the inner cavity of the eye. This procedure is commonly performed in cases of retinal detachment or if there is a vitreous hemorrhage present. Learn more about retinal surgery.

Leading Diabetic Eye Specialists in Austin, TX

For over 40 years, the physicians of Austin Retina Associates have provided advanced care for the full range of diabetic retinal diseases to patients throughout the Greater Austin region. To schedule an appointment with our diabetic eye specialists, contact Austin Retina Associates today.