Diabetic retinopathy is a complication of diabetes, caused by high blood sugar levels damaging the back of the eye (retina). It can cause blindness if left undiagnosed and untreated. However, it usually takes several years for diabetic retinopathy to reach a stage where it could threaten your sight.

The risks of not treating your eyes and not controlling the diabetic retinopathy are many. You can have blurring of vision, you can have loss of vision—some of which is recoverable once you start treatment. But you can also have permanent loss of side vision or centre vision in a way that can’t be recovered. If ignored long enough the doctor can help you but maybe not enough.

You can also have bleeding inside the eye that will completely blot out your vision. It can be extremely sudden, so that you wake up one morning and you say “I can’t see out of my eye.” It can also cause tearing above the retina with growth blood vessels that maybe can be fixed by surgery and may be not even fixable despite good surgery.

Often seeing a local Ophthalmologists or Optometrist in conjunction with your family physician or a registered dietician is a great option to dealing with eye conditions and symptoms. Smart Food Now and exercise is also important for overall health.

Presenter: Dr. Amit Gupta, Ophthalmologist, Scarborough, ONNow Health Network  Local Practitioners: Ophthalmologist

Diabetic retinopathy, we start treating from a holistic approach. We have to deal with the diabetes as it affects a patient’s body. So our first step in treating diabetic retinopathy is making sure a patient’s blood sugar is optimized, that whatever treatments they’re receiving for their diabetes in the systemic level are optimally managed, that the blood sugar is controlled with the context of good blood pressure control, cholesterol control, kidney function is assessed, and all those potential risk factors for all the complications of diabetes, but including diabetic retinopathy, are optimized.

At that point, we tend to be in a situation where we are monitoring people for the development of diabetic retinopathy. And this can typically be done with a yearly eye assessment, dilating drops and then evaluation.

And in doing that, we would tend to pick up people who have developed early diabetic retinopathy. The follow-up interval then changes. If you have changes that are worrisome, you might be coming back at the three or four monthly interval. If everything looks good, you may even be sent away for up to two years. But in general, it’s ideal to try to stick that that one-year interval as much as possible.

The treatment of diabetic retinopathy is really based on what type of retinopathy you have in your eyes. If you have swelling in the central part of your vision or near the central part of your vision, which is called diabetic macular edema, then we tend to start with one of two treatment options.

If the leakage is not very close to your center vision, we can do a little bit of laser treatment, which is a bright flashing light in the eye, and it is pretty painless and it doesn’t really set you back in terms of recovery.

You’re pretty much good to go the same day. Up to injection treatments. And we do the injection treatments when the swelling or the leakage is more in the center vision, where it’s not safe to do laser.

And there in that setting, you may undergo a series of injections with a class of drugs called anti-VEGF drugs, and those drugs – there’s a few different ones – they tend to reduce the fluid and the leakage from the blood vessels and help restore vision if it’s becoming deteriorated or if you’re having distortion or vision loss.

The other type of diabetic retinopathy, where blood vessels grow in the back of your eye and often lead to bleeding, that’s initially treated with more of an extensive laser, of the peripheral retina, and that tends to stop the blood vessels from growing and can cause them to regress and go away. That laser can be a bit more uncomfortable and often takes a lot longer to administer.

So that would be something to discuss with your ophthalmologist, the process around that in more detail if you were scheduled for a more extensive laser called pan retinal photo coagulation.

There’s also a role for the anti-VEGEF drugs in treating the type of diabetic retinopathy where blood vessels are growing, and that’s still being clarified in the literature. But there does tend to appear to be some significant benefit to using these injectable drugs when you have blood vessels that are growing in the back of your eye.

Now in the advanced stages of the blood vessel growth part of diabetic retinopathy, there can be bleeding in the eye, and there can be scar tissue that starts to pull your retina off. When those things occur, you’ll ultimately probably need a vitrectomy or surgical intervention to remove the scar tissue and blood from your eye. Local Ophthalmologist

And again, that’s a more involved procedure, and you would definitely want to discuss any issues around that with your ophthalmologist, your vitreoretinal surgeon at that point in time.

Presenter: Dr. David Maberley, Ophthalmologist, Vancouver, BC

Local Practitioners: Ophthalmologist

When it comes to treating diabetic retinopathy with injections, the frequency and duration of treatment can vary. Initially, treatment typically involves monthly injections. As your eye responds to treatment, the doctor will assess your progress and may extend the time between injections. However, because diabetes and high blood sugar levels can cause ongoing damage, ongoing treatment is often necessary.

The need for regular eye exams will depend on the severity of the disease and the doctor's observations. While treatment may improve your vision and blood sugar control, damage caused by diabetes can persist even with good control. As a result, ongoing monitoring and treatment may be necessary.

If you want more information, consult with your eye doctor, who can provide guidance on your individual treatment plan. eing a local Ophthalmologists or Optometrist in conjunction with your family physician or a registered dietician is a great option to dealing with eye conditions and symptoms. Smart Food Now and exercise is also important for overall health.  Presenter: Dr. Amit Gupta, Ophthalmologist, Scarborough, ON