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VeteransEyeCare.com

Diabetes

Signs To Look For/Symptoms:

There are 2 types of diabetic retinopathy: nonproliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR).

Nonproliferative diabetic retinopathy is the early stage of diabetic retinopathy, and the symptoms are a leaking fluid that causes the retina to swell or form deposits called exudates.

Proliferative diabetic retinopathy symptoms include when abnormal new vessels begin growing on the surface of the retina or the optic nerve.

Clinically observable symptoms are red lesions, white lesions, abnormalities in the caliber of the retinal vessels, and retinal thickening.

Risk Factors:

A risk factor of NPDR is mild to severe vision loss, but even in the worst cases, peripheral vision continued to function.

PDR’s risk factor is severe vision loss which can be caused in several ways:

  • Vitreous hemorrhage: where the abnormal new vessels bleed into the vitreous, a clear, gel-like substance that fills the center of the eye. This can block the person’s vision depending on how large the floaters are.
  • Traction retinal detachment: where scar tissue associated with neovascularization shrinks, thus causing the retina to shift from its normal position. This can lead to visual distortion.
  • Neovascular glaucoma: where extensive retinal closure causes new abnormal blood vessels to grow on the iris and block the normal flow of fluid out of the eye. This cause pressure to build up in the eye, resulting in neovascular glaucoma that causes damage to the optic nerve.

Preventative Measures:

In order to prevent diabetic retinopathy, strict control of your glucose, blood pressure, and lipid levels, will reduce the long-term risk of vision loss.

Early detection of diabetic retinopathy can prevent against vision loss. Retinal examinations are recommended every 2 years.

Recommendations:

Laser surgery is often recommended for people with macular edema PDR, and neovascular glaucoma.

Digital imaging systems should improve the quality of retinal screening and detection.

Eye Disease in Veterans with Diabetes

Diabetes is the number one cause of blindness in adults each year, according to the American Diabetes Association.  In people with diabetes, loss of vision can result from eye disease complications such as cataracts, glaucoma and diabetic retinopathy. 

The good news is that the combination of regular eye exams, appropriate referral, diagnosis and timely treatment leads to the best visual outcomes.  This is why it is so important for veterans with eye disease or veterans with diabetes to get an annual eye examination from an ophthalmologist.  In fact, VA guidelines call for an annual eye exam or a biennial follow-up exam in patients who have diabetes. 

The VA health care system was established so that vets could receive the best treatment possible.  However, the vet participation is the one variable that the VA does not control.  The American Academy of Ophthalmologists encourages all veterans to utilize the VA system and get an eye exam.

Did You Know?

  • Eye procedures performed in veterans with diabetes accounted for about ¼ of all eye surgeries performed in the VA system.
  • Nearly 85% of veterans with diabetes got an eye exam in one calendar year.
  • Most veterans with diabetes and with a lower-limb amputation also had an eye exam in the same year.  This is important because having a lower-extremity amputation for diabetes-related reasons increases risk for diabetic retinopathy.
  • Nearly 5%of all veterans are blind.  These 11,500 veterans require rehab and care in a VA healthcare system.