Regular eye exams essential for diabetics

Diabetes when left untreated is the largest cause of blindness in the United States.  It is for this reason that annual eye exams are strongly recommended for all diabetics.  Diabetes develops due to damage of the beta cells of the islets of Langerhans named after Paul Langerhans at the age of 22.  These cells which are found within the pancreas can be damaged by age or immune reactions resulting in elevated blood glucose.  This in turn causes damage to various organs within the body such as the eye. Diabetics have a higher incidence of glaucoma and cataracts, but the most serious damage occurs within the retina.  

The earliest signs of retinal damage noted on an eye exam consist of small red dots which represent microaneurysms of the smallest vessels in the eye known as capillaries. This in turn can lead to leakage of a proteinaceous yellowish exudate as well as bleeding within the eye.  Because blood perfusion to tissues within the eye is compromised normal capillaries disappear and can be replaced by new, abnormal vessels termed neovascular vessels,  which causes further bleeding, swelling, and scarring within the retina.

Much of the damage that occurs to the retina is irreversible which is why it is so important to to receive early diagnosis and treatment.  Laser treatment had been the mainstay for treatment of diabetic retinopathy but recently it has been found that with a vascular endothelial growth inhibitor such as avastin or lucentis when combined with focal retinal laser therapy provided better results than treatment with laser alone.

The doctors at North Shore Eye Care now use sophisticated equipment that help assess early damage from this disease.  We are now able to take digital fluorescein angiograms that show early leakage and swelling of the retina. Additionally these fluoresceins are excellent at revealing early capillary loss mentioned above.  Another useful tool is optical coherence tomography that gives a microscopic analysis of the retina and has been invaluable with the diagnosis of various retinal disease states.