Diabetic Eye Care
It is recommended by the American Diabetes Association to have an annual eye exam once the diagnosis of diabetes is made. For the diabetic eye exam, the pupils are dilated with drops and a careful inspection of the retina is performed. Long standing diabetes, along with poor HgA1c levels, chronically elevated sugars, poor hypertension control and hypercholesterolemia can weaken the blood vessels in the retina causing microaneursyms. If these weak blood vessels begin to leak protein or fluid into the retina, a diagnosis of macular edema is made. This stage of retinopathy is called non-proliferative. It is possible to have significant damage to the retina prior to noticing any decrease in vision.
If the retina doesn’t get enough oxygen, new fragile blood vessels called neovascularization form. Unfortunately, these vessels are weak and prone to bleeding into the vitreous or retina leading to devastating loss of vision.
At Eye Associates, we stress early diagnosis and prompt referral to a retinal specialist in the area if diabetic eye disease is detected. Early intervention and correspondence with your primary physician and endocrinologist is stressed in our practice to prevent visual loss from diabetes.
Flashes and Floaters (eye floaters)
A common condition frequently encountered is the sudden onset of spots, webs, lines, hairs or dots that move with the eye when looking side to side. These opacities that develop in the vitreous gel are known as floaters. Sometimes associated with floaters are peripheral vision flashes that are noticed most prominently in the nighttime. Not all patients with floaters notice flashes of light.
Frequently, this condition is associated with a condition called a posterior vitreous detachment or PVD. A PVD occurs frequently with aging or higher nearsightedness (myopia) as the vitreous gel gets softer. The gel is fused strongly to the retina at birth, and gradually an event happens where a pocket of liquid gel separates the fusion of the vitreous gel to the retina. Floaters are resultant protein and cellular debris that float in the gel. Flashes come from the pulling of the gel on the retina, stimulating an arc of light.
It is important to get checked in the office when this event occurs, because some patients with new floaters will have a tear in the retina. A retinal tear cannot be diagnosed without a dilated eye exam. If caught early, the tear can be lasered by a retinal specialist. If the tear is not promptly treated, a retinal detachment may occur, leading to loss of vision. Surgery is required once the retina detaches. In the office, a dilated retinal exam is performed to search for tears or holes in the retina in the weeks following the gel detachment.
Floaters can be very annoying, but are harmless to the overall health of the eye. Careful observation for tears is recommended in the time following a PVD.
Other retinal conditions that we may diagnose include macular hole, macular pucker (surface wrinkling retinopathy), uveitis or iritis and other retinal dystrophies.