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  • Diabetic Retinopathy

    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.

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    <div> <p><a href="">Ophthalmologist</a> , Vitreoretinal Surgeon, talks about how who gets diabetic retinopathy, what the symptoms are and what causes damage to the eyes.</p> </div>

    Ophthalmologist , Vitreoretinal Surgeon, talks about how who gets diabetic retinopathy, what the symptoms are and what causes damage to the eyes.

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    <div> <p><a href="">Ophthalmologist</a> , Vitreoretinal Surgeon, talks about how diabetic retinopathy is caused in patients with diabetes as well as treatment and management strategies.</p> </div>

    Ophthalmologist , Vitreoretinal Surgeon, talks about how diabetic retinopathy is caused in patients with diabetes as well as treatment and management strategies.

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    <p><a href="">&nbsp;Ophthalmologist,</a> talks about the cause of diabetic retinopathy and also who typically gets it.</p>

     Ophthalmologist, talks about the cause of diabetic retinopathy and also who typically gets it.

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    <p><a href="">&nbsp;Ophthalmologist, </a>talks about what patients can expect from their vision before and after being treated for diabetic retinopathy.</p>

     Ophthalmologist, talks about what patients can expect from their vision before and after being treated for diabetic retinopathy.

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    <p><a href="">&nbsp;Ophthalmologist</a>, discusses how diabetic retinopathy is treated.</p>

     Ophthalmologist, discusses how diabetic retinopathy is treated.

  • Diabetic Retinopathy Detection and Prevention

    Diabetic retinopathy is a serious eye condition that can develop in individuals with diabetes, and it has been explained by Dr. Bernard Hurley, MD, FRCSC, a Vitreoretinal Surgeon. Here is an overview of his explanation:


    Diabetic retinopathy occurs when the blood vessels supplying oxygen and nutrients to the retina, the light-sensitive tissue at the back of the eye, become blocked, leaky, or a combination of both. This leads to various changes in the retina, including swelling and ischemia (lack of oxygen). As parts of the retina become ischemic and die, they may release a substance called vascular endothelial growth factor, which stimulates the growth of new blood vessels within the eye. However, these new blood vessels are usually abnormal and can cause complications such as retinal detachment or glaucoma.

    The symptoms and detection of diabetic retinopathy can vary depending on the stage of the disease:

    • Early Stages: Patients may not notice any symptoms.
    • Later Stages: Symptoms may include blurry vision, reduced visual acuity, floaters, blurred or patchy vision, dark or empty areas in vision, eye pain or redness, and even sudden vision loss. The severity of symptoms often corresponds to the progression of the condition.

    People at the highest risk of developing diabetic retinopathy are those with type 1 or type 2 diabetes, particularly if their diabetes is poorly controlled. Prolonged high blood sugar levels can damage the tiny blood vessels that supply the retina, leading to leakage of fluid or bleeding. This results in swelling of the retinal tissue. Additionally, the eyes may attempt to compensate for the blocked blood vessels by growing new ones, but these new vessels are often dysfunctional. This damage to the retina can result in cloudy or blurred vision. It's important to note that diabetic retinopathy usually affects both eyes.

    If you have been diagnosed with type 1 or type 2 diabetes, it's crucial to have regular eye check-ups, including retinal examinations. Early detection and management of diabetic retinopathy can help prevent or minimize vision loss. If you suspect you might be at risk for diabetic retinopathy, it's recommended to reach out to a local optometrist for screening or speak to your family physician.                            

    Now, assuming that you're doing the best you can with your systemic control, then you still need to have your eyes examined, and that process would require going to see an ophthalmologist, having dilating drops put in your eyes so the retina can be examined in properly. You would then sit at a high powered microscope, have your retinas examined, often with a headlamp microscope as well, and depending on what was seen, supplementary testing might be necessary. Now many times this testing can be performed the same day. It would include such a test as a fluorescein angiogram dye that is injected into your arm where photos are taken of your eye. There's a laser photograph tests that can be done to look at the thickness of the retina if we're worried about leakage of fluid into your central vision area. And really those are the main tests that we would do to look at your eye in conjunction with the eye exam to diagnose diabetic retinopathy. Your pupils will be dilated during the process, so bringing a pair of sunglasses with you or having someone drive you to pick you up and take you home is probably a good idea.

    Once you're seen by your ophthalmologist, if testing is required, depending on the facilities available to that individual, there may be an opportunity for performing your tests the same day and even possibly treatment the same day so that your treatment if you need it can be initiated as quickly as possible for your diabetic retinopathy.

    If you have questions or further queries about diabetes and diabetic retinopathy, please talk to your family physician or your local ophthalmologist Is in good standing with the College of Physicians and Surgeons of Canada, Canadian Ophthalmological Society and the Canadian Medical Association

    Keywords: retina, macular disease, vitreous humour, Dry Eye,  vitreoretinal surgery, uveitis, diabetic retinopathy, age-related macular degeneration, Glaucoma and Intravitreal Injections Pars Plana Vitrectomy


  • Diabetic Retinopathy Treatment Options

    diabetic retinopathy takes a holistic approach that goes beyond just addressing the eye condition. Managing diabetes effectively is a key aspect of preventing and treating diabetic retinopathy. Dr. Bernard Hurley's explanation highlights the importance of this approach.

    When dealing with diabetic retinopathy, it's essential to focus on the overall management of diabetes. This involves several steps:

    1. Blood Sugar Management: Controlling blood sugar levels is crucial to prevent or slow down the progression of diabetic retinopathy. High blood sugar levels can contribute to damage in the blood vessels of the retina. Monitoring blood sugar and following a diabetes management plan are fundamental.

    2. Systemic Treatment Optimization: Treating diabetes requires a comprehensive approach. This includes ensuring that the patient's treatment plan for diabetes, such as medications or insulin therapy, is effectively managed. The goal is to keep blood sugar levels within a healthy range to minimize complications like retinopathy.

    3. Blood Pressure Control: Hypertension (high blood pressure) is a common complication of diabetes and can exacerbate diabetic retinopathy. Managing blood pressure through lifestyle changes and medications, if needed, can help protect the blood vessels in the retina.

    4. Cholesterol Management: Elevated cholesterol levels can contribute to vascular problems, including those in the eyes. Proper management of cholesterol levels through diet, exercise, and medication, if necessary, is essential.

    5. Kidney Function Assessment: Diabetes can impact kidney function, and kidney problems can exacerbate diabetic retinopathy. Regular monitoring of kidney function and appropriate management are crucial components of holistic care.

    6. Comprehensive Risk Assessment: Addressing potential risk factors for complications of diabetes, including diabetic retinopathy, is vital. These risk factors can include heart health, nerve function, and foot care, among others.

    Taking a holistic approach to treating diabetic retinopathy not only improves the eye condition but also enhances the patient's overall health and quality of life. By managing diabetes effectively and addressing its associated risk factors, healthcare professionals can help prevent or mitigate the progression of diabetic retinopathy and other related complications. It's important for individuals with diabetes to work closely with their healthcare team, including ophthalmologists, endocrinologists, and primary care physicians, to ensure comprehensive and coordinated care.

    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.

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