If you have been diagnosed with diabetes, you may be at risk of losing your vision since your body does not utilize sugar properly and, when the sugar levels rise, damage to the retinal blood vessels may occur. This injury to the retinal vessels is known as Diabetic Retinopathy. Diabetic Retinopathy is the leading cause of blindness in working-age adults.
Often, one may not be aware of any symptoms even when significant diabetic retinopathy is present. When macular edema occurs, vision often becomes blurry and may fluctuate. If abnormal new blood vessels form, as in proliferative diabetic retinopathy, they may bleed and result in small specks or large floaters obscuring the vision. If a large hemorrhage occurs, vision often becomes very blurry.
A comprehensive eye examination by an optometrist or retina specialist is the only reliable means of detecting diabetic retinopathy. After the pupil is dilated, a device called an ophthalmoscope is used to view the retina and determine the extent of the retinopathy. If diabetic retinopathy is discovered, a fluorescein dye test and/or optical coherence tomogram (OCT) may be recommended. A fluorescein angiogram involves the injection of a dye into a vein in the arm followed by several minutes of intermittent photos with a special digital camera focused on the retina. An OCT is a non-invasive photo that creates a detailed cross-sectional image of the macula.
The best therapy for diabetic retinopathy is prevention. Studies show that strict control of blood sugar levels can significantly lower the risk of vision loss from diabetic retinopathy. High blood pressure and kidney problems should also be treated to minimize their effect on the retinopathy. Laser surgery is often the first line of treatment if macular edema or proliferative retinopathy is present. For macular edema, the laser is focused on leaky areas of the retina to aid in reabsorbing the excess fluid. The primary goal of this treatment is to prevent further vision loss. It is uncommon for people to recover significant vision following treatment but some do experience partial restoration. Laser surgery is not a cure for diabetic retinopathy and is not guaranteed to prevent further loss of vision. Other treatments for diabetic retinopathy include medications like steroids or a novel class of medication called anti-VEGF.
Macular degeneration is a chronic eye disease that can severely impact vision. We offer vitamin care as a suggested form of treatment. The most common type is called dry macular degeneration. The less common wet form is more severe and can be very disabling. Today, through early detection and treatment, eye care professionals are better able to manage this disease.
The term “macular degeneration” includes many different eye diseases, all of which affect central, or detail vision. Age-related macular degeneration is the most common of these disorders, mainly affecting people over the age of 60. Although there are many types of macular degeneration, age-related macular degeneration (AMD or ARMD) is the most common type. Age-related macular degeneration occurs in two forms: “wet” age-related macular degeneration and “dry” age-related macular degeneration. “Wet” age-related macular degeneration is less common but more aggressive in its development to severe central vision loss. “Dry” age-related macular degeneration is the more common type and is more slowly progressive in causing loss of vision.
Wet age-related macular degeneration occurs when abnormal blood vessels begin to grow underneath the retina. These new blood vessels (known as choroidal neovascularization or CNV) tend to be very fragile and often leak blood and fluid. The blood and fluid raise the macula from its normal place at the back of the eye and interfere with the retina's function and causes the central vision to blur. Under these circumstances, vision loss may be rapid and severe. Some patients, however, do not notice visual changes despite the onset of CNV. Therefore, periodic eye examinations are very important for patients at risk for CNV. Once CNV has developed in one eye, whether there is a visual loss or not, the other eye is at relatively high risk for the same change.
In dry AMD, the light-sensitive cells in the macula slowly break down. With less of the macula functioning, central vision diminishes. Dry AMD often occurs in just one eye at first. Later, the other eye can be affected. The cause of dry AMD is unknown. The dry form is much more common than the wet form. Dry AMD can advance and cause vision loss without turning into wet AMD. Dry AMD can also rapidly transform into the wet form by the growth of new blood vessels.
We do not know the precise cause for the development of ARMD. However, we do know that there are certain risk factors for the development of age-related macular degeneration.
The greatest risk factor is age. Although AMD may occur during middle age, studies show that people over age 60 are clearly at greater risk than other age groups.
Neither dry nor wet AMD cause any eye pain. The most common early symptom in dry AMD is blurred vision. Dry macular degeneration symptoms usually develop gradually and do not include total blindness. However, the symptoms may worsen the quality of life by making reading, driving, and facial recognition difficult. Other symptoms may include decreased night vision, a decrease in the intensity or brightness of colors, increase in the haziness of overall vision. All of the above symptoms may also be noticed in the wet form of AMD. In addition, the most common symptom in wet macular degeneration is straight lines appearing crooked or wavy.
A thorough examination by an eye doctor is the best way to determine if you have macular degeneration or if you are at risk for developing the condition. The exam begins by testing your visual acuity or the sharpness of your vision. There are several different tests for visual acuity. The most familiar one has lines of black letters on a white chart. Next, your eyes may be tested with an Amsler grid. This test helps your doctor determine if you are experiencing areas of distorted or reduced vision, both common symptoms of macular degeneration. If you do have macular degeneration, your doctor will use the Amsler grid to determine if your vision has changed. After these visual tests, the front part of your eyes will be examined to determine if everything is healthy. Your doctor may put anesthetic drops in your eyes before measuring the pressure in each eye. Drops are also administered, which cause your pupils to dilate. This will allow your doctor to examine the retina through the enlarged pupil. After the dilating drops are administered and allowed time to work, the eye doctor will then use a slit-lamp to examine the eyes. The slit-lamp is a special microscope that enables the doctor to examine the different parts of the eye under magnification. When used with handheld lenses or special contact lenses, the slit-lamp gives the examiner a highly magnified view of the retina.
Wet AMD can be treated with laser surgery, photodynamic therapy, vitamin treatment and injections into the eye. None of these treatments is a permanent cure for wet AMD. The disease and loss of vision may continue to grow despite treatment.
There is currently no treatment available to reverse dry macular degeneration. However, dry macular degeneration usually develops at a slower pace and most patients with this condition are able to live relatively normal, productive lives. Often one eye is affected more than the other.
Your lifestyle can play a role in reducing your risk of developing AMD. This includes:
Dr. Mirabile has a vitamin supplement that is ARADS II recommended to help keep the macula supplied with the nutrients it needs.
Glaucoma, the leading cause of blindness and visual impairment, is an eye disease that can lead to a permanent loss of vision. We provide all diagnostic and treatment options for glaucoma care. Glaucoma generally provides no warning signs or symptoms of disease, making testing an important part of a full vision exam.
Glaucoma is not just one eye disease, but a group of eye conditions resulting in optic nerve damage, which causes loss of vision. Abnormally high pressure inside your eye (intraocular pressure) usually, but not always, causes this damage.
Glaucoma is the second leading cause of blindness. Sometimes called the silent thief of sight, glaucoma can damage your vision so gradually you may not notice any loss of vision until the disease is at an advanced stage. The most common type of glaucoma, primary open-angle glaucoma, often has no noticeable signs or symptoms.
Early diagnosis and treatment can minimize or prevent optic nerve damage and limit glaucoma-related vision loss. It's important to get your eyes examined regularly, and make sure your eye doctor measures your intraocular pressure.
Our OCT scan helps with early detection of all three: diabetic retinopathy, macular degeneration and glaucoma.
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