Dr. Lalwani: 'Diabetes Sufferers Can Prevent Vision Loss'

Every person living with diabetes is at risk of vision loss or blindness. In fact, roughly half will face diabetic retinopathy, the most common vision-related complication of diabetes.

“If caught in its earlier stages, we can often maintain or improve vision. But there is a point at which the vision loss from diabetic retinopathy can be irreversible,” retinal specialist Geeta Lalwani, MD, warned during a free health lecture held in Boulder.

“Unfortunately, even in its late stages, diabetic retinopathy can often have no symptoms, making it critical for patients with diabetes to have a yearly eye exam,” Dr. Lalwani added.

What is Diabetic Retinopathy?

Diabetic retinopathy results from persistently high blood sugar levels that damage blood vessels within the retina. The damaged blood vessels then start to leak fluid or blood into the retina.

“In early stages of diabetic retinopathy, the leakage of blood or fluid is called nonproliferative diabetic retinopathy (NPDR). In later stages, the leakage causes an oxygen deficiency, which can lead to blood vessels growing in an irregular fashion. This stage is called proliferative diabetic retinopathy, or PDR. Untreated, PDR usually proceeds to severe vision loss,” Dr. Lalwani explained.

Either of the two diabetic retinopathy stages — NPDR or PDR — can produce diabetic macular edema (DME), which is the accumulation of fluid in the macula. The macula is the center part of the retina that allows you to have fine vision.

Symptoms of DME can include:

• blurred or distorted vision
• difficulty focusing

How to Protect Your Vision

According to Dr. Lalwani, people with diabetes can prevent or delay vision loss from diabetic retinopathy and DME by following these steps:

• Control your blood sugar. Taking medications as prescribed, staying physically active and maintaining a healthy weight are key to lowering your risk and slowing the progression of vision complications.
• Undergo dilated eye exams annually. During an exam, your doctor can check for changes to blood vessels within the retina or warning signs of leaky blood vessels.
• Lower your blood pressure and cholesterol levels. People with diabetes who also have high blood pressure and cholesterol levels are at greater risk for diabetic retinopathy.
• Stop smoking. Some studies suggest that smoking speeds up the progression of the condition.

Treatments for Reducing or Halting Vision Loss

Dr. Lalwani stated that if your diabetic retinopathy is mild or moderate controlling your blood sugar can often slow its progression. Regular monitoring by a physician may be all that is needed. However, if the disease advances, the following treatments can help control its progression:

• Laser treatment. A laser beam of light targets leaking blood vessels and seals them off to stop fluid or blood leakage. Laser treatment can also prevent further growth of new blood vessels.
• Injections of steroid. Steroid medication can be injected into the eye to reduce swelling of the macula (DME).
• Injections of anti-VEGF. Eye injections of vascular endovascular epithelial anti-growth factor drugs (anti-VEGF) can help reduce fluid buildup or widespread blood-vessel growth, which often occurs in the more advanced stages of diabetic retinopathy.
• Surgery. Patients may need surgery to remove bleeding from inside the eye or to repair retinal detachments related to diabetes.

Dr. Lalwani said, “These treatment options don’t cure diabetic retinopathy, but they can be effective in stabilizing vision loss and often result in improved vision. Your eye care team can help you manage your eye health and recommend the best treatment option.”

View PowerPoint slides from Dr. Lalwani's lecture on "Preventing & Treating Diabetes-Related Blindness."

If you wish to be screened or treated for diabetic retinopathy, schedule an appointment with Geeta Lalwani, MD by calling 303-900-8507.