Diabetic Retinopathy Specialists

When an Exam Is Necessary

Certain people may need to schedule an exam with their local ophthalmologist right away, such as:

• Patients already diagnosed with diabetic retinopathy, whether mild NPDR or more advanced disease.
• Pregnant diabetic patients, including those with gestational diabetes, in their first trimester.
• Patients experiencing non-blood sugar-related visual changes like blurred vision or floaters in one or both of their eyes for several days, which could be signs of diabetes in the eyes.

Types of Diabetic Retinopathy

Diabetic retinopathy has two classifications: NPDR, or nonproliferative diabetic retinopathy, and PDR, or proliferative diabetic retinopathy.

Mild nonproliferative diabetic retinopathy (NPDR), commonly called background retinopathy, happens in the initial stages of this disease. When mild NPDR occurs, the small retinal blood vessels leak fluid or blood, which are early-stage diabetes eye symptoms. The leaking causes retinal deposits, or exudates, and swelling. Central vision loss may occur due to secondary conditions such as macular ischemia, capillary constriction, diabetic macular edema, or retinal blood vessel swelling.

Severe nonproliferative diabetic retinopathy can progress to PDR, which is caused by the mass constriction of retinal blood vessels due to the growth of abnormal vessels. Although the body grows these vessels in an attempt to restore blood flow, the scar tissue that accompanies the abnormal vessels may cause retinal detachment and wrinkling. Since PDR impacts peripheral and central vision, the patient’s vision loss is more severe. Vision-loss conditions, neovascular glaucoma, traction retinal detachment, and vitreous hemorrhage (bleeding at the back of the eye due to diabetes) are caused by PDR.

Diagnosing Diabetic Retinopathy

Using an ophthalmoscope, the diabetic ophthalmologist dilates the patient’s pupils and examines the eyes in order to detect changes indicative of diabetic retinopathy, such as microaneurysms. A comprehensive dilated eye exam allows the eye doctor to check for diabetic eye disease. If diabetic retinopathy is present, the ophthalmologist conducts a fluorescein angiography test or takes color retinal photographs to look for signs like diabetes and black spots in vision. Often, the ophthalmologist can diagnose and treat diabetic retinopathy during a comprehensive eye exam before the patient suffers from vision problems. Blurred vision, floaters, or seeing dark spots are some of the first signs of diabetic retinopathy.

Treating Diabetic Retinopathy

Preventing the further development of diabetic retinopathy is the ideal treatment. Patients should control their blood sugar through glycemic control and regular A1C tests to reduce their risk of vision loss and blindness from diabetes eyes complications. Kidney problems and high blood pressure must also be addressed.

Laser treatment is an option for diabetic macular edema, neovascular glaucoma, and PDR patients who need to prevent additional vision loss. Anti-VEGF drugs may also be used. Patients may experience partial to complete vision restoration. In some cases, multiple laser sessions are required.

Advanced PDR patients may be candidates for vitrectomy. This microsurgical procedure removes abnormal vessels to prevent further bleeding. If the patient has retinal detachment, it can be repaired with vitrectomy surgery. Surgery soon after diagnosis achieves the best results because traction retinal detachment and macular distortion cause permanent vision loss.