OE Patients

Tag: diabetic retinopathy

  • Treatment For Diabetic Retinopathy

    Treatment For Diabetic Retinopathy

    If you have diabetes and develop any changes in your vision, contact your ophthalmologist immediately.  While we currently do not have therapies that can completely reverse diabetic retinopathy (DR), we have effective treatments that can slow down or stop its progression and prevent your vision from further deteriorating.  In some cases, therapies are effective at recovering some lost vision.

    Therapies are employed to treat swelling of the central retina called diabetic macular edema (DME) and for treatment of severe DR that compromises blood flow to the retina.

     

    Diabetic Macular Edema

    If you are experiencing DME, your doctor might suggest injections into your eye with a medication known as anti-vascular endothelial growth factor (anti-VEGF) agents.  These medications help to decrease the macular edema and improve vision.  While the idea of a needle being inserted in your eye scares almost everyone at first, these therapies are highly effective and are in fact, a common procedure that retina specialists perform daily in their office.  There are multiple anti-VEGF medications to choose from for diabetic macular edema.  You should discuss with your retina specialist to determine which one is most appropriate for you.

    In some cases, your doctor might also recommend an injection into your eye of an anti-inflammatory medication known as a steroid.  These injections may be suggested in patients that have had a prior cataract surgery and are experiencing worsening of their DME or have chronic DME despite treatment with anti-VEGF injections. 

    If the DME is just outside, but threatening to disrupt the central vision, your doctor may recommend a light focal laser to seal off the leaking blood vessels that are contributing to the retinal swelling.

     

    Diabetic Retinopathy illustration diagram.

    Severe Diabetic Retinopathy

    If your DR results in a severe compromise of blood flow to the eye, your doctor may recommend a laser called panretinal photocogulation.  This laser, while sometimes painful or uncomfortable, is remarkably effective in preventing total blindness from bleeding in the eye and retinal detachment. 

    If there already is blood in the eye, with or without scar tissue on the retinal surface, your doctor will likely recommend a surgery known as a vitrectomy to remove a gel-like substance inside your eye called the vitreous body.  This procedure can also remove the bleeding and some of the scar tissue that has developed.  These treatments are complex and visual recovery expectations need to be discussed with your treating retinal surgeon.

    Recently, there has been growing evidence to support treatment of DR with anti-VEGF injections.  While these treatments are effective, the frequency of treatments could pose compliance challenges for patients.

    In conclusion, several management and treatment options are available for patients with diabetic eye diseases.  Please consult with your doctor on the best management plan for you.

     

    Written by:

    Luis Martinez-Velazquez, MD, PhD will be starting his ophthalmology residency at Massachusetts Eye and Ear Infirmary.
    Yasha Modi, MD is an Assistant Professor of Ophthalmology at New York University specializing in vitreoretinal surgery, retinal disease, and uveitis.

     

  • What Is Diabetic Retinopathy?

    What Is Diabetic Retinopathy?

    If you have been diagnosed with Diabetic retinopathy (DR), you’re not alone.  DR is a common complication of both type 1 and type 2 diabetes and a major cause of vision loss in adults of all ages in the United States and throughout the world.  One-third of the people with diabetes have DR, that translates to an astonishing 95 million patients with diabetic eye disease worldwide. 

    How long does it take for diabetes to damage eyes?

    Studies done in the United States have shown that patients with diabetes typically develop some form of DR within 10 years of diagnosis.  While some forms of DR are quite mild, one-third of patients will develop vision-threatening retinopathy.

    Diabetic eye disease is caused by damage to the blood vessels and neurons in your retina, the light-sensitive tissue of your eye.  It is a progressive condition, meaning the longer you have diabetes and the higher your blood sugar, the more likely you are to develop this eye complication.

    What is the first sign of diabetic retinopathy?

    In the early stages, DR may not cause any symptoms or only mild changes in vision.  Nevertheless, even at these early stages, there is damage to nerve cells and blood vessels that your doctor would be able to see during a retinal examination. It is important to catch DR in its early stages before it progresses to the more advanced stages that threaten eyesight.

    At any stage of DR there could also be changes that lead to fluid accumulation, also known as edema, in the retina.  If fluid accumulates in the macula, or the central area of the retina which provides your sharpest vision, the vision may become severely compromised.

    How can you tell if diabetes is affecting your eyes?

    If you have diabetes, some of the symptoms that may indicate retinopathy include intermittently blurry vision, new floaters, and dark or blurry areas in your vision.  Because diabetes affects your whole body, these symptoms usually affect both eyes.

    Man with black eye glasses having difficult time trying to read book.

    Who should get screened for diabetic retinopathy?

    Patients with type 1 diabetes should have yearly eye examinations to screen for DR starting five years after their diabetes diagnosis.  Patients with type 2 diabetes should be screened starting the year of their diagnosis. 

    Women who develop gestational diabetes do not require an eye exam during pregnancy because studies currently indicate that they do not have an increased risk of developing DR.  However, women with diabetes who become pregnant should be examined early in the course of the pregnancy.  Timely detection can help control the disease before it can damage your vision.  All patients diagnosed with DR should be referred to an ophthalmologist, or more specifically a retinal specialist, to help manage the visual complications of diabetes.

    Can lowering blood sugar improve vision?

    Two of the most important steps you can take to preserving your vision are lowering your blood sugar and controlling high blood pressure.  In fact, good sugar control can often slow the progression of mild to moderate retinopathy.  Your doctors can also assist by monitoring and helping you control your glycosylated hemoglobin levels (A1C), serum lipids, and blood pressure.

    Is diabetic eye disease reversible?

    If you have diabetes and develop any changes in your vision, you should contact your ophthalmologist immediately.  While we currently do not have therapies that can completely reverse diabetic retinopathy, we have effective treatments that can slow down or stop its progression and prevent your vision from deteriorating further.  In some cases, therapies are effective at recovering some lost vision.

     

    Written by:

    Luis Martinez-Velazquez, MD, PhD will be starting his ophthalmology residency at Massachusetts Eye and Ear Infirmary.
    Yasha Modi, MD is an Assistant Professor of Ophthalmology at New York University specializing in vitreoretinal surgery, retinal disease, and uveitis.

     

  • OE Patients: Best Of 2018 Articles

    OE Patients: Best Of 2018 Articles

    This year, we created a roundup of our most popular articles on OE Patients. Our best-of list for 2018 covers technology, health, and tips for making adjustments — from the secret to mastering iPhone’s VoiceOver to accessibility at arts museums.

    We hope you’ll be inspired to develop a new skill or create a good habit for the fresh new year!

    Apple’s iPhone

    10 Things To Know About iPhone Accessibility For Vision

    The iPhone is quite possibly the most adopted device, ever, for people with vision loss. This is because it is accessible out-of-the-box, even if you can’t see the screen at all.

    Discover the top reasons for using the iPhone.

    Let iPhone’s VoiceOver Do The Reading

    Apple’s built-in screen reader was a game-changer for those living with vision loss. Our accessibility expert, Dorrie Rush, writes about the secret to mastering iPhone’s VoiceOver gestures — practice, practice, practice.

    Learn how to master VoiceOver.

    Microsoft

    “Seeing AI” Is A Gift from Microsoft

    We love Microsoft’s Seeing AI, a free, intelligent camera app that translates images into words for people with visual impairments and blindness. Here are four features we especially like.

    Learn more about Seeing AI.

    Microsoft Soundscape 2018, A Review of What It Can Do

    Our accessibility expert Dorrie Rush appreciates the enhanced narration and awareness provided by Microsoft Soundscape, a navigation tool for people with vision loss.

    Read the full review of Soundscape.

    Apps and Technology

    App Happy

    Discover a collection of wonderful apps that empower people with visual impairments in ways we could only once dream.

    Click for our recommended apps.

    Electronic Glasses Event Recap

    In October, OE Patients held an accessibility event on wearable devices for audiences with vision loss.  We took a closer look into head mounted products including: OrCam, IrisVision, Jordy and more.

    Explore featured electronic glasses.

    GoGo Grandparent Gets Uber Without An App

    For older adults who need to get an Uber or Lyft without an app or smartphone, GoGoGrandparent is perfect.

    Find out more about GoGo Grandparent.

    Making Adjustments and Health

    Doctor, Am I Going Blind?

    Every eye condition is different. Read our article by ophthalmologist Dr. Yale Fisher, to understand how vision loss caused by macular degeneration, diabetic retinopathy and glaucoma rarely results in blindness.

    Learn more about vision across eye conditions.

    What Is A Cataract?

    Cataract is the leading cause of reversible blindness and vision loss in the world. Read more by Dr. Amilia Schrier, Director of Education at Manhattan Eye, Ear and Throat Hospital.

    Learn more about cataracts.

    Museums Making Art More Accessible

    From Florence to New York City, museums everywhere are making it easier for visitors who are visually impaired or blind to experience art.

    Find out how museums are opening up art.

  • Doctor, Am I Going Blind?

    Doctor, Am I Going Blind?

    To the question, “Am I going blind?,” the answer is most often, “No.”

    For the great majority of patients diagnosed with disease-causing progressive vision loss, use of the word “blindness” actually does not apply.  Fortunately, most patients treated for degenerative diseases retain some degree of visual function.

    While the amount varies (dependent on disease type, severity, persistence, and progression), it is far more accurate to describe most cases as visual impairments and not as blindness.

    Obviously, total loss of light perception is the ultimate fear.  Ophthalmologists must be extremely careful in their discussions with patients to address this fear.  While some diseases are severe, most can be limited.

    Macular Degeneration

    A frightening diagnosis always, and is the most common ocular disease in older age.  Some forms are genetically inherited and present in adolescents, teens, and much younger adults.  Although often described as the “leading cause of blindness in people over 65,” it is highly unlikely and extremely rare that it results in loss of light perception or blindness.  Macular degeneration generally affects the central vision, leaving peripheral intact.

    Progression of the disease is slow in most cases and can be well compensated.  Patients are able to continue their full and productive lives, making some adjustments and utilizing magnification and speech in widely available accessible technologies.  A strong mental approach coupled with a willingness to learn, are proven factors in maximizing remaining vision and enjoying life.

    Diabetic Retinopathy

    Diabetes-related eye disease is another common malady often associated with the reduction in normal sight.  While historically unrelenting, attention to medical and ocular problems early in the course of diabetes have completely altered the potential for devastating visual loss.  With current and updated treatments, visual loss can be prevented or at least limited.  Often, patient cooperation and participation in treatment is the key to success for diabetics.

    Glaucoma

    Primarily a disease of superficial retinal loss associated with elevated pressure within the globe of the eye.  The earliest patterns of visual loss from glaucoma are peripheral, not central, so a reduction of visual field can go relatively undetected by the patient.  As the disease progresses, more of the peripheral field is lost, followed finally by the loss of the central areas.

    Fortunately, with treatment and early recognition by a qualified professional, visual loss can be prevented or limited.

    Legal Blindness

    Many have heard the term “legal blindness” and automatically interpret it to mean “blindness.” Legal blindness is a government definition or statute utilized to determine qualification for disability benefits.  The definition requires 20/200 vision or worse in the best eye with correction in place or visual field limitation to 20 degrees in diameter.  The condition causing the vision loss must be present or expected to be present, for one year or more.

    Legal blindness does not mean “no vision” and many people with this degree of vision loss live very full visual lives, albeit with a significant visual impairment.  On the other hand, “blindness” is usually understood to mean “no visual perception”.

    Clarification of the language associated with vision loss is critical, especially for those on the receiving end of these difficult words.  Speak with your ophthalmologist.  Make sure you understand your visual status and to what degree it is likely to change over time.  Most of the time vision can be preserved and loss can be limited.