DIABETIC RETINOPATHYThis eye condition, a very common complication of diabetes, rivals glaucoma and cataracts as a leading cause of blindness in this country. Its incidence is rising as a result of the increased life span of diabetics. The likelihood of retinopathy increases with the length of time a person has had diabetes. Long-term diabetes often brings about changes in the tiny blood vessels in the retina (the lining of the back of the eye). There are two forms of diabetic retinopathy. The milder form, background or nonproliferative retinopathy, is the more common. It involves development of microaneurisms in retinal capillary blood vessels, which usually do not cause serious vision loss. A relatively small number of diabetics develop the more severe, or proliferative, form of retinopathy, which can cause blindness. With its onset new, abnormal blood vessels may be formed; blood vessels may become engorged with too much blood and burst, or the retina may break loose from the back of the eye. In addition to the direct interference with vision caused by these events, blood from the burst vessels enters the vitreous (jelly-like) part of the eye and makes it cloudy instead of transparent. Modern medical treatment administered as early as possible in the course of the disorder can often slow the course of diabetic retinopathy. Laser treatments sometimes can seal or "weld" broken blood vessels or seal a detached portion of the retina back into place. Photocoagulation treatment consists of scattering hundreds of small, quick flashes of intense laser light across the retina in order to seal or dry up new blood vessels. It must, however, be undertaken before there is bleeding into the vitreous or detachment of the retina. Although in many cases these kinds of treatment are wholly or partially unsuccessful, the techniques are continually being refined. Medical science does not yet fully understand just what characteristics
of diabetes bring about retinopathy. Although good adherence to a diet,
regular administration of insulin, and other prescribed regimens will
improve the patient's general health and help to lower the likelihood
of complications in general, the most careful and conscientious patient
may still become blind. On the other hand, some people have severe diabetes
for many years and never develop eye problems. |