Of the three diabetes eye diseases, diabetic retinopathy is the most serious and also the most typical; it occurs in 90 % of people with type 1 diabetes and in 65 percent of people with type 2 diabetes. It is estimated that between 40 and 45 percent of Americans with diabetes may have some stage of diabetic retinopathy. My friend Seth Bernstein, an optometrist, said that most people with diabetes might have retinopathy within five years of diagnosis as a result of uncontrolled blood sugars.
These statistics sound awfully high, but neither Seth, who's had type 1 diabetes for nearly two decades, nor I, who may have had it for thirty-seven years, have any retinopathy. The message: Don't let the risk profile get you down; get your blood sugars down instead. See your eye doctor every year, because diabetic retinopathy is one of the most preventable diabetic complications.
There's two kinds of diabetic retinopathy, nonproliferative and proliferative. Nonproliferative retinopathy is less severe; arteries in the retina weaken or swell and could leak fluid or become blocked from providing blood to the retina. Your vision is generally not affected with no treatment is essential. To avoid continuing development of the condition, you need to keep your blood sugar, blood pressure level, and cholesterol levels as near to normal as you possibly can.
In proliferative retinopathy the small arteries in the retina become severely damaged and close off completely, and new arteries grow. The new vessels are abnormal and fragile and tend to break, releasing blood to the eye. This causes your vision to blur or seem cloudy. You might see dark, floating spots. At its most severe, retinopathy may cause blindness.
Hemorrhages, discharges of blood in the blood vessels, often happen and can even happen while asleep. Half of those individuals who have proliferative retinopathy also provide macular edema, an ailment wherein fluid leaks into the macula, that is the small and highly sensitive central part of the retina that accounts for straight-ahead vision.
If caught early, both nonproliferative and proliferative retinopathy may be treatable, and significant damage can be avoided. Both proliferative retinopathy and macular edema are given laser surgery, which shrinks the abnormal and leaky blood vessels. Timely treatment can help to eliminate the risk of blindness by 95 percent in people with proliferative retinopathy. Laser surgery can cause some loss of peripheral vision and may impair color and night vision, but laser treatment is very good at saving the rest of your sight.
Joan, a religious studies teacher I met, told me that ever since she got diabetes more than half a century ago at the age of thirteen, she has always prayed for 2 things: strength and courage. Joan's first diabetic complication was hemorrhaging of her eyes. "It was like taking a black magic marker, putting it in water, and rubbing it over my eyes. That's what I saw all day." After twenty-eight laser surgeries on eyes, which did rob Joan of her color vision, her sight was saved.
Owen, sixty-nine years old and a retired engineer, was diagnosed with type 2 diabetes at the age of forty-nine, while in the midst of a painful divorce. Owen ignored his diabetes the first ten years. When he developed retinopathy, Owen had an awakening. "This won't get any worse," he said to himself. Laser treatments stopped Owen's retinopathy from progressing, and his eyesight is simply fine today.
Even though your doctor may look at your eyes during a routine visit, it's important to have your eyes checked annually by a specialist who are able to detect a significant eye problem. Eye diseases for example retinopathy typically don't cause any symptoms until a late stage of the disease. Even if you don't notice any vision problem, you should have a dilated eye exam every year to detect the beginning of any eye problem while it's early enough to avoid damage.
In a dilated eye exam, an eye specialist puts special drops in your eyes that cause your pupil (the middle opening) to spread out wider so he or she can examine your retina, the region behind your eyes, for damaged nerve tissue and any changes to the arteries. The exam is painless, but go from me - leaving your ophthalmologist's office on the sunny day without sunglasses is not! Come prepared, or your eyes will tear completely home.
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