Advance with MUSC Health

Eye Exams Are A Must For Diabetes Patients

Advance With MUSC Health
November 01, 2022
A patient's eye is examined by a clinician.

Diabetes affects more than the pancreas. In addition to the heart and kidneys, it can cause diabetic retinopathy, a complication characterized by damage to the blood vessels in the back lining of the eyeball.

“If you have diabetes long enough, like for 20 years, you’ll probably develop some degree of retinopathy in the eye,” says Dr. Emil Say, clinical assistant professor at MUSC Health Storm Eye Institute and a retinal specialist who treats patients with diabetes.

Diabetic retinopathy is a broad disease, ranging from mild to severe, and not everyone presents the same way. “It is a spectrum disease associated with microvascular changes in the retina and progresses to abnormal blood vessel growth. The abnormal growth leads to its more advanced findings like glaucoma, scar tissue formation, retinal detachment and hemorrhage.”

Unless someone has glaucoma, most symptoms are painless and include blurry vision, lots of floaters, seeing light, flashes of light and circles of light, and, in severe cases, total loss of vision.

In its early stages, called non-proliferative disease, changes are minimal. “Most people are in the non-proliferative disease group, with no growth of abnormal blood vessels. Patients are often asymptomatic,” he says.

If retinopathy advances to its non-proliferative stage, the blood vessel walls weaken or close. Leakage, causing swelling in the back of the eye or formation of cholesterol deposits, may occur.

“The most serious cases are when the retina has become detached because of scar tissue, advanced glaucoma, or vitreous hemorrhage,”

Dr. Say says. “These manifestations take years to develop, and it’s important to have the eyes examined routinely as earlier detection of non-proliferative disease will likely lead to a better outcome.”

Even someone who has been diagnosed with diabetic retinopathy and has changes in the eyes can still have 20/20 vision, Dr. Say says. “It does not mean you’ll go blind right away. You can have these changes and still see well, but unless someone dilates the eye and checks the retina, patients will have no idea that retinopathy is starting to develop.”

Diabetic retinopathy cannot be reversed completely and not all types of retinopathy need treatment. When it starts to affect vision, it can be treated with injections, laser, or surgery, all of which are offered at Storm Eye Institute.

Injections, which stop blood vessel leakage and abnormal vessel growth, are effective. Most patients respond well, but treatment must be repeated.

While the laser, which consists of creating small burns on the retina, has a better lasting response, it has some drawbacks. Visual acuity is not as good as with injections, and it may lead to loss of peripheral vision and decreased night vision, Dr. Say says.

He encourages patients to keep their blood pressure and cholesterol at a normal level, to stop smoking, to monitor their blood sugar levels regularly and schedule regular visits with their primary physician or endocrinologist.

He also urges patients diagnosed with diabetes, particularly those who are newly diagnosed, to get regular eye exams to help ensure their eyes remain as healthy as possible.

“Even when sugar is controlled, getting eyes checked regularly is imperative,” he says. “At Storm Eye Institute, when we evaluate and treat patients with diabetes, our goal is to preserve their vision and keep their eyes as healthy as possible so they can maintain their quality of life. They deserve ongoing care and, in many cases, advanced treatment that our multidisciplinary team of specialists is here to provide.” 

To make an appointment with Dr. Say, call 843-792-2020.