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Diabetic Retinopathy: What you should know

Diabetic retinopathy is a serious complication of diabetes and a major cause of blindness in the United States. It occurs when the tiny blood vessels in the back part of the eye, also known as the retina, are damaged by high levels of sugar in the blood.

These damaged blood vessels then leak blood and fluid into the retina. We often tell patients that the retina is like a sponge. When the sponge is dry, it works well and allows us to have good vision. When the sponge is wet (from blood vessels leaking fluid into the retina) we lose our best vision. We call this macular edema when the leakage occurs in the center of the retina, or macula. This is the part of the retina needed for such activities as reading and driving.

diabeticretNot only can these tiny blood vessels leak into the retina, but if they become so damaged that they can no longer deliver blood (and oxygen), the retina begins to suffocate. This is known as retinal ischemia. New, abnormal blood vessels then grow to try to help bring blood and oxygen to the retina. We refer to the presence of these new vessels as proliferative retinopathy. These abnormal vessels can bleed into the center of the eye causing a vitreous hemorrhage. These blood vessels can also cause the formation of scar tissue. This scar tissue sometimes pulls on the retina which can dislodge the retina from its natural position. This is called a tractional retinal detachment. Macular edema, retinal ischemia, vitreous hemorrhages, and retinal detachments can all lead to decreased vision and even blindness. The diagnosis of diabetic retinopathy is made when your doctor performs an eye exam and dilates your eyes to look at the retina of each eye. If the retina shows evidence of damage from diabetes, your doctor may refer you for additional testing to obtain a fluorescein angiogram. This is a test in which dye is injected into a vein in your arm. The dye circulates in the blood stream and can be seen, with a special camera, circulating in the blood vessels of the retina. We can tell by the pattern or dye circulation in the retina whether any blood vessels are damaged, and even if new abnormal blood vessels exist on the retina. This helps us decide if treatment is necessary.

The treatment of diabetic retinopathy starts with good control of blood sugar, blood pressure, and blood cholesterol levels. If macular edema is present, we may recommend focal laser treatment. This causes the damaged blood vessels to stop leaking fluid into the retina. If the initial laser treatment does not work, we may suggest either a second laser treatment, or an injection of steroids below or into the affected eye. Steroid injections have also been shown to dry up the macular edema. If proliferative retinopathy is present, and meets certain criteria as described in previous studies, we will recommend scatter laser treatment to the retina. This has been shown to cause the abnormal vessels to regress. This significantly decreases the chances of these blood vessels bleeding into the vitreous and/or causing a retinal detachment.

If the proliferative retinopathy is very advanced, scatter laser alone may not be sufficient to protect the eye. In these cases, we may suggest a vitrectomy to remove the blood-filled vitreous and, if present, the scar tissue from the retinal surface.

Research studies looking into new treatments for diabetic retinopathy are currently being done at many academic centers around the country. One such study suggests that through the administration of specific drugs, we will limit the retina’s ability to send signals to the body to grow new, abnormal blood vessels. This could help prevent proliferative diabetic retinopathy. None of these drugs have yet been approved for general use on patients with diabetic retinopathy.

It is important to understand that not all diabetic retinopathy will respond to treatment; however, retinopathy identified and treated early will usually do better. For this reason, we strongly recommend at least yearly, a dilated eye exam with one of our doctors at Vision Care Consultants. If you have any questions regarding diabetic retinopathy, please come into our office to discuss your eye health.

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Eyecare services are currently available for you, your children and family. However, please consult our Google Business page or call us for our current hours of operation. We want to advise you about the procedures and efforts that we are making to address the challenges regarding COVID-19/Coronavirus. (Read more)

Our efforts you can expect at our practice:

  • Staggered appointment times with minimal to no wait times in our reception area. Patients may also check in and wait outside in their cars to be called in for exam.
  • Following guidelines based upon medical evidence and closely monitoring the guidance from the Centers for Disease Control (CDC).
  • Educating our doctors and staff on preventative measures provided by the CDC with daily staff meeting updates.
  • Increasing the frequency and extent of our cleaning practices, such as additional wipe downs of all hard surfaces including the front desk, examination rooms after every exam and additional cleaning for all “patient touch points” (door handles, eyeglasses, counter tops, and other high-touch surfaces).
  • Providing additional resources that are available to patients and employees including hand sanitizers, extra soap and paper towels at all sinks and restrooms.
  • Implementing heightened sanitation and hand-washing procedures for all staff.


  • Only bring scheduled patients to the office (1-Accompanied adult per minor or elderly patient).

  • If you recently traveled to any of the high risk countries within the past 30 days, please, delay & reschedule your appointment for 30 days after you returned from your travel.

  • If you have any flu-like symptoms (fever, chills body aches, & trouble breathing), please, delay your appointment for 30 days.

  • If you are experiencing any of the symptoms listed above, and you arrive at our office, we will kindly ask you to leave & reschedule your appointment

  • Please notify us as soon as possible if you need to reschedule your appointment. This allows us to release your reserved time to another patient.

With appropriate precautions we will together address this challenge and modify behaviors that will make us better prepared to face such challenges in the future. Thank you for your cooperation.


Dr. Brawley, Dr. Friederich, Dr. Seibel, Dr. Wehner & Staff at Vision Care Consultants