Picture Review of Diabetic Retinopathy

Unfortunately, Americans are being diagnosed with diabetes at record rates, which means that eye examinations mean a lot more than just screening for glasses.  I am often asked what diabetic changes in the eye look like, so below are a few pictures of some of my most advanced diabetic changes.  An eye exam is a crucial part of your diabetic care because the eye is the only part of the body where blood vessels can be seen.  If you have bleeding from damaged blood vessels in your eye, there are likely changes going on throughout your body.  I always send a letter to my patient's primary care doctors when they have been diagnosed with diabetes, reporting any ocular findings.  If we all work together (patients, and all doctors!) we can help prevent severe damage from occurring!

Diabetic retinal (internal eye) findings can be as mild as a small spot of blood, which may just require yearly examination.  The three pictures below are actual patients where things have gotten a lot more advanced.  

Non-Proliferative Diabetic Retinopathy with Diabetic Macular Edema.  Please excuse the annoying camera flash

This photo shows bleeding or hemorrhaging throughout the retina, but you also see exudate which is the yellow changes you see above the central vision spot (the macula).  Exudate is evidence of swelling, which means that the blood vessels have been actively leaking in the area.  This patient's central vision was reduced because the swelling was so close to her macula.  She was seen by an ophthalmologist, who is monitoring closely for resolution.

Proliferative Diabetic Retinopathy

Proliferative Diabetic Retinopathy

The 2 photos above are from the same patient who has even more advanced damage.  At the bottom of both photographs you can see small, "squiggly" spider-web like blood vessels.  I know these pictures might not appear as severe as the first, but these new blood vessels (or neovascularization) are evidence of advanced changes.  These lacy and thin blood vessels are created by the body when the ocular tissue is not getting enough oxygen.  Instead of letting the tissue die, the body tries to get it more oxygen and nutrients by making new vessels.  Unfortunately these vessels are delicate and prone to breaking, causing massive bleeding and sometimes even retinal detachments.  This patient was immediately referred to an ophthalmologist for treatment!

I can't stress enough, even if you have great vision, it is essential to have regular eye exams.  If you have been diagnosed with diabetes (type 1 or type 2) your eyes need to be checked at least yearly.  With regular check ups and good blood sugar control, the risk of permanently losing your vision (and the function of other organs!) can be greatly minimized.