The condition of your eyes is a window into your overall health. Any signs of serious eye problems often serve as wake up call for you to better manage your disease.
Thinking of your eye like a camera, the “film” of the eye is called the retina. The macula is the center of the retina. This critical structure can get damaged if your diabetes is not under good control for an extended period of time.
- If you run high levels of sugar in your system, the sugar is eventually broken down into a number of substances that are bad for your body. Vascular endothelial growth factors (VEGF’s) production is triggered by high blood sugar. VEGF can damage the very small blood vessels of your body called capillaries.
- Two things are bad for capillaries. One thing that can happen is that the capillary wall can become leaky. VEGF damage the capillary wall and then the capillaries leak fluid into the retina. The retinal does not function as well when it is “wet” so vision inevitably declines. This is called macular edema. The other scenario is that the capillaries and close off, this is called ischemia and can also worsen the vision significantly.
Proliferative diabetic retinopathy (PDR)
- Capillary non-perfusion in the retinal elicits the formation of a substance called vascular endothelial growth factor. (VEGF). The VEGF signals to the retinal to produce new abnormal blood vessels. The new vessels are very delicate and may appear on the optic nerve (NVD, neovascularization of the disk) or in the retinal periphery (neovascularization of the peripheral retina).
- The fragile new vessels may bleed into the vitreous, a clear, gel-like substance that fills the center of the eye. It may take days, months, or even years to resorb the blood, depending on the amount of blood present. Patients describe loss of vision, large black spots in front of the vision, streaks in front of the vision, among other symptoms depending upon the size of the hemorrhage.
- This condition is frequently associated with high blood pressure.