Dr. David Maberley

MD, MSc. (Epid), FRCSC, Ophthalmologist

VIDEO : What is Diabetic Retinopathy and its Causes

Dr. David Maberley, MD, MSc. (Epid), FRCSC, Ophthalmologist, discusses diabetic retinopathy and how it is prevented and treated.

Diabetic retinopathy is the second leading cause of vision loss in North America, but it’s the leading cause of vision loss in people of working age.

So it has major implications in terms of health economics and impact on society. It develops with a diagnosis of diabetes, and tends to occur 10 to 15 years after a patient is diagnosed with diabetes.

Type 1 diabetes is diabetes that tends to occur as people are younger, and it tends to be the insulin-treated form of diabetes. And really when that disease begins, we can start counting because we have a very precise diagnosis to when Type 1 diabetes begins.

With Type 2 diabetes, which tends to occur in elderly people, in obese people and people with vascular disease, that can often grumble along for years before a diagnosis is actually made.

And so when a diagnosis of Type 2 diabetes is made, a patient may already have five or six years of diabetes in their system, and their risk of developing eye disease from diabetes could be very frequently, very quickly developing after that.

And we often see people coming in with diabetic retinopathy who haven’t even been diagnosed with diabetes yet. So in the context of Type 2 diabetes, it is important for people who are diagnosed with that to have an eye exam very early on in the course of their disease management.

Now diabetes affects the eye primarily in two ways. Diabetes causes high blood sugar levels in the body. Those sugars, when they’re broken down, can damage the blood vessels, and they damage the blood vessels in the eye.

Most frequently, the blood vessels start to leak, and we get fluid leaking into the macula or the central part of your retina, and that causes blurring of vision and can cause loss of vision.

That’s called diabetic macular edema. The second problem that can occur is the blood vessels in the back of your eye can start to break down in a way that the retinal tissue loses blood supply and tries to grow its own blood vessels to compensate.

Now those compensatory vessels are a problem because they’re fragile and they don’t grow properly, and they can form scar tissue and they can bleed and they can cause traction and pulling on your retina, and can even lead to retinal detachment or an eye full of blood. So we’re obviously very concerned about diabetic retinopathy. The biggest problem is, is that most people’s vision is very, very good until the disease is already rampant in their eyes. And so early detection and prevention is very important for this condition. This condition only occurs if you have diabetes.

But if you have more questions, please talk to your family doctor about a diagnosis of diabetes, if you’re concerned about that. And if you’re concerned about diabetic retinopathy, a referral to your local ophthalmologist would likely be a good idea. We tend to recommend yearly examinations for patients with diabetes for their eyes.

Presenter: Dr. David Maberley, Ophthalmologist, Vancouver, BC