
Diabetes mellitus causes the body to not use and store sugar correctly. High blood glucose levels can damage the blood vessels in the retina and lead to diabetic retinopathy. The best treatment for diabetic retinopathy is prevention of the development of retinopathy. Strict blood sugar control can significantly decrease the long-term risk of vision loss. Diabetic eye care treatment is meant to prevent blood vessels from leaking or to eliminate abnormal blood vessels. This can be accomplished with medical treatment, laser eye surgery and/or traditional surgery.
Diabetics are more susceptible to a multitude of ocular problems than non-diabetics. High glucose levels and high blood pressure put diabetics at higher risk for developing cataracts, glaucoma, and diabetic retinopathy. Dr. Reena Patel offers diabetic eye care in Wichita at her full-service ophthalmology practice. She encourages people with diabetes to schedule regular dilated eye exams so that any early signs of diabetic complications can be diagnosed and treatment can be initiated quickly.
Common Eye Problems in Diabetics
Diabetic Retinopathy: The most common diabetes-related eye condition is diabetic retinopathy, which affects the retina. The retina has tiny blood vessels that are susceptible to damage. In diabetics, these blood vessels are more likely to swell, weaken or become clogged. There are two types of diabetic retinopathy: non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR). NPDR is an early stage of diabetic retinopathy whereas PDR is a late stage of diabetic retinopathy.
With NPDR, tiny retinal blood vessels leak blood or fluid in the retina. The fluid can cause the retina to swell or to form small deposits called exudates. Many diabetics who have early NPDR may not have any visual changes.
Vision is usually impaired when macular edema or macular ischemia is present. Macular edema is a thickening or a swelling of the macula, which is the small central area of the retina that allows us to distinguish fine details. Macular edema is caused by fluid leaking from retinal blood vessels and is the most common cause of vision loss in diabetes. Macular ischemia occurs when small blood vessels close off in the central portion of the retina. Vision becomes blurred because the macula receives an insufficient blood supply to function properly.
Proliferative diabetic retinopathy occurs when abnormal blood vessels (neovascularization) start to form on the optic nerve or retinal surface. The neovascularization usually occurs because multiple retinal blood vessels closed, preventing sufficient blood flow. The retina then responds by forming new blood vessels to try to supply blood flow to an area where the original blood vessels closed. The new blood vessels do not work properly and are usually associated with scar tissue, which can cause detachment or wrinkling of the retina. PDR can cause severe vision loss because it can affect both central and peripheral vision. Proliferative diabetic retinopathy can cause vitreous hemorrhage, traction retinal detachment, and/or neovascular glaucoma.
The best treatment for diabetic retinopathy is prevention. However, if diabetic retinopathy is present, treatment may be needed. Medical treatment can include injections of anti-VEGF medication to stop the growth of new blood vessels and bleeding. Anti-VEGF injections can also reduce swelling due to diabetic macular edema.
Laser surgery can be recommended for macular edema, proliferative diabetic retinopathy, and neovascular glaucoma. The main goal of laser treatment for macular edema is to prevent further vision loss. For proliferative diabetic retinopathy, laser treatment is focused on all parts of the retina except the macula. This panretinal photocoagulation (PRP) treatment causes abnormal blood vessels to shrink and prevents further blood vessels from growing in the future. PRP also reduces the chance of vitreous hemorrhage and traction retinal detachment. Some diabetics may need multiple laser treatments over time as laser surgery does not cure diabetic retinopathy and does not guarantee further vision loss.
Some patients with advanced PDR may need a vitrectomy. A vitrectomy is a surgery in which the blood-filled vitreous is replaced with a clear solution. A vitrectomy can prevent further bleeding by removing abnormal blood vessels that cause bleeding.
Cataracts: People with diabetes are 60 percent more likely to develop cataracts than people who do not have diabetes. A cataract is a clouding of the eye’s natural lens which blurs vision. If cataracts interfere with a person’s ability to perform necessary daily tasks such as driving or reading, cataract surgery may be necessary. During cataract surgery, Dr. Patel breaks up the eye’s lens, removes it and replaces it with an intraocular lens that remains permanently in place. To learn more about cataract surgery, please visit our cataract page.
Glaucoma: Glaucoma is the result of an increase in intraocular pressure, and it is more common in diabetics than in non-diabetics. In fact, people with diabetes are 40 percent more likely to develop glaucoma than people without diabetes. Glaucoma occurs when the pressure of the eye’s natural fluid builds up without filtering normally through the eye. This damages the optic nerve, which carries signals from the eye to the brain, causing vision loss in many cases. There are several ways to treat glaucoma, all of which aim to lower the pressure on the optic nerve and open up the proper channels for the aqueous humor to flow through. Treatment may include a surgical procedure or the use of certain medications.
Prevention
The best treatment of diabetic retinopathy is prevention of retinopathy. Strict blood glucose control will substantially reduce the risk of vision loss due to diabetes. Regular dilated eye exams are critical for people with diabetes. With better diagnostic testing and treatments, a smaller number of diabetics have serious vision problems. During an eye exam, Dr. Patel dilates the eyes and checks for signs of eye disease. She may also order photographs of the retina or order an optical coherence tomography test (OCT) which creates a three-dimensional view of your retina. If she finds anything of concern, she will begin treatment quickly.
I Can See Clearly Now
by Don Burrows
Category: cataract surgeryDr. Patel saved my wife’s vision and mine too. I now live 770 miles from her office and would still make the trip, even if it required a cross-country trip.
I highly recommend Dr. Patel
by Jim Guhl
Category: cataract surgeryDr. Patel is a physician whose sincere goal is to improve the quality of life for her patients. When I first became a patient under Dr. Patel’s care, I was diagnosed with cataracts in both of my eyes; dry eye syndrome; and astigmatism. Previous records from my Lasik surgery, which occurred 17 years ago, were no longer available. The Lasik surgery documentation was important in determining the exact corrections that now needed to be made to properly correct my astigmatism. Dr. Patel wisely recommended I postpone the cataract removal and astigmatism correction procedure, until she received newly developed diagnostic equipment. This newly developed technology would provide her with the most accurate metrics possible. New specialized lens implants were also becoming available, which would correct my astigmatism. Dr. Patel explained my chances for a successful outcome would be significantly increased if I would be patient and wait a little longer. Dr. Patel is truly a physician with high integrity and would never perform surgery until she knew it was the right time. She truly cares about providing her patients with the best care she can. Dr. Patel successfully treated my dry eye symptoms with a regiment of eye drops, cleansing techniques and vitamins, which prevented me from requiring more extensive - and more expensive treatment. Prior to the surgery on my right eye, she provided me with sample eye drops from her office and coupons for the eye drops I would need to purchase after my surgery. She did all she could to reduce my expenses. During preparations for right eye surgery, Dr. Patel spent quality time with me explaining the results of my pre-surgery testing and asking questions to determine my vision goals. One of my desires was to once again see the front sight on a pistol. I thoroughly enjoyed going to the firing range, but due to the cataract in my right eye I could no longer see the sights, on my pistol. Although the cataract in my left eye was not as bad yet – I was also experiencing difficulty seeing and firing left handed. Using a blue gun (authentic plastic replica of a Sig P229 pistol), Dr. Patel took additional measurements which she used in determining the correct lens to implant, during my surgery. My right eye surgery took place on November 1, 2017. Two days after the surgery, I happened to glance at my mobile phone and for the first time in 10 years or more, I could read the information on the screen without glasses. I pulled the Sig out of its case and – wow! – The sight picture was there clear as a bell. So the right eye cataract is gone along with the rainbow halos around cars at night and the astigmatism has been corrected better than I dreamed possible. Quality of life restored! The process included the latest diagnostic equipment; the newest technology in an intraocular lens implant; and the use of a laser surgery technique performed by Dr. Patel. Sadly, insurance does not cover much of the cost for the process that produces the optimal results. When it comes to the long term correction of your vision and significant increase in the quality of life it is well worth the investment. Dr. Patel is a very accomplished and highly competent physician and surgeon. I will be forever grateful to her for restoring my vision. I highly recommend Dr. Patel. Jim Guhl Wichita, KS November 13, 2017
In Good Hands
by Luke F.
Category: lasik surgeryTalk about a life changing surgery!!! From the consultation to the surgery I knew I was in good hands. I would recommend WVI to anyone who is considering LASIK. Thanks WVI!
Life Changing!
by Ashley J.
Category: lasik surgeryI love Dr. Patel! After having my dreams crushed at another place when they told me I wasn't a candidate, I went to Dr Patel for a lasik consultation. She is very thorough and gave me information about my eyes that no doctor in almost 20 years has told me. A week ago I had Lasik and it has been life changing! I couldn't be happier and I'm so glad I chose Dr Patel. She truly cares about her patients and her passion shows. The wait time can be very long, but if you are prepared for that ahead of time, you won't be disappointed once you see the doctor. I'm recommending WVI to everyone I know. She is now the only doctor I trust for my eyes.
Impressed with Dr. Patel and Staff
by William D.
Category: cataract surgeryI first saw Dr. Patel about 6 years ago when my left eye wandered to the left side and stayed there. She sent me to the Dean McGee Eye Institute in Oklahoma City for further evaluation. No reason was ever found as to why it did that but it corrected itself after about two months. Since then I have been seeing Dr. Patel regularly. I damaged the left eye in an accident and had to have a vitrectomy performed. She referred me to another specialist Dr. Paul Weishaar and that outcome was also great. The eye did develop a cataract and she performed that surgery a few months ago and suggested a plan for treating dry eyes. It was outstanding and since wearing glasses for over 50 years, I now just wear sunglasses. Simply amazing. Dr. Patel and her staff are the greatest and they know other great professionals if the need arises. They also do charity work and they are all a total blessing to me. I would not even consider going anywhere else. Just gotta love them.
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