What You Should Know About Diabetic Retinopathy

By Dr. Steven Rhee

Diabetic retinopathy is an eye condition that affects those with diabetes. It occurs when there is damage done to the blood vessels in the retina. This complication can appear in both types of diabetes, type 1 and 2, and though symptoms may be mild at first, it can eventually lead to blindness.

Oftentimes, there are no symptoms in its early stages. However, as the condition progresses, you may experience symptoms such as blurry/Double vision, seeing flashes of light or floating spots in your vision (Known as flashes and floaters), blank or dark areas in your vision, reduced or low vision, and pain or pressure in one or both eyes.

When we eat, your body breaks down food into glucose (sugar), and then a peptide hormone called insulin, moves this glucose from your blood into different cells.

When your body lacks enough insulin (a condition known as hyperglycemia) or your diet is too rich in sugars and forms of glucose,

70 years old in men), family history, previous fractures (especially if the injury occurred after 50 years old), medications, and overall health.

The report will show bone density scores and provide a percentage risk for injury. Your doctor can use these results to determine the next steps for prevention/ treatment, and timing for your next surveillance scan.

The medical course of treatment for a hip fracture is not easy. Moreover, it is worth mentioning the emotional toll that it takes on the patient and caregivers, as this fracture, although treatable, is indeed life-changing.

My Mom has and con- this can result in blood sugar levels rising higher than normal. This is known as having high blood sugar.

Diabetes is often associated with hyperglycemia and high blood sugar, and the longer you have diabetes and the less you monitor and maintain adequate blood sugar levels, the more prone you are to medical complications associated with this issue.

Diabetic Retinopathy is a common condition for those with diabetes because it is caused when too much sugar is in the blood, creating blockages in the bloodstream.

These blockages result in changes to the blood vessels in the retina and cut off its blood supply. This is crucial because blood carries important nutrients and without it, the retina will begin to deteriorate.

Once blockages occur, the body responds by attempting to develop new blood vessels in its place. However, these blood vessels are very fragile and often do not develop properly, which causes leaking and swelling tinues to spend a significant amount of time rehabilitating. I can sense her frustration, anger, and sadness, that she cannot move the way she did before her injury. She has lost part of her independence. She loves to go out and travel, and now she is mostly homebound.

These events impact others in the family as well. I had to hurry and arrange for alternate childcare, as Lola/Lolo daycare (the best that there is!) was no longer available.

I worry about my dad and brother who continue to take time off from work and other parts of their lives to aid my Mom with her needs.

This one injury has af- and results in major eye and vision complications.

Because of the effects of diabetes on the blood, anyone with diabetes is prone to diabetic retinopathy. There are, however, risk factors that may raise your risk of developing this condition that you may be cautious of, such as:

• Pregnancy

• Tobacco use

• Poor control of blood sugar levels

• High blood pressure

• High cholesterol

• Race (Black, Hispanic, fected all of us and our daily routines, but my Mom most of all. We continue to be positive and adjust daily.

I realize that we don’t expect bad things to happen to us or our family members; but we can’t have a “bahala na” attitude and have a passive approach to our health, especially as we age.

It is important to be aware of our overall health risks, be prepared for the just-in-case, and focus on prevention. With special regard to hip fractures, if you suspect injury after a fall, it is important to go to the ER for evaluation since timely treatment decreases overall mortality.

It is important to acknowl- betes, and come up with a treatment plan.

If you have diabetes and become pregnant, we highly suggest receiving a dilated eye exam in your first trimester and throughout the pregnancy, up to one year after.

Diabetic retinopathy cannot always be prevented, but severe vision loss and eye problems resulting from diabetic retinopathy can be. This can be done by:

• Monitoring and maintaining your blood sugar levels

• Keeping your blood pressure and cholesterol under control

• Eating a healthy and balanced diet

• Keeping your body active

• Quitting smoking and tobacco use

• Testing hemoglobin A1c levels regularly and Native American ethnicities show the highest risk)

Unfortunately, the longer you have diabetes, the higher the risk of developing diabetic retinopathy. That is why it is crucial for those with diabetes to receive a dilated eye exam every year.

Through this, your doctor will be able to check your signs in the retina and other parts of the eye, and diagnose any eye conditions that may be brought on by dia- edge the risks and make efforts to be safer. Speak up to your doctor about falling concerns, check your medications, and assess risks. Check your eyes and feet. Wear proper footwear. Keep moving with activities like Tai Chi and walking to strengthen your legs and balance. Make your home safe by removing clutter, having handrails, increasing lights, and being mindful of kids and pets. Start conversations with your family about contingency plans and advanced care directives for if and when something should happen.

For more information about preventing falls as a core focus of Hawaii’s Injury Prevention Plan, please

• Testing urine for ketone levels regularly

• Taking medication as directed and on schedule

• Using Insulin as directed Remember, diabetes does not mean inevitable vision loss. With proper management and an active healthy lifestyle, you can live life to the fullest and without serious health complications brought on by diabetes.

DR. STEVEN RHEE, Medical Director and Cornea Specialist with Hawaiian Eye Center.

visit health.hawaii.gov/injuryprevention/home/preventing-falls/information/.

I’d like to thank my mother Agnes Rustia Ver for allowing me to share her story. We hope that you are more informed on what to expect and prompted to take action.

I’d also like to acknowledge my orthopedic surgeon colleagues Dr. Mariya Opanova and Dr. Tim Fei who contributed their expertise to this article and very thankfully to my mother’s care.