Diabetic Eye Disease encompasses a number of eye conditions, including diabetic retinopathy, and it is the leading cause of blindness among working-age Americans. Diabetic retinopathy consists of leaking blood vessels and growth of new, unhealthy blood vessels in more advanced stages. Mild diabetic eye disease does not usually have symptoms, but as it becomes more advanced, patients can suffer from central vision loss due to fluid leakage in the retina. In addition, diabetic eye disease can lead to retinal detachments or to ischemia (a condition where there is not enough oxygen in the retina). In both of these cases, the vision loss can be severe and is not often reversible.
Diabetic eye disease is treated with lasers, ocular injections and it sometimes requires surgical intervention. Many of these treatments can reduce peripheral vision and lead to impaired night vision.
All patients with diabetes are at risk for developing diabetic eye disease but the risk goes up with poor blood sugar control as well as with a longer period of time with the disease. Additional information about the types of diabetic eye disease, risk factors and treatments are available on the NIH website: http://www.nei.nih.gov/health/diabetic/retinopathy.asp
In the Vision Rehabilitation Service, we work with patients with all types of diabetic eye disease. Many people with vision loss from diabetes describe fluctuating vision. This can vary day to day or even within a single day. Additionally, people with diabetic eye disease have difficulty adapting to varying lighting conditions, i.e. coming inside after being in the bright sun or entering dark subway stations. Diabetic eye disease can lead to increased glare sensitivity both indoors (fluorescent and other lighting) and in the bright sun.
In some cases, there is central vision loss from macular edema or macular ischemia and magnification can be the best option to maximize reading fluency. In other cases, we recommend environmental modifications such as changes to lighting, enhancing contrast of everyday objects (i.e. in the kitchen and for medication/blood sugar management).
Specific recommendations for maximizing mobility safety including appropriate spectacles, mobility aides or referrals for mobility assistance can be instrumental in enhancing independence. In conjunction with the patient, and when applicable, we develop a rehabilitative plan to maintain employment and to maximize independence at home.