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Diabetic Retinopathy: A Q&A with Drexel Ophthalmologist Dr. Williamson

Human Eye

People with type 1 or type 2 diabetes may also develop diabetic retinopathy, a diabetes complication that affects the eyes. Diabetic retinopathy may begin with no symptoms or mild vision problems, but it could eventually cause blindness. Drexel Ophthalmologist Kelly A. Williamson, MD, who specializes in the management of diabetic retinopathy, answers some common questions and explains why it is important to have a yearly eye exam, even if you have no symptoms.

What is diabetic retinopathy?

Diabetic retinopathy describes abnormalities of the retina as the result of diabetes mellitus. The retina is the area inside of your eye that perceives light. In diabetic retinopathy, the small blood vessels in the eye begin to function abnormally due to chronically elevated blood glucose levels. Poor blood flow to the eye causes the retina to become starved for oxygen, which in turn leads to the production of chemicals that cause the blood vessels to leak and bleed. This results in hemorrhaging, swelling, and “exudates,” which are abnormal deposits of material in the retina. Severe diabetic retinopathy can result in the growth of new, abnormal blood vessels that have a high risk of bleeding or causing structural problems in the eye. Diabetic retinopathy can result in blurred vision in the mild and moderate stages and can result in blindness if it becomes very severe.

Diabetic Retinopathy vector illustration diagram anatomical scheme

What is the difference between nonproliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR)?

Nonproliferative diabetic retinopathy (NPDR) is a milder form of the disease that results in blood vessel abnormalities (“microaneurysms”), hemorrhages, exudative deposits, and/or swelling in the retina. Proliferative diabetic retinopathy (PDR) occurs when the retina is even more starved for oxygen and chemicals are released that cause new blood vessels to grow in the retina. These new blood vessels do not function normally, have a high tendency to bleed into the eye and can cause scarring that may result in retinal detachments. While some milder forms of nonproliferative retinopathy do not require treatment other than blood sugar control, proliferative diabetic retinopathy is a sign that the eye is very starved for oxygen and almost always requires some sort of treatment to the eye. Treatment may include laser, injections of medications into the eye and/or surgery in the operating room.

What complications may arise from diabetic retinopathy?

Even milder forms of nonproliferative diabetic retinopathy can result in swelling of the retina that may result in blurred vision. In this case, ophthalmologists usually begin treatment to reduce the swelling with laser treatments, injections of medications into the eye or some combination of those two. With the more severe condition of proliferative diabetic retinopathy, patients can suffer from vitreous hemorrhage (bleeding into the eye, or an “eye full of blood”), retinal detachments, and even a dangerous form of glaucoma that can result in pain and/or blindness.


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What puts a patient with diabetes at risk for developing diabetic retinopathy?

In general, patients with higher blood sugar levels and higher hemoglobin A1c levels are at a higher risk of developing diabetic retinopathy. The hemoglobin A1c level is a blood test that your primary doctor or endocrinologist may use that gives an idea of what the blood glucose levels have been over a period of a few months. Several studies have shown that even small reductions in the hemoglobin A1c can result in significant reductions to the risk of developing retinal disease. Patients who have had diabetes for a longer period of time are also at a higher risk of developing retinopathy.

Can patients do anything to prevent diabetic retinopathy?

The most important things that patients can do to prevent the development of diabetic retinopathy are to 1) work hard with their primary doctor and/or endocrinologist to monitor and control their blood glucose levels, and 2) remember to get an annual eye examination. Even patients with normal vision may have severe diabetic retinopathy and be completely unaware. Having a dilated eye examination every year is critical to help monitor for problems and allows us to intervene early if problems are seen.

What services do Drexel Eye Physicians offer for patients with diabetic retinopathy?

Mild diabetic retinopathy may require only more strict blood glucose control and more frequent eye examinations. If retinal swelling is present, patients may require injections of medications into the eye or laser procedures to reduce the swelling and restore vision to normal. Patients with severe nonproliferative or proliferative retinopathy are often treated with laser surgery in the office. Very severe proliferative retinopathy may require surgery in the operating room to correct structural problems such as retinal detachments or intraocular hemorrhages to adequately treat the disease. These services are provided by our fellowship-trained, vitreoretinal surgeons at Drexel Eye Physicians. Laser procedures and intraocular injections are performed regularly in our office, and surgery is performed at Hahnemann University Hospital.

Related Physician

Kelly A. Williamson, MD

Kelly A. Williamson, MD
Title: Faculty
Practice: Drexel Eye Physicians
Specialty: Ophthalmology

The information on these pages is provided for general information only and should not be used for diagnosis or treatment, or as a substitute for consultation with a physician or health care professional. If you have specific questions or concerns about your health, you should consult your health care professional.

The images being used are for illustrative purposes only; any person depicted is a model.

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