Q: What are the earliest signs of diabetic eye disease?

A: Since changes in the blood sugar level can cause blurred vision, sometimes newly diabetic patients may have received several new prescriptions for glasses over a short period. Once treatment brings blood sugar under control, the vision will no longer fluctuate.

Q: How can I avoid diabetic complications in my eyes?

A: Consistent, close control of diabetes offers the best hope, and methods of control are improving. For instance, an inexpensive portable device helps some patients monitor their blood sugar better. However, ocular complications can develop even in patents with well-controlled diabetes.

Q: What else can I do to avoid diabetes ocular complications?

A: Early diagnosis and treatment are important. So every diabetic patient should see and eye specialist regularly -- even if you are not having eye problems. Most ocular complications occur after more than 10 years of diabetes, but problems can strike anytime. To spot such problems, the eye specialist often uses a simple exam that dilates the pupil of the eye. This exam causes some blurred vision for a brief time, but the short inconvenience is worth the benefit of diagnosing eye trouble early.

Q: How often should I see my eye doctor?

A: The doctor will recommend a schedule, based on your particular needs.

Q: Are special tests required to detect ocular diabetic changes?

A: Often a simple exam is enough, but techniques such as ocular photography sometimes help the doctor determine the vest treatment for a damaged retina (the light-sensitive cell layer in the back of the eyeball.)

Q: Are there different types of diabetic retinopathy?

A: Two major types exist: Background and Proliferative. Background diabetic retinopathy occurs when the retina's small blood vessels become damaged. Signs include microaneurysms (tiny bulges in the vessels), cytoid bodies (also called cotton-wool spots) and bleeding within the retina. Proliferative diabetic retinopathy is the abnormal growth of blood vessels on the optic nerve, the retina or the jelly-like vitreous inside the eyeball. These blood vessels may cause sudden loss of vision if they bleed into the eyeball. Retinal detachment, which can require surgery, also may occur with proliferative diabetic retinopathy.

Q: What can prevent vision loss from background diabetic retinopathy?

A: The argon laser often can reduce blood vessel leakage and help swollen retinal areas. Such treatment helps the retina continue working.

Q: How does background diabetic retinopathy cause problems?

A: One clearly defined problem, among many complex changes, involves pericytes. These cells in the blood flow in capillaries, the smallest blood vessel wall most likely regulate blood flow in capillaries, the smallest blood vessels. When diabetes causes the body to mishandle the way it absorbs sugar, this improper sugar metabolism damages pericytes. The malfunctioning pericytes then cause loss of circulation, damage occurs, and other changes may start. For instance, leaking fluid may cause swelling in the central retinal area (the macular) and sharp vision may fade.

Q: What causes proliferative diabetic retinopathy?

A: Loss of retina circulation most likely triggers the problem. When retina cells do not get enough oxygen and nourishment from damage blood vessels, the cells send chemical commands called mediators, which cause new blood vessels to grow. Unfortunately, these new vessels often cause problems by bleeding into the eye.

Q: What is the best treatment for proliferative diabetic retinopathy?

A: Panretinal laser photocoagulation often can help avoid total loss of vision in an eye with proliferative diabetic retinography. The laser treatment, directed to non-vital areas of the retina, lessens the retina's need for oxygen and nutrients so fewer troublesome blood vessels grow.

Q: Have any scientific studies proven the best way to control diabetes and avoid eye problems?

A: Several methods, in combinations or alone, can help handle diabetes. Each patient requires individualized therapy, but one fact is certain: Doctor and patient must work together to control diabetes.