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EYE CARE AND EYE CARE AND
QUALITY OF LIFE QUALITY OF LIFE

Diabetes and the Eye leaking new blood vessels, reduce retinal swelling, and remove vitre- In summary, it is imperative for clinicians to recognize the sub-

ous blood or scar tissue to preserve vision and prevent further damage stantial threat Diabetes Mellitus poses to ocular health, with the
to the eye. The rule is always: the earlier the intervention, the better potential for vision loss if not diligently managed through timely
By Jake Trinidad, MD the outcome. detection and intervention. The ophthalmologic examination, par-
ticularly utilizing fundus photography, not only aids in diagnosis
iabetes mellitus, a chronic metabolic disorder characterized What is Diabetic Retinopathy? Other Complications of Diabetic’s on Eye Health and Vision: but also serves as a pivotal educational tool for patients, elucidating
by high levels of glucose in the blood, can lead to a multitude Diabetic retinopathy is the most common and one of the most Cataracts the profound impact of diabetes on vascular health. I have witnessed
Dof complications, including several that affect the eye. Lever- serious eye conditions associated with diabetes. It is classified into two Diabetes can also accelerate the formation of cataracts, a clouding firsthand how this knowledge can catalyze a transformative shift
aging my experience as a practicing ophthalmologist, I aim to highlight stages: non-proliferative diabetic retinopathy (NPDR) and proliferative of the eye’s lens that obstructs light from reaching the retina. People in patients’ attitudes towards their health. Ultimately, the corner-
in this article the imperative of a holistic care approach in managing diabetic retinopathy (PDR). NPDR is the early stage, characterized by with diabetes tend to develop cataracts at a younger age and progress stone for preserving vision in diabetic populations lies in meticulous
diabetic patients, illustrating how vigilant eye health monitoring can swelling and weakening of the retinal blood vessels, which will eventually more rapidly than individuals without diabetes. Cataracts can be debil- glycemic control coupled with prompt detection, treatment and
act as a crucial early warning system for diabetes's broader impact. By lead to blood and fluid leaking into the retina. As the condition progress- itating to a patient’s quality of life and can be corrected quickly with comprehensive care. Regular eye assessments are indispensable for
closely and consistently observing these ocular changes, we possess the es to PDR, tissue hypoxia and vascular damage leads to the release of a minimally invasive surgery. Cataract surgery is one of the most per- all diabetic individuals, as various forms of diabetic eye pathology
opportunity to utilize the eye as a mirror to one’s general health, thus vascular endothelial growth factor (VEGF). VEGF signals the prolifer- formed and one of the safest procedures in all of medicine, and can can advance stealthily without early warning signs. Therefore, it is
mitigating the more severe consequences of diabetes. ation of new, fragile blood vessels that grow on the surface of the retina greatly improve the quality of life of your patients. recommended that diabetic patients undergo a thorough dilated eye
and into the vitreous. These new vessels are prone to bleeding (vitreous examination at least annually, with increased frequency if pathology
Pathophysiology of Diabetic Eye Disease hemorrhage) and can lead to scarring and retinal detachment, a severe Glaucoma is present. As healthcare providers, it is our duty to underscore the
The etiology of diabetic ocular pathology hinges primarily on the complication that can ultimately lead to blindness. These ocular changes The propensity to develop glaucoma, a spectrum of disorders charac- significance of integrated management in diabetes care, ensuring our
prolonged exposure to sustained hyperglycemia, which instigates a are avoidable with early detection and treatment. terized by optic nerve damage, is markedly elevated in individuals with patients receive holistic support in safeguarding both their vision
cascade of microvascular damage within the retinal vasculature. diabetes. Among the various forms of glaucoma, neovascular glaucoma, and overall well-being.
This phenomenon results in a state of tissue hypoxia, paving the way Diabetic Macular Edema marked by the proliferation of new blood vessels on the iris and into the
for the emergence of diverse pathological manifestations encapsu- Diabetic Macular Edema (DME) represents a critical complication angle of the eye, can be the most devasting. As these vessels proliferate
lated within the umbrella of diabetic retinopathy. Moreover, the arising from the progression of diabetic retinopathy. Characterized by and scar the drainage structures, controlling intraocular pressure becomes Jake Trinidad, MD, is a board-certified ophthalmic surgeon
systemic hyperglycemia and concurrent vasculopathic changes not the pathophysiological accumulation of intraretinal fluid within the exceedingly difficult, necessitating surgical intervention rather than con- and clinician. A native of San Antonio, his educational journey
only potentiates the development of diabetic retinopathy, but also macular region of the retina, this area can undergo cytogenic and ventional medication due to the intricacies of the disease process. Con- took him from Clark High School to Trinity University and
heighten the predisposition to other ocular comorbidities, notably vasogenic edema due to the breakdown of the inner blood-retina barri- sequently, patients afflicted with neovascular glaucoma often face grim UIW, culminating in a medical degree from Indiana University
cataracts and glaucoma. er, precipitated by chronic hyperglycemia-induced microvascular dam- prognoses if it is allowed to advance unchecked. However, such dire out- School of Medicine. Following a residency, Dr. Trinidad chose to serve the
age. The macula rests at the center of the retina, comes can be averted through early detection and intervention strategies community of his hometown, where he has practiced for nearly a decade.
and is pivotal for central vision and high-resolu- such as Panretinal Photocoagulation targeting the peripheral retina. He is a member of the Bexar County Medical Society.
tion visual acuity. The resultant macular swelling
and disruption of retinal architecture can lead
to significant visual distortion and impairment.
Notably, DME does not adhere to a linear pro-
gression within the stages of diabetic retinopa-
thy, but can manifest across the spectrum of the
disease, underscoring its role as a principal etio-
logical factor in vision loss among the diabetic
population. It is of utmost importance to diag-
nose and treat DME as early as possible with laser
therapy and intravitreal injections to improve the
Right and left fundus photographs of retina demonstrating diabetic retinopathy. long-term outcome of visual prognosis.
Image taken by Dr. Jake Trinidad.
Management and Treatment of Diabetic
Retinopathy

Management of diabetic eye disease begins
first and foremost with the patient. Tight con-
trol of blood glucose levels, blood pressure and
lipid levels is essential in slowing the progression
of diabetic retinopathy. For those with advanced
diabetic retinopathy or DME, treatments such
as laser surgery (Panretinal Photocoagulation/ Fundus photograph of Panretinal Photocoagulation Macular edema with exudate. Regressed NVD with fibrosis after PRP with
Focal Grid), intravitreal injections of steroids, (PRP) laser for treatment of PDR. Image taken by Dr. Jake Trinidad. vitreous hemorrhage.
Image taken by Dr. Jake Trinidad.
Image taken by Dr. Jake Trinidad.
anti-VEGF (anti-vascular endothelial growth
Right and left fundus photographs demonstrating proliferative diabetic retinopathy. factor) agents and vitrectomy may be necessary.
Image taken by Dr. Jake Trinidad. The goal of each of these treatments is to seal

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