Diabetes is one of the most common causes of vision loss in adults. The changes diabetes causes in your eyes often develop silently, with no noticeable symptoms, until significant damage has already occurred. That is why catching problems early through regular examinations is so critical.

At Zelenak Eye Institute in Wixom, Michigan, Dr. Zelenak performs thorough dilated eye exams to screen for diabetic eye disease and works closely with patients throughout Novi, Northville, Livonia, and the broader Metro Detroit area to monitor and manage their eye health over time.

A complete eye exam is not the same as getting your glasses checked. Patients with diabetes need a full dilated exam where Dr. Zelenak examines the back of the eye for subtle signs of damage. Just like with glaucoma, your best chance of preventing severe vision loss means catching problems early and treating them.


What Is Diabetic Eye Disease?

Diabetic eye disease refers to a group of eye conditions caused by diabetes, most commonly diabetic retinopathy. When someone has uncontrolled or poorly managed diabetes, the walls of the tiny blood vessels in the body, called capillaries, are damaged and begin to shut down, causing a lack of blood and oxygen to affected tissues.

This process, known as capillary dropout, is the same reason people with diabetes are at higher risk for strokes, heart attacks, kidney damage, neuropathy, and wounds that do not heal. When Dr. Zelenak looks in the back of your eye during a dilated exam, he is looking directly at these small blood vessels and can see early signs of this damage.

Damage to the blood vessels in the back of the eye is called Diabetic Retinopathy, and it generally indicates that similar damage is occurring elsewhere in the body. The earlier it is detected, the more options we have to protect your vision.

When Dr. Zelenak examines your retina, he is looking directly at the small blood vessels affected by diabetes. This makes a dilated eye exam one of the most informative windows into your overall health.


How Does Diabetic Retinopathy Progress?

Diabetic retinopathy is categorized into two main stages. Understanding where you fall helps Dr. Zelenak determine the right monitoring and treatment plan for your specific situation.

Mild Non-Proliferative
Lower Risk

Early changes in the retinal blood vessels. Careful monitoring is the primary approach at this stage.

Moderate Non-Proliferative
Moderate Risk

More significant vessel damage. Some patients develop macular edema, which can affect central vision.

Severe Non-Proliferative
Higher Risk

Extensive vessel damage. A significant risk of progressing to the proliferative stage without treatment.

Proliferative Retinopathy
Most Severe

New, fragile blood vessels grow in the eye. Risk of vitreous hemorrhage, retinal detachment, and blindness.

In the non-proliferative stages, Dr. Zelenak closely monitors the eye for early signs of worsening. Some patients at this stage develop macular edema, a swelling of the retina that can lead to central vision loss. This can be treated with steroids, laser treatment, or injections of medication into the back of the eye.


What Is Proliferative Diabetic Retinopathy?

When diabetic retinopathy progresses to the proliferative stage, it becomes very serious. The damage to the retina has become so severe that the tissue is not receiving enough oxygen. In response, the retina sends out chemical signals that cause new blood vessels to grow, or “proliferate.”

These new blood vessels are fragile and cause significant problems. They can bleed into the vitreous gel at the back of the eye, a condition called a vitreous hemorrhage, which can block vision suddenly and severely. Unfortunately, this is often the first sign patients notice, presenting to our office because they can no longer see out of one or both eyes.

These new blood vessels can also pull on the retina, causing a retinal detachment, which is one of the leading causes of blindness from proliferative diabetic retinopathy. This is why regular monitoring is so critical before complications develop.

Proliferative retinopathy is a medical emergency. If you experience a sudden loss of vision or a significant increase in floaters, contact our office immediately or go to the nearest emergency room.


How Is Diabetic Retinopathy Treated?

The right treatment depends on the stage of your retinopathy and the specific complications present. Dr. Zelenak will discuss the best approach for your individual situation.

  • Observation and monitoring: For mild non-proliferative retinopathy, close monitoring with annual or more frequent exams may be all that is needed, alongside tight control of blood sugar and blood pressure.
  • Anti-VEGF injections: Medications injected into the eye that block the chemical signals causing new blood vessel growth and reduce macular swelling. These newer medications have significantly improved outcomes for many patients.
  • Laser treatment for macular edema: Targeted laser applied to areas of swelling in the retina to reduce fluid leakage and help preserve central vision.
  • Panretinal Photocoagulation (PRP): A laser treatment for proliferative retinopathy that carefully destroys the oxygen-deprived areas of the peripheral retina sending out the signals causing new vessel growth. PRP has been performed since the 1950s and remains one of the most effective tools for stabilizing proliferative retinopathy and preserving central vision.
  • Referral to a retina surgeon: Patients with advanced proliferative retinopathy involving vitreous hemorrhage or retinal detachment are typically referred to a retina specialist for surgical intervention.

Controlling your blood sugar is the single most critical factor in reducing your risk of developing diabetic retinopathy and slowing its progression. Controlling blood pressure and not smoking are equally important steps you can take to protect your vision.


Key Factors in Managing Diabetic Eye Disease

While regular eye exams with Dr. Zelenak are essential, the following factors play a major role in protecting your vision over time.

Blood Sugar Control
The most important factor. Keeping A1C levels in your target range dramatically reduces the risk of retinopathy.
Blood Pressure
High blood pressure accelerates damage to the retinal blood vessels. Keeping it controlled is critical.
Not Smoking
Smoking significantly worsens blood vessel damage and increases the risk of vision loss.
Annual Eye Exams
Regular dilated exams catch changes early, when treatment is most effective and vision can be preserved.
Cholesterol Control
Elevated cholesterol can contribute to retinal damage and macular edema in diabetic patients.
Duration of Diabetes
The longer you have had diabetes, the higher your risk. Long-term patients benefit most from consistent monitoring.

Diabetic Eye Care for Patients Throughout Metro Detroit

Patients with diabetes throughout Wixom, Novi, Northville, Livonia, and the greater Metro Detroit area trust Zelenak Eye Institute for their annual diabetic eye care because of Dr. Zelenak’s thorough, personalized approach.

Schedule Your Annual Diabetic Eye Exam Today

If you have diabetes and have not had a dilated eye exam in the past year, do not wait. Early detection is the key to preserving your vision. We welcome patients from throughout Michigan.

Wixom, MI Novi, MI Northville, MI Livonia, MI Walled Lake, MI Brighton, MI Metro Detroit, MI
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