Watch a video on diabetic retinopathy (NP)
Moore Eye, Experts in Diabetic Eye Care
Dr. Ginsburg co-authored,
with the inventor of the
PRP laser for diabetes at Harvard, for the American Academy of Ophthalmology, the Focal Points
The Diabetic Eye Center at Moore Eye Institute brings a pioneering, multi-disciplinary team approach to the diagnosis, treatment and prevention of diabetes in the Philadelphia. All too often, eye care centers just treat the eyes but forget the systemic nature of the condition and the person that has diabetes. The best treatment comes from caring and preventing progression is our goal.
Our Diabetic care is led by Dr. Ginsburg, one of the only retina specialists in the world that is also a certified diabetes educator. We put together a team of doctors and allied professionals that motivate, evaluate and care for the total person in a unique way. When one takes on the challenge of motivating patients to change a lifestyle so that blood sugar can be more tightly controlled, which is proven to reduce complications by 78%, a patient’s family, background, ethnicity, religion, and economic challenges all must be taken into consideration. Because Dr. Ginsburg’s grandfather, who eventually became blind but had been passionately cared for at the Joslin Diabetes Center, Dr. Ginsburg has dedicated his life to the care of diabetes and ultimately trained at the Joslin Diabetes Center at Harvard University. He was the founder and chairman of a total diabetes center that, at one point, had more certified diabetes educators than almost anywhere else in the world. By working with endocrinologists, nephrologists, primary care physicians, optometrists, ophthalmologists, and most importantly, the patient themselves and their family, the challenges are recognized, but when you speak of eye disease, the number one cause of blindness in those under the age of 65, prevention is not the only answer. Proper diagnosis and treatment is critical. This Diabetes Center has groundbreaking technology permitting the finest care and diagnosis for patients with diabetes.
New techniques that were implemented included the first OCT in the state of Pennsylvania, the best method for evaluating diabetic macular edema, which occurs from leakage and swelling in the very center of the eye. Using a tiny laser beam or intravitreal injections of steroid or new drugs such as Lucentis and Avastin, which are known as anti-VEGF medications that can act to decrease or eliminate the growth of abnormal vessels, the retina doctors are Moore are truly making a difference in the sight of their patients. Our visual rehabilitation center, through the Moore Eye Foundation, has literally world leaders in rehabilitation of patients with vision loss with groundbreaking research and developing new methods to maximize patients’ vision under the leadership of Dr. Richard Brilliant.
Although vision loss from diabetes cannot yet be “cured”, each day doctors at the Center are working to tirelessly make a difference.
Diabetic Eye Disease There is no medical condition that requires the patient’s involvement than diabetes. No patient with diabetes is like any other patient, and care must be individualized. Prevention is the key through a total systemic approach through exercise, proper nutrition and medication, when needed. It is critical that patients with diabetes have a multi-disciplinary team where the primary care physician works with specialists, such as those at the Diabetes Center at Moore Eye Institute.
What is Diabetic retinopathy? The retina (film of the eye) has thousands of small retinal blood vessels. Changing blood sugar from diabetes causes the small retinal vessels (capillaries) to weaken and to either leak or to be clogged and close off. This causes two major challenges to the eye are Diabetic macular edema (swelling within the center of the retina from fluid) and Neovascularization (new blood vessels that are abnormal and grow on the surface of the retina).
Diabetic Macular Edema (DME) This is the number one cause of permanent decreased vision among patients with diabetes. The blood vessels that are damaged from high blood sugars result in leakage of fluid into the very sensitive retinal tissue causing swelling and thickness of the retina, just as you would see if a dry sponge became soaked with water. Initially, a person may not even know they have it until it hits the very center. Only a good exam by an eye doctor will discover this. The initial symptoms are a slight blurring of vision. It is critical to begin treatment prior to significant vision loss.
Neovascularization of the Retina This occurs when blood vessels that have become weakened slowly become clogged. This results in the growth of abnormal new blood vessels that are extremely fragile and could easily break. Since these vessels contain blood in them, when they break, you get a hemorrhage and suddenly a person can see black spots in their vision and can actually result in profound vision loss if the entire eye fills with blood. As with DME, the first signs of neovascularization have no symptoms whatsoever. This is when treatment is most effective. That is why it is critical to be examined even if there are no symptoms.
Moore Eye Institute has groundbreaking technology to help discover the problems at the most treatable stage.
Physicians at Moore Eye Institute, through the OCT, which they introduced in Pennsylvania, can actually measure if the retina and macula are thickened, how much and where. Then, using a fluorescein angiogram, they can see precisely where the blood vessel is leaking from and close it with a laser called a focal treatment. When blood vessels are abnormal, multiple and grow, a laser treatment called panretinal photocoagulation can be applied. This treatment that was invented by Dr. Lloyd Aiello at Joslin Diabetes Center in 1969 and who taught Dr. Ginsburg, the Director of the Retina and Diabetic Eye Specialists and Chairman of Moore Eye Institute, can close these blood vessels.
Below are examples of diabetic macular edema. You can see within the retina white spots, which are actual salt deposits from the blood. (Blood is composed of red blood cells and salt water, and it is this salt residue that you see in the pictures). After laser, the leaks are closed and the salt residue that destroys vision, along with the swelling of fluid, disappears and the retina returns to normal. (One slide of pre and post laser treatment)
The second slides are examples of Neovascularization (proliferative diabetic retinopathy). These are the abnormal blood vessels that grow in diabetes that can break and bleed. Examples of them breaking and bleeding are seen below. Note, the black spots that might appear in someone’s vision when they look out from this blood in the eye. Laser treatment can make these blood vessels entirely disappear and was invented by Dr. Aiello. (See the slide where the retina returns to mostly normal.)
If the eye fills with blood, the bloody jelly in the eye needs to be removed and replaced with clear fluid through a process called vitrectomy, a surgical procedure that the doctors at Moore Eye Institute are expert in using the finest surgical equipment in their advanced operating rooms in their associated hospitals.
To learn more about the latest Diabetic Treatments we provide for people in Chester County, Montgomery County, Delaware County, and the surrounding areas, calll Moore Eye Institute at 610-690-4900 or click here to schedule an appointment today.