A spot of yellow light.
That’s all Erica Powell could see during a 10-minute procedure where a doctor used a laser to seal hemorrhages in her eye.
As a Type 1 diabetic for 30 years, Powell, 58, was not surprised when on a recent morning she woke up to see blood in her right eye.
“I could see the blood — not by looking in the mirror. By me looking, I could see the blood,” said Powell, of Allapattah.
Like many other people with diabetes, Powell has had problems with her eyes. About three years ago , she was diagnosed with diabetic retinopathy, which causes blood vessels in the retina to bulge and leak plasma. The condition also leads to the formation of new harmful blood vessels that may hemorrhage, hindering vision.
More than 60 percent of people who have had Type 2 diabetes for at least 20 years, along with nearly all who have had Type 1 diabetes for the same amount of time, will develop diabetic retinopathy, according to the American Diabetes Association.
More than five million people in the U.S. have diabetic retinopathy, according to the Centers for Disease Control and Prevention, a number that is expected to grow to 16 million by 2050.
If left untreated, diabetic retinopathy can lead to loss of eyesight. It is the leading cause of blindness among working-age Americans.
Doctors at Bascom Palmer Eye Institute, part of the University of Miami Health System, use one of three procedures to aid patients with diabetic retinopathy: surgery, an injection and a laser. The choice of treatment depends on whether the diabetic retinopathy is non-proliferative or proliferative.
Non-proliferative diabetic retinopathy occurs in an earlier stage and is associated with bulging blood vessels and plasma leakage in the eye. Doctors administer an injection into the eye, which counters the signal that causes leakage within the retina. The medication reduces the leakage in the eye and may improve eyesight.
Proliferative diabetic retinopathy is the result of narrowing blood vessels in the eye due to diabetes. The tighter blood vessels make it difficult for blood, oxygen and nutrition to circulate to the eye.
Through a chemical signal, new blood vessels are formed. However, these new blood vessels grow in the wrong locations and are harmful, resulting in a condition called neovascularization, said Dr. William Smiddy, a professor of ophthalmology at Bascom Palmer Eye Institute.
Doctors use a laser to burn the areas of the eye where the new blood vessels have formed. The laser makes a scar in the retina, which makes the newly formed blood vessels disappear.
“It’s like scraping your knee and having a scar there. There are no blood vessels in the scar,” Smiddy said.
While a laser procedure is permanent, the injection procedure is a temporary fix and should be repeated every six to 12 weeks.
Sometimes the new blood vessels turn into scar tissue after they have bled. The scar tissue pulls on the retina, detaching it from its normal position. Surgery is then required, a procedure known as a vitrectomy.
That was the condition Powell developed about three years ago when she first started having issues with her eyes because of her Type 1 diabetes.
“It looked like I had a shadow over my left eye,” she said, describing the way she was seeing.
After her surgery, it took her about one week to heal and see normally. And although the scare of retinopathy remains, she said it is not something she spends a lot of time worrying about.
“I know the risk is there,” she said. “But I am more concerned about taking care of my blood-sugar level, taking my insulin and eating properly.”