Eye Conditions

Diabetic & Hypertensive Eye Care | Retinal Disorders | Macular Degeneration

Diabetic & Hypertensive Eye Care

People with diabetes are unfortunately at a higher risk for numerous diabetic eye diseases, which can lead to severe vision loss and sometimes even blindness.  Diabetic eye diseases include diabetic retinopathy.

Diabetic Retinopathy

Diabetic retinopathy is an eye disease that damages the blood vessels in the retina and usually affects both eyes.  Diabetic retinopathy can affect people with Type 1 and Type 2 diabetes.  There are four stages to diabetic retinopathy:

  • Mild Nonproliferative Retinopathy – Minor swelling occurs in small regions in the tiny blood vessels of the retina.
  • Moderate Nonproliferative Retinopathy – The blood vessels in the retina are blocked.
  • Severe Nonproliferative Retinopathy – The blockage of the blood vessels causes malnourishment to the retina, which causes the retina to send signals to the body to create new blood vessels.
  • Proliferative Retinopathy – The newly formed blood vessels develop along the surface of the retina and are very fragile.  Their fragility can cause them to leak, which can cause severe vision loss and even blindness.  This stage can also cause macular edema, which can lead to vision loss.

There are no common symptoms present during the early stages of diabetic retinopathy.  If you experience blurred vision or "floating" spots, schedule an eye exam as soon as possible.

People with diabetes can help prevent the development of diabetic retinopathy by carefully managing their blood sugar level and blood pressure.  If a person is in the final stage of diabetic retinopathy (Proliferative Retinopathy), laser treatments are available to help shrink the fragile blood vessels, which can ultimately preserve the rest of their sight.

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Retinal Disorders

Retinal Detachment

Retinal detachment is a very serious condition which can cause severe or even permanent vision loss.  It occurs when the retina becomes separated from the underlying supportive tissues, which prevents the retina from functioning properly.  Some common symptoms may include: spots, floaters, flashes of light, poorer vision or a shadow appearance across the top of the eye.  No pain is associated with retinal detachment.  If you notice any of the above symptoms or believe you have a detached retina it is vitally important to seek ophthalmic care immediately to prevent permanent vision loss.


Floaters are small specks that move in and out of your field of vision.  They may be more noticeable when looking at a plain background.  Floaters are tiny clumps of cells inside the vitreous humor (the clear fluid that fills the inside of the eye) that can be different shapes.

Macular Hole

Macular holes are tears or cysts that can develop in the macula (a small spot in the retina, or back inner part of the eye).  This is where fine focusing occurs.  A macular hole is usually noticed when there is a sudden decrease in vision in one eye.  Macular holes are most often related to the aging process and are most common in people over 60.

Occasionally, macular holes may resolve without treatment, but we recommend you schedule an eye exam as soon as possible if you notice a sudden loss of vision in one eye, so the doctor can determine if treatment is necessary.  This can help prevent permanent vision loss.

The most common treatment for macular holes is a surgery called vitrectomy, which removes the vitreous gel to prevent it from pulling on the retina.  Then, a mixture of air and gas is inserted where the vitreous once was, putting pressure on the macular hole, allowing it to heal.  This treatment will require a long recovery period to ensure lasting results.  For more information about this surgery, please contact our office.

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Macular Degeneration

Macular degeneration (AMD or ARMD) is an age-related condition that leads to vision loss in the center of the field of vision.  Along with glaucoma, AMD is one of the leading causes of vision loss in Americans 65 and older.

There are two types of macular degeneration:

  • Dry Macular Degeneration is the more common form of AMD that causes the center of the retina (macula) to deteriorate, resulting in blurred vision.  Dry macular degeneration occurs as part of the normal aging process, causing the macular tissue to thin and deposit pigmentation in the center part of the eye, thus distorting your vision.
  • Wet Macular Degeneration is not as common as dry AMD, but it is more damaging and can lead to more serious vision loss.  Wet macular degeneration occurs when new blood vessels begin to grow under the retina and leak fluid and blood, which can cause permanent damage and loss of vision.

There are two categories of wet macular degeneration: occult and classic.  Occult wet macular degeneration is when the growth of blood vessels is not as prominent and the leakage is less apparent.  This is less damaging than classic wet degeneration, which is when the blood vessel growth is very obvious producing noticeable outlines beneath the retina.  This produces more severe vision loss.

Generally, AMD is a progressive condition slowly causing vision loss.  In rare instances though, symptoms can appear suddenly.  If you begin to have difficulty reading in low lighted areas, notice an increase in blurriness in words, recognize an apparent blind spot in the center of your field of vision or begin to notice a decrease in the brightness of colors, you may have macular degeneration.

The exact cause of dry macular degeneration is still unknown, but aging and genetics are suggested contributing factors of this condition.  There is no cure for age-related macular degeneration, but there are treatments available that may help slow down the progression of the disease or possibly even improve vision.

Treatments vary depending on the type and severity of AMD.  There are no FDA-approved treatments available for dry AMD, but certain nutritional therapies have shown to help prevent the progression to wet AMD.  Treatment for wet AMD uses certain medications that focus on preventing future growth of abnormal blood vessels.

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William N. Rosenthal, MD, FACS

Main Office: 10740 Nall Ave., Suite 220 • Overland Park, KS 66211 • Phone: 913.663.5900Fax: 913.663.5902

916 Highway 69 S. • Fort Scott, KS 66701

2790 Clay Edwards Dr., Suite 1240 • North Kansas City, MO 64116