Diabetic retinopathy is a complication of diabetes that results from damage to the blood vessels of the light-sensitive tissue at the back of the eye (retina). At first, diabetic retinopathy may cause no symptoms or only mild vision problems. Eventually, however, diabetic retinopathy can result in blindness. In the United States as in most parts of the advanced world, diabetic retinopathy is a leading cause of blindness in adults.
Diabetic retinopathy can happen to anyone who has type 1 diabetes or type 2 diabetes. In fact, up to 45 percent of adults diagnosed with diabetes in the United States have some degree of diabetic retinopathy, according to the National Eye Institute. And the longer you have diabetes, the more likely you are to develop diabetic retinopathy.
To protect your vision, take prevention seriously. Start by controlling your blood sugar level and scheduling yearly eye exams.
Most people can have diabetic retinopathy and not know it. In fact, symptoms are unusual in the early stages of diabetic retinopathy. As the condition progresses, diabetic retinopathy symptoms may include:
When you have diabetes, your body doesn't use sugar (glucose) properly. If your blood sugar level is too high, your natural lens may swell - which can blur your vision. Eventually, too much sugar in your blood can damage the tiny blood vessels (capillaries) that nourish the retina. This can result in diabetic retinopathy.
Diabetic retinopathy is usually classified as early or advanced.
Early Diabetic Retinopathy: Nonproliferative diabetic retinopathy (NPDR) is the most common type of diabetic retinopathy. It can be described as mild, moderate or severe. When you have NPDR, the walls of the blood vessels in your retina weaken. Tiny bulges protrude from the vessel walls, sometimes leaking or oozing fluid and blood into the retina. These bulges are called microaneurysms. As the condition progresses, the smaller vessels may close entirely and the larger retinal veins may begin to dilate and become irregular in diameter. Nerve fibers in the retina may begin to swell. Sometimes the central part of the retina (macula) begins to swell, too. This is known as macular edema.
Advanced Diabetic Retinopathy Proliferative diabetic retinopathy (PDR) is the most severe type of diabetic retinopathy. When you have PDR, abnormal blood vessels grow in the retina. Sometimes the new blood vessels grow or leak into the clear, jelly-like substance that fills the center of your eye (vitreous). Eventually, scar tissue stimulated by the growth of new blood vessels may cause the retina to detach from the back of your eye. If the new blood vessels interfere with the normal flow of fluid out of the eye, pressure may build up in the eyeball. This can damage the nerve that carries images from your eye to your brain (optic nerve).
Diabetic retinopathy can happen to anyone who has diabetes. The risk is highest if you:
- 1. Have poor control of your blood sugar level
- 2. Have high blood pressure
- 3. Have high cholesterol
- 4. Are pregnant
- 5. Have duration of diabetes for more than 7 to 10 years
- 6. Smoke
Early detection of diabetic retinopathy is the best way to prevent vision loss. If you have diabetes, see your eye doctor for a yearly dilated eye exam - even if your vision seems fine. If you become pregnant, your eye doctor may recommend additional eye exams throughout your pregnancy.
Contact your eye doctor right away if you experience sudden vision changes or your vision becomes blurry, spotty or hazy.
It is important to understand that diabetic retinopathy causes irreversible loss of vision and therefore early detection and prevention is of paramount importance.
Once your eye doctor has confirmed the diagnosed during your routine eye examination, he may order supplementary tests like a Fundus Fluroscein Angiography and a OCT Scan of the Retina to assess the extent to which the disease has affected the retina.
Depending on the severity of the disease at the time of presentation, treatment may range from observation and control of blood sugars to retinal laser photocoagulation, Intravitreal injections of Anti- VEGF agents like Lucentis, Eyelea or Avastin and even surgeries like Vitrectomy in advanced stages of the disease where they may be excessive bleeding into the back of the eye threatening vision.
It is equally important to understand that whatever the modality of treatment, strict control of blood sugar and co-morbid risk factors like systemic hypertension, dyslipidemias, obesity and smoking and disciplined follow up with your eye care provider will go a long way in the control and management of the disease.