DIABETIC RETINOPATHY

Diabetic retinopathy is a condition that may occur if in people who have diabetes, either Type 1 or Type 2. It causes progressive damage to the retinas, usually affecting both eyes, resulting in cloudy or blurred vision.

Diabetic Retinopathy DiagramDiabetic retinopathy is a serious sight-threatening complication of diabetes.

Diabetic retinopathy occurs when tiny blood vessels in your retina become damaged, and leak blood and other fluids into your eye. The longer a person has diabetes, the more likely they are to develop diabetic retinopathy. Left untreated, diabetic retinopathy can cause serious vision complications, including:

  • Vitreous hemorrhage: Blood vessels may bleed into the clear, jelly-like substance that fills the center of your eye, filling the vitreous cavity and completely blocking your vision.
  • Retinal detachment: The abnormal blood vessels associated with diabetic retinopathy stimulate the growth of scar tissue, which can pull the retina away from the back of the eye, and cause spots floating in your vision, flashes of light, or severe vision loss.
  • Glaucoma: New blood vessels may grow in the front part of your eye and interfere with the normal flow of fluid out of the eye, causing pressure in the eye to build up (glaucoma and damage your optic nerve.
  • Blindness: Eventually, diabetic retinopathy, glaucoma, or both, can lead to complete vision loss.

TYPES OF DIABETIC RETINOPATHY

Over time, too much sugar in your blood can lead to the blockage of the tiny blood vessels that nourish the retina, cutting off its blood supply. As a result, the eye attempts to grow new blood vessels. But these new blood vessels don’t develop properly and can leak easily. There are two types of diabetic retinopathy:

In this early stage of the disorder, new blood vessels aren’t growing (proliferating), and symptoms may be mild or non-existent. But the blood vessels in the retina are weakening, and tiny bulges, call microaneurysms, may leak fluid into your retinas, and also cause swelling of your macula.

Diabetic retinopathy can progress to this more severe type, in which the damaged blood vessels close off, causing the growth of new, abnormal blood vessels in the retina. These abnormal vessels can leak into the clear, jelly-like substance that fills the center of your eye. As a result:

  • Scar tissue stimulated by the growth of new blood vessels may cause the retina to detach from the back of your eye.
  • Pressure may build up in the eyeball and damage your optic, resulting in glaucoma.

RISK FACTORS FOR DIABETIC RETINOPATHY

Anyone who has diabetes can develop diabetic retinopathy. Risk of developing it and its damaging eye conditions can increase as a result of:

Risk factors

  • Duration of your diabetes
  • Being black, Hispanic or Native American
  • Poor control of your blood sugar level
  • High blood pressure
  • High cholesterol
  • Pregnancy
  • Smoking

PREVENTING DIABETIC RETINOPATHY

Diabetes doesn’t necessarily lead to vision loss. Regular eye exams, good control of your blood sugar and blood pressure, and early intervention for vision problems can help prevent severe vision loss.

If you have diabetes, reduce your risk of getting diabetic retinopathy by doing the following:

  • Managing your diabetes, through good diet and regular moderate exercise, and taking your prescribed medications as directed.
  • Monitoring your blood sugar level, which you may need to check several times a day — ask your doctor how often you need to test your blood sugar.
  • Keeping your blood pressure and cholesterol under control, which is also a benefit of diet and exercise, but medication is sometimes needed, too.
  • Avoiding alcohol and smoking, which both increase your risk for diabetic retinopathy.
  • Paying attention to vision changes, which are an obvious sign of trouble and should prompt an immediate call to your optometrist.

SYMPTOMS OF DIABETIC RETINOPATHY

You might not experience symptoms in the early stages of diabetic retinopathy, but as it progresses, symptoms may include:

  • Blurred vision
  • Seeing spots or floaters
  • Dark or empty areas in your vision
  • Difficulty seeing well at night
  • Impaired color vision
  • Vision loss

If you have diabetes, and begin to experience any of these symptoms,
you should make an appointment to see your optometrist as soon as possible.

DIABETIC RETINOPATHY DIAGNOSIS

According a recent AOA (American Optometric Association) survey more than one-third of Americans don’t know that a comprehensive eye exam is the only way to determine if a person’s diabetes wil cause blindness.

If you have diabetes, you should have a comprehensive dilated eye exam with your optometrist annually. Early detection and treatment can limit the potential for significant vision loss from diabetic retinopathy.

As with other eye disorders, your medical and family history will be an important part of the assessment; and you will tell your eye doctor about any symptoms you may be experiencing. During your exam, tests will be done with emphasis on evaluating the retina and macula, and may include:

  • Visual acuity measurements, to determine how much of your central vision may be affected
  • Tonometry, to measure the pressure inside the eye, which can indicate increased risk factors for glaucoma.
  • Ocular evaluation, including evaluation of your retinas through dilated pupils
  • Measurement of the pressure within the eye
  • Retinal photography, or tomography, to document the current status of your retinas
  • Fluorescein angiography, to evaluate if you have any abnormal blood vessel growth

TREATMENT FOR DIABETIC RETINOPATHY

The goal of any treatment for diabetic retinopathy is to slow or stop the progression of the disorder, and treatment for depends on the stage of the disease.

In the early stages of non-proliferative diabetic retinopathy (NPDR), regular monitoring may be the only treatment. Following your eye doctor’s advice for diet and exercise and controlling blood sugar levels can help control the progression of the disease.

In some cases, your optometrists might need to inject medications into your eye, to decrease inflammation or stop the formation of new blood vessels.

Because diabetes is a serious, lifelong condition often leading to progressive deterioration of your body’s organs, including your eyes, it is important that you continually monitor the condition of your eyes with your optometrist.

If your condition progresses to proliferative diabetic retinopathy, (PDR), more aggressive treatments may be advised by your optometrists, and he or she will refer you to a specialist, who may perform one or more of these procedures:

  • Laser surgery (photocoagulation), to seal leaking blood vessels or to discourage other blood vessels from leaking
  • Vitrectomy, a surgery to remove and replace the gel-like fluid in the back of your eyes, called the vitreous.
  • Retinal surgery, to repair a retinal detachment.

The information on this website is offered as part of a public information campaign supported by NHOA member donations, grants, and funding from vision-related corporations. It is extended thanks to broadcasters across the Granite State, in order that you, your family members, and every resident of New Hampshire gets as close to healthy 20/20 vision as possible in 2020, and beyond.