Diabetic Retinopathy is one of the most serious eye complications caused by diabetes. Diabetic Retinopathy is caused from damage to the blood vessels of the retina, which is a layer of tissue located at the back of the inner eye. Its function is to change light and images entering the eye into nerve signals, which reaches the brain and allows us vision. Damage to the retina occurs of a period of time as high blood pressure and/or high blood sugars which are not controlled cause the tiny blood vessels of the retina to swell and become weak. Over time, these blood vessels become blocked and blood flow to the eye is disturbed or completely cut off. The damage results in slowly progressing vision problem and eventually blindness in one or both eyes.
Studies show that on average 40% of patients with Type I Diabetes and 20% of patients with Type II Diabetes are likely to develop diabetic retinopathy. Diabetic Retinopathy is the leading cause of blindness in working age Americans. Diabetics with uncontrolled diabetes have a significantly higher risk of developing this ocular complication. It should also be noted that nearly all patients of diabetes, who are suffering from the disease for more than 30 years, have signs of diabetic retinopathy.
There are two stages of diabetic retinopathy which are called Non Proliferative Stage and Proliferative Stage.
- In Non Proliferative stage blood vessels in the eye become larger in certain spots. It is known as micro aneurysms. There may be a blockage in any of the blood vessels in the retina or any amounts of bleeding and fluid leaking into the retina. This bleeding may be caused due to retinal hemorrhages.
- In proliferative stage of diabetic retinopathy new blood vessels start to grow in the eye that are fragile and can bleed. There may also be small scars on the retina and in other parts of the eye called the vitreous.
Symptoms of Diabetic Retinopathy
In its early stages there are no pronounced symptoms, however, as the damage progresses the following symptoms can be noted:
- Blurred vision
- Double vision
- Slow vision loss over time
- Rings, flashing lights, or blank spots while seeing
- Dark or floating spots
- Shadows or missing some areas while seeing
- Pain or pressure in one or both eyes
- Vision problem at night
- Trouble seeing things out of the corners of eyes
Though diabetes retinopathy could be prevented, there are certain risk factors, which could not be controlled. They are listed below.
- Patient having diabetes for longer period are at higher risk of developing diabetic retinopathy.
- Elderly patients are at higher risk of diabetic retinopathy
- Patients belonging to ethnic group at higher risk of diabetes are at increased risk of developing diabetes and associated eye problems including diabetic retinopathy.
Because of the seriousness of Diabetic Retinopathy, it’s important to understand how to lower your risks of this serious complication by understanding and taking the following measures:
- Control your blood sugar through diet, exercise, medications and monitoring
- Control your high blood pressure
- Keep your cholesterol levels (LDL and HDL) within normal ranges
- Maintain a healthy weight
- Regular eye exams
- Stop smoking
- Gestational diabetics should be screened for diabetic retinopathy both during and post pregnancy
It is highly recommended that yearly eye exams are performed by an ophthalmologist. The diagnosis of diabetic retinopathy is done through eye examination. Your ophthalmologist will dilate the pupils of your eyes with eye drops and then carefully examine the retina. Other tests for diagnosis include a retinal photography or fluorescein angiography. The following is what doctors are looking for with the tests:
- Enlargement of blood vessels
- Blockage of blood vessels
- Bleeding or leaking fluids (hemorrhages)
- New, fragile blood vessels
- Scarring on the retina and other parts of the eye
There is no treatment that can restore or correct the damage of diabetic retinopathy. However, treatments are available to assist in preventing further damage. Click here to learn more about the treatments of diabetic retinopathy.
If diabetic retinopathy is monitored closely after an early stage diagnosis, the prognosis is good. Regular eye exams have a high rate of catching any complications early and allow the patient to be treated promptly, this drastically improves the prognosis. As always, working with your health care team on all aspects of your diabetes is important for the best possible prognosis.