What is diabetic retinopathy?
Retinopathy is a disease of the retina. The retina is a layer of nerves at the back of the eye. It is responsible for “taking pictures” and sending images to the brain. People with diabetes develop retinopathy, called diabetic retinopathy.
Diabetic retinopathy can lead to weakened vision and even blindness, and it gets progressively worse. First, the blood vessels in the retina become weak, which can lead to leakage of blood and other fluid from the vessels into the retina, which is called non-proliferative retinopathy and is the most common form of retinopathy. If fluid leaks into the center of the eye, it may cause blurred vision. Many patients with nonproliferative retinopathy have no symptoms. If blood glucose levels remain high, diabetic retinopathy will continue to worsen. New blood vessels grow in the retina, but the new blood vessels are very fragile and can rupture easily, even during sleep. Once ruptured, blood can leak into the center of the eye in front of the retina, altering vision. Bleeding may also lead to scar tissue formation. The scar tissue may pull on the retina, causing it to detach from the wall of the eye (retinal detachment), which is called proliferative retinopathy. Sometimes, patients have no symptoms and by the time they present they have missed treatment.
Thus, it is extremely important to have regular eye exams. Diabetic retinopathy may also cause swelling of the macula, which is called macular edema. The macula is located in the center of the retina, and it allows the eye to see objects in detail. When the macula is swollen, it can cause significant vision loss and can even lead to legal blindness.
What causes diabetic retinopathy?
If blood glucose levels are not kept in the target range, vascular damage may result. Diabetic retinopathy occurs when high blood sugar damages the capillaries in the retina. Hypertension can worsen diabetic retinopathy when there is diabetic nephropathy.
High blood pressure can cause more damage to blood vessels in the eye that have become weakened, causing more fluid or blood to leak and making vision more blurry.
What are the symptoms of diabetic retinopathy?
In most cases, diabetic retinopathy is asymptomatic until there is a change in vision. At that point, diabetic retinopathy is already severe.
Regular eye exams can detect diabetic retinopathy early enough to treat it and help prevent vision loss. If you notice problems with your vision, contact your eye doctor immediately. Changes in vision may be a sign of serious eye damage. Vision changes include having floating objects in front of your eyes, eye pain, blurred vision, or new onset of vision loss.
How is diabetic retinopathy diagnosed?
An eye exam by an eye specialist is the only way to detect diabetic retinopathy. Regular dilated pupil exams help detect retinopathy before vision changes. Patients may not notice symptoms until the disease worsens.
Can diabetic retinopathy be prevented?
Keeping blood glucose and blood pressure levels within target ranges reduces the chance of capillary damage in the eye. If you smoke, quit. These can reduce the risk of retinal damage and also help slow the rate of deterioration of retinopathy and prevent future vision loss.
If regular dilated eye exams are performed, diabetic retinopathy can be detected early and prevented from getting worse. Patients should have an annual eye exam. Early detection of retinopathy is helpful to avoid vision loss and blindness.
How is diabetic retinopathy treated?
Surgery, laser treatment, or medications can help slow the vision loss caused by diabetic retinopathy.
Multiple treatments may be needed because the disease continues to get worse.