Diabetic Retinopathy
Diabetic retinopathy is a condition that occurs due to damage to the blood vessels of the retina in people suffering from diabetes. If you have type 1 or type 2 diabetes, and a long history of uncontrolled blood sugar levels, you might develop diabetic retinopathy.
Though the condition generally starts with a mild vision loss, eventually you might even lose your sight. Diabetic retinopathy is known to be the most common eye disease among people who suffer from diabetes.
Symptoms
Although you might not have any symptoms in the early stages of diabetic retinopathy, as the condition progresses, some of the symptoms might include:
- Blurred vision
- Fluctuating vision
- Floaters
- Dark or empty areas in your vision
- Impaired color vision
- Vision loss
This condition is known to generally affect both eyes. If you are suffering from diabetes, managing it carefully is one of the best ways to prevent loss of vision. Even if your vision seems fine, see your eye doctor once every year for an examination.
Pregnancy might also worsen diabetic retinopathy, and therefore if you are pregnant, additional eye exams might be recommended by your doctor.
If your vision changes suddenly or becomes blurry, spotty, or hazy, then contact your eye doctor right away.
Causes & risk factors
High levels of sugar in your blood over long periods can lead to diabetic retinopathy. The excess sugar causes damage to the blood vessels supplying your retina with blood. High blood pressure is a risk factor, as well, for retinopathy.
The retina is a layer of tissue in the back of your eye, which helps to change the images that the eye sees into nerve signals so that the brain can understand them. When the retina’s blood vessels undergo any damage, they can get blocked. This cuts off some of the blood supply of the retina. This loss of blood flow can even lead to other, weaker blood vessels to grow and these new blood vessels may leak and also create scar tissue which can lead to loss of vision.
The longer you suffer from diabetes, the higher are your chances of developing diabetic retinopathy. People who suffer from diabetes for over thirty years generally show signs of retinopathy. Managing your diabetes can generally slow the progression.
Although any person with diabetes is at risk of diabetic retinopathy, the risk becomes higher if the person:
- Has uncontrolled blood sugar levels
- Has high cholesterol
- Has high blood pressure
- Is suffering from diabetes for a very long time
- Is pregnant
- Smokes regularly
Diagnosis
Eye exam
Diabetic retinopathy can be diagnosed using a dilated eye exam. This also involves the use of eye drops that can make the pupils open wide, and allows the doctor to get a good look at the inside of your eye. Your doctor is going to check for:
- Abnormal blood vessels
- Swelling
- Scarring
- Leaking of the blood vessels
- Blocked blood vessels
- Changes to the lens
- Retinal detachment
- Damage to the nerve tissue
Fluorescein angiography test
They may also perform a fluorescein angiography test, which involves injecting a dye into your arm, which allows them to track how the blood flows in your eye. They will need to take pictures of the dye circulating inside your eye so that they are able to determine which vessels are blocked, leaking, or broken.
OCT exam
An OCT (optical coherence tomography) exam might be used as well. It uses light waves in order to produce images of the retina. These images let your doctor determine the thickness of your retina and let him/her known if any fluid has accumulated in it.
Treatment
For people suffering from early diabetic retinopathy, treatment options are limited. Your doctor might want to perform regular eye exams, in order to monitor the eye health just in case, treatment becomes necessary. An endocrinologist can also help you slow the progression of the condition by helping you manage your diabetes.
For people suffering from advanced diabetic retinopathy, the treatment options depend on the type and severity of the condition. Treatment can be of various types.
Photocoagulation surgery
Photocoagulation surgery can help in preventing loss of vision. This type of surgery uses a laser in order to control or stop leakage by burning the vessels for sealing them. Photocoagulation is also of different types:
Scatter photocoagulation
Scatter photocoagulation is a method that involves using a laser to burn hundreds of tiny holes in the eyes so that the risk of blindness is reduced.
Focal photocoagulation
Focal photocoagulation, meanwhile, involves using a laser to target a specific leaky vessel in the macula so that macular edema doesn’t worsen.
Vitrectomy
Vitrectomy is another method of treatment that involves removing scar tissue and cloudy fluid from the vitreous fluid of the eye.
Complications
If left untreated, diabetic retinopathy might lead to several complications.
When blood vessels bleed into the vitreous, the main jelly that fills the eye, this is called vitreous hemorrhage. The symptoms include floaters, in mild cases, but in severe cases, symptoms can include vision loss, as the blood in the vitreous blocks any light from entering the eye. If the retina remains undamaged, then the bleeding in the vitreous is able to resolve itself. In some cases, diabetic retinopathy might even cause a detached retina. This complication can happen if scar tissue pulls the retina away from the back of the eye.
The abnormal blood vessels which are associated with this condition stimulate the growth of scar tissue as well, which can pull the retina away from the back of the eye. This is known as retinal detachment. This can cause spots floating in your vision, flashes of light, or in some cases, severe vision loss.
In some cases, blood vessels might grow in the front part of your eye, and this might interfere with the normal flow of fluid out of the eye, causing pressure in the eye to build up. This is known as glaucoma. This pressure can damage the nerve carrying images from your eye to your optic nerves.
Diabetic retinopathy, glaucoma, or a combination of both can lead to you losing your vision completely.
Prevention
Diabetic retinopathy can’t be always prevented. However, regular eye examinations, as well as proper control of your blood sugar and blood pressure, as well as an early intervention for vision problems can help to prevent severe vision loss.
If you smoke or use any other kind of tobacco, quitting is the best way to prevent diabetic retinopathy. Ask your doctor if you need help in quitting.