What is diabetic retinopathy?

People who suffer from diabetes often have an eye disease called diabetic retinopathy as the two conditions go hand-in-hand. Diabetic retinopathy is caused when high blood sugar causes damage to blood vessels in the retina, leading them to swell or leak; they can also close, blocking the passage of blood. Sometimes abnormal new blood vessels grow on the retina too. All of these changes can take your vision.

Eye Words to Know

Retina: Nerve cells inside the back-end of the eye. The retina senses light and sends signals to the brain so you can see.

Macula: Small area in the center of the retina that is essential for clear vision and detail identification.

Macular edema: Swelling of the macula from leaking blood vessels leading to loss of vision.

Vitreous: Thick, liquid substance that fills the center of eye.

Floaters: Tiny clumps of cells or other material inside the vitreous causing specks, strings or clouds to appear in field of vision.

Stages of diabetic eye disease

Two main stages include:

NPDR (non-proliferative diabetic retinopathy): This is the early stage and very common amongst diabetics.

Also with NPDR, blood vessels in the retina can close off, blocking the passage of blood to the macula. This is called macular ischemia and can be detrimental to vision.

With NPDR, tiny blood vessels leak, making the retina swell, this is called macular edema. This is the most common reason why people with diabetes become blind.

Fluid behind retina Hard exudates

With diabetic retinopathy, fluid in your retina may affect your vision.

PDR (proliferative diabetic retinopathy):  the more advanced stage of diabetic eye disease. Occurs when the retina starts growing new blood vessels. This is called neovascularization. You might see a few dark floaters or completely blocked vision.

These new blood vessels can form scar tissue. Scar tissue can cause problems with the macula or detach retina.

PDR is very serious, and can steal both your vision.

What are diabetic retinopathy symptoms?

No symptoms at early stages. As diabetic retinopathy worsens, symptoms may include:

  • increased number of floaters
  • blurry vision
  • vision that changes from blurry to clear
  • seeing blank or dark areas
  • poor night vision
  • colors appear faded
  • loss of vision

Diabetic retinopathy symptoms usually affect both eyes.

Traction retinal detachment

How is diabetic retinopathy diagnosed?

Pupils will be dilated prior to eye exam to allow the ophthalmologist to look through the inside of your eye.

Your doctor may do fluorescein angiography to see what is happening with your retina and determine if blood vessels are blocked or leaking fluid. It also shows any abnormal blood vessels that may be growing.

A close look at the retina can be done through Optical coherence tomography. A machine scans the retina to determine thickness in the area.

Treatment

Medicine such as “anti-VEGF” medication to reduce swelling of the macula, slowing vision loss and perhaps improving vision. This drug is injected in the eye. Steroid medicine is another injection option to reduce macular swelling. Your doctor will recommend which medication and how many doses.

Laser surgery might be used to help seal off leaking blood vessels and reduce swelling of the retina. Laser surgery can also help shrink blood vessels and prevent regrowth.

Vitrectomy surgery for advanced PDR. During this procedure your surgeon will remove vitreous gel, blood, and scar tissue from leaking vessels in the back of your eye. Your retina will now accept light again.

Medical control of blood sugar and blood pressure can stop vision loss if you carefully following a diet by your nutritionist and take the medicine your diabetes doctor prescribed for you.

See your ophthalmologist regularly for eye exams, this condition can be diagnosed before you even notice any vision problems.

Summary

Diabetic retinopathy is caused by high blood sugar levels that affect your retina and macula, leading to vision loss. No symptoms may be present in the early stages; however, vision loss will occur eventually.

Treatment may include medication, eye injections, and surgery.

See your ophthalmologist to check for damage from diabetic retinopathy.