Diabetic Retinopathy
This common eye disease is the leading cause of blindness in middle-aged adults. Diabetic retinopathy is caused when high blood sugar damages blood vessels in the retina. The retina is a layer of light-sensitive cells in the back of the eye. Damaged blood vessels can swell and leak, causing blurry vision or stopping blood flow. Sometimes new blood vessels grow, but they aren’t normal and can cause further visual problems. Diabetic retinopathy usually affects both eyes.
Risk Factors for Diabetic Retinopathy
Anyone with type 1, type 2, or gestational diabetes (diabetes while pregnant) can develop diabetic retinopathy. The longer you have diabetes, the more likely you are to develop diabetic retinopathy. These factors can also increase your risk:
● Blood sugar, blood pressure, and cholesterol levels that are too high.
● Smoking.
● Race/ethnicity: African Americans, Hispanics/Latinos, and American Indians/Alaska Natives are at higher risk.
Stages of Diabetic Retinopathy
Diabetic retinopathy has 2 main stages:
Early stage (nonproliferative): Blood vessel walls in the retina weaken and bulge, forming tiny pouches (you won’t be able to detect them, but an opthalmologist can). These pouches can leak blood and other fluid, which can cause a part of the retina called the macula to swell (macular edema) and distort your vision. Macular edema is the most common cause of blindness in people with diabetic retinopathy. About half of people with diabetic retinopathy will develop macular edema.
Advanced stage (proliferative): In this stage, the retina begins to grow new blood vessels. These new vessels are fragile and often bleed into the vitreous (the clear gel between the lens and retina). With minor bleeding, you may see a few dark spots that float in your vision. If there’s a lot of bleeding, your vision may be completely blocked.
You may not notice symptoms in the early stage. That is why it is very important to get a dilated eye exam at least once a year to catch any problems early when treatment is most effective.
Symptoms in the advanced stage may include:
● Blurry vision
● Spots or dark shapes in your vision (floaters)
● Trouble seeing colors
● Dark or empty areas in your vision
● Vision loss
How Diabetic Retinopathy Is Diagnosed
During your eye exam, the ophthalmologist will check how well you see the details of letters or symbols from a distance. Your doctor will also look at the retina and inside of your eyes and may use a dye to reveal leaky blood vessels. If it turns out you have diabetic retinopathy, your ophthalmologist might want to check your vision more often than once a year.
You should be checked for diabetic retinopathy immediately if you’re diagnosed with type 2 diabetes. If you have type 1 diabetes, you should be checked within 5 years of your diagnosis and then regularly thereafter, typically every year. The sooner you are treated for diabetic retinopathy, the better that treatment will work.
Call your ophthalmologist if you notice any changes in your vision, especially if it happens suddenly. Changes may include:
● Blurring
● Spots
● Flashes
● Blind spots
● Distortion
● Difficulty reading or doing detail work
Diabetic Retinopathy Treatment
Treating diabetic retinopathy can repair damage to the eye and even prevent blindness in most people. Treatment can start before your sight is affected, which helps prevent vision loss. Options include:
● Laser therapy (also called laser photocoagulation). This creates a barrier of scar tissue that slows the growth of new blood vessels.
● Medicines called VEGF inhibitors, which can slow down or reverse diabetic retinopathy.
● Removing all or part of the vitreous (vitrectomy).
● Reattachment of the retina (for retinal detachment, a complication of diabetic retinopathy).
● Injection of medicines called corticosteroids.
Help for Low Vision
If you are diagnosed with diabetic retinopathy, low-vision aids such as magnifying glasses and special lenses can help. It is important to seek help from your optometrist as they can assist with these devices.
Source: https://www.cdc.gov/diabetes/managing/diabetes-vision-loss.html