What is diabetic retinopathy?
Diabetes is a chronic disease in which your blood glucose or sugar levels are very high. Uncontrolled levels pose a risk to associated heart, kidney and eye disorders. People with diabetes may develop three major eye problems – glaucoma, cataract and retinopathy. The early symptom of all these disorders is blurred vision. High blood sugar causes swelling of the lens in the eye, distorting the ability to focus clearly. Retinopathy is the most common eye disease associated with diabetes, and is one of the leading causes of blindness in adults.
Diabetic retinopathy is a disease which damages the tiny blood vessels in the retina (the light-sensitive tissue at the back of the eye). Having diabetes for a long time increases the chances of developing diabetic retinopathy.
What are the different types of diabetic retinopathy?
There are three main types of diabetic retinopathy:
- Background retinopathy: blood vessels are damaged, but vision is not affected.
- Maculopathy: the macula (center of the retina) is damaged. This significantly reduces vision.
- Proliferative retinopathy: new blood vessels may grow from damaged blood vessels when the eye is deprived of oxygen. These new vessels are fragile and can bleed easily.
Who is most likely to get diabetic retinopathy?
Your chances of developing diabetic retinopathy increase with the following factors:
- Long duration and poor control of diabetes
- High cholesterol
- High blood pressure
High levels of sugar in the blood from diabetes can cause damage to the blood vessels supplying the retina and loss of sight when the vessels become blocked and blood supply is cut off. In response, the eye grows new vessels, but these do not develop properly, and can leak and cause vision loss. Scar tissue can also form, pulling the retina and causing it to detach.
What are the symptoms?
The early stages of the condition do not show any symptoms; but as the condition worsens, you may have blurred vision, spots or dark shapes floating in your vision (floaters), lowered night vision, or temporary or permanent blindness.
How is diabetic retinopathy diagnosed?
Your doctor will diagnose diabetic retinopathy using the following methods:
- Dilated eye examination is a good diagnostic tool for retinopathy. Drops will be placed in your eye to dilate your pupils (the black of your eye). This will help your doctor look for the presence of cataract, abnormal or new blood vessels, swelling, blood or fat deposits in the retina, scar tissue and retinal detachment.
- Tests for vision and eye pressure may be performed.
- Fluorescein angiography may be performed, in which a special dye is injected into your arm and images of the blood vessels are taken as the dye circulates into the eye. This will show the blood vessels that are broken, leaking or blocked.
- Optical coherence tomography takes sectional images of the retina to determine leakage into the retinal tissue.
What are the consequences of not treating diabetic retinopathy?
Diagnosis is critical, as, if it is not detected and treated early, diabetic retinopathy can eventually lead to blindness.
What are the treatments for diabetic retinopathy?
Treatment is decided based on the type and severity of the disease, and your response to prior treatment. Non-proliferative diabetic retinopathy may not require immediate treatment. Maintenance and control of blood sugar levels can prevent progression to more serious stages of retinopathy. However, severe cases may require surgery. The procedures include:
- Focal laser treatment: A laser is used to burn abnormal vessels to stop or slow down blood leakage.
- Scatter laser treatment: A laser is used to burn, shrink and scar abnormal vessels.
- Vitrectomy: Scar tissues pulling the retina and blood leakage are removed and replaced with a salt solution to maintain the shape of the eye.
What can I do to reduce my risk for visual loss from diabetic retinopathy?
Treatment can slow down the progression of the disease, but is not a cure, as the underlying cause, diabetes, is a lifelong condition. Regular monitoring of the condition of the eye is important and additional treatment may be required.