Diabetic retinopathy is caused by damage to the blood vessels of the retina or the layer of the tissue at the back of the inner eye. The retina is responsible for transforming light and images that enter the eye into nerve signals sent to the brain. Diabetic retinopathy is a sight-threatening condition associated with long-term diabetes. Blood vessels may swell and leak out fluid or abnormal new blood vessels may also grow on the retina’s surface. It is the leading cause of vision loss in American adults. At risk for this condition are persons with type 1 and type 2 diabetes.
Diabetic retinopathy may be classified into four stages:
• Mild Non-proliferative. This is the earliest stage when microaneurysms occur or there are small areas of balloon-like swelling in the tiny blood vessels of the retina.
• Moderate Non-proliferative. Blockage in some blood vessels that nourish the retina may occur.
• Severe Non-proliferative. More blood vessels are blocked. Several areas of the retina are deprived of blood supply and send signals to the body to grow new blood vessels for nourishment.
• Proliferative. This is an advanced stage where growth of new, abnormal and fragile blood vessels is triggered in the retina and along the surface in the clear and vitreous gel that fills the inside of the eye. Due to the thin and fragile walls of these blood vessels, they can leak blood, which can cause severe loss of vision and blindness.
While symptoms of diabetic retinopathy will not manifest until the eye is severely damaged, here are some signs that you may be suffering from this condition:
• Gradual vision loss
• Blurred vision
• Seeing floaters or spots
• Trouble seeing at night
• Missing areas of vision or shadows
• Bleeding in the eyes, often during sleep.
When you are diagnosed with diabetes, it is best to have regular eye check-ups to address this eye condition at the onset. Your optometrist may need to conduct some tests such as a comprehensive dilated eye exam to determine whether or not you are suffering from this eye disease.
Prevention and Treatment
Controlling blood sugar, blood pressure and cholesterol levels may prevent diabetic retinopathy. Smoking and alcohol intake should also be stopped.
The first three stages of this condition would usually not need treatment but close monitoring of an eye doctor is essential.
While treatment will not reverse damage and cure the disease, it can prevent its worsening and can decrease the chances of becoming blind to less than five percent. Here are some procedures that may be undertaken to treat diabetic retinopathy:
• Scatter Laser Treatment. This is used to treat proliferative retinopathy to shrink the abnormal blood vessels. High number of laser burns are necessary, thus, two or more sessions are usually needed to complete the treatment. It may result in some loss of side vision and reduction of color and night vision. This is best done before new blood vessels start to bleed.
• Vitrectomy. This surgical procedure where blood is removed from the center of the eye is undertaken if bleeding is severe. Vitrectomy involves the removal of the gel inside the eye called the vitreous humour and with it is removed any adhensions that can cause further damage to the diabetic eye. If both eyes are affected, vitrectomy will usually be done several weeks apart.
• Anti-VEGF or Corticosteroid injections. These are probably the most feared of treatments. The thought of an injection into your eye can be psychologically challenging. The reality is very effective treatments probably hurt less than an injection in your arm. These are used to suppress new vessel or fluid formation in the retina, which can cause scarring and loss of vision.
As with any disease, prevention and proper monitoring is necessary to avoid the adverse effects of diabetic retinopathy.