Diabetic Retinopathy: What You Need to Know

Diabetic retinopathy is a common eye condition that can occur in people with diabetes. It causes damage to the blood vessels in the retina, the light-sensitive tissue at the back of the eye. As diabetic retinopathy progresses, it can lead to vision loss or even blindness. Here is some key information about diabetic retinopathy that is important for people with diabetes to understand.

Who is at risk?

If you have diabetes, you can get an eye disease called diabetic retinopathy. The longer you have diabetes, the more chance you have of getting this eye problem. After 20 years of living with diabetes, nearly all patients will have some degree of retinopathy. High blood sugar levels over time cause damage to the tiny retinal blood vessels. Having high blood pressure, high cholesterol, pregnancy, and smoking that can increase your risk of diabetic retinopathy

What are the stages?

Diabetic retinopathy can be mild, moderate, or severe. There are different stages:

Nonproliferative Retinopathy

The earliest stage. Small areas of blood vessels in the retina weaken and start to balloon out into pouches called microaneurysms. Fluid may leak into the retina.

Proliferative Retinopathy

Damaged blood vessels trigger the growth of new abnormal blood vessels on the surface of the retina. These are fragile and can leak blood into the eye, causing vision loss.

Macular Edema

Fluid builds up in the macula, the central part of the retina responsible for sharp vision. The macula swells, resulting in blurred central vision.

Advanced Diabetic Retinopathy

The advanced stage with serious damage to blood vessels and nerves in the retina. Vision loss is common.

Symptoms of Diabetic Retinopathy

• Blurred or fluctuating vision
• Impaired color vision
• Poor night vision
• Seeing spots or floaters in your vision

At first, diabetic retinopathy may not cause symptoms you can notice. But as it gets worse, it can make you lose vision. That's why it's crucial for people with diabetes to get regular eye exams to detect and monitor diabetic retinopathy.

Causes of Diabetic Retinopathy

Diabetic retinopathy is caused by high blood sugar levels damaging the blood vessels in the retina over time. If you have had diabetes for many years, you are more likely to get diabetic retinopathy. Other risk factors include:

• Having high blood sugar levels that are not well controlled
• High blood pressure
• High cholesterol
• Pregnancy (for women with diabetes)
• Smoking
• Ethnic background (Hispanics, African Americans, and Asians are at higher risk)

How is it diagnosed?

Diabetic retinopathy is diagnosed through a comprehensive dilated eye exam. Your eye doctor will place drops in your eyes to widen the pupils, allowing them to view the retina closely. They will look for signs of retinal damage, microaneurysms, retina swelling, leaking blood vessels, and any changes in the optic nerve. Eye exams are essential for detecting diabetic retinopathy early when treatment is most effective.

How is it treated?

Catching diabetic retinopathy early is crucial for preventing vision loss. Treatment options depend on the stage and include:

Laser surgery

Laser therapy seals leaking blood vessels and prevents them from growing abnormally.

Injections

Medications injected into the eye can slow the formation of new blood

Vitrectomy

Surgery to remove blood from the center of the eye and repair retinal detachments.

Improved diabetes control

Keeping your blood sugar, blood pressure, and cholesterol levels on target can help prevent further eye damage.

Conclusion

The key is detecting diabetic retinopathy early through regular comprehensive eye exams. People with diabetes should have annual eye exams to monitor for any changes or progression in retinal health. Good communication with your endocrinologist and ophthalmologist is essential for protecting your vision. With proper monitoring and treatment, blindness from diabetic retinopathy can often be prevented.