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What is Diabetic Retinopathy?

What is Diabetic Retinopathy?

Do you know that diabetes is not limited just to your blood sugar levels? Prolonged diabetes and uncontrolled blood sugar levels can even affect your eyesight. Among the many eye diseases caused by diabetes, one of the severe ramifications is diabetic retinopathy. Let’s know more about diabetic retinopathy, diabetic retinopathy grading, the symptoms, causes and treatment.

What is Diabetic Retinopathy?

Diabetic retinopathy is a diabetic complication that occurs due to the damage of blood vessels in the retina. When the tiny blood vessels present in the light sensitive tissue (retina) leak blood and other fluids, it causes the retinal tissue to swell. This swelling results in cloudy and blurred vision. It is a serious eye condition that usually affects both the eyes. Those who have a prolonged history of diabetes are more prone to developing diabetic retinopathy symptoms.

High levels of blood sugar in the body adversely affect the blood vessels, leading to fluid accumulation in the lens of the eyes. The swelling of the retina tissue changes the curvature of the lens, causing hazy and blurred vision. However, if the blood sugar levels return to normal, the swelling may decrease and better vision is restored. Diabetic patients who follow a strict diet and maintain their blood sugar levels are at a lower risk of developing diabetic retinopathy. The symptoms of diabetic retinopathy progress slowly as mild vision problems and eventually intensify.  If not diagnosed or given adequate diabetic retinopathy treatment on time, it may lead to permanent damage in the eyesight and even blindness.

Diabetic Retinopathy Causes

If a diabetic person’s blood sugar stays high for a long period, it blocks the blood supply of the small blood vessels to the retinal tissue. The eyes try to grow new blood vessels but fail to develop properly leading to blood and fluid leakage into the retina. As the condition gets worse, more blood vessels malfunction and lead to other eye diseases like macular edema, retinal detachment, glaucoma and cataract. Relax; the right diabetic retinopathy treatment can help reduce the effects.

Any form of diabetes- type 1, type 2, or gestational can lead to diabetic retinopathy. The longer the diabetic history of a patient, the higher is the risk of being affected by this eye condition.

Some of the other risks factors and diabetic retinopathy causes include:

  • High blood pressure
  • High cholesterol levels
  • Irregular blood glucose levels
  • Habitual tobacco usage
  • Being of African American, Hispanic or Native American lineage
  • Diabetic history in family
  • Gestational diabetes during pregnancy

Now that we know about the risk factors and reasons behind diabetic retinopathy, let’s look at some common diabetic retinopathy symptoms.

Diabetic Retinopathy Symptoms

How do I know if I have diabetic retinopathy? Many diabetic patients who suffer from diabetes retinopathy go undiagnosed during the early stages because of the lack of obvious symptoms. This is precisely why your Optometrist insists on regular eye check-ups if you are diabetic. However, in the later stages, you might notice the following symptoms:

  • Blurred, distorted and cloudy vision that cannot be corrected with prescription glasses
  • Frequent eye floaters or moving specks in the field of vision
  • Difficulty in reading boards, watching TV or driving
  • Unusual pain in one or both eyes
  • Increased sensitivity to light and glare
  • Difficulty in adjusting vision in dim light or at night
  • Straight lines appear distorted
  • Having an empty spot or dark blob in the centre of your field of vision

Diabetic retinopathy symptoms develop slowly and are often unnoticeable in the beginning.  It becomes crucial for diabetic patients to keep a watch on their blood sugar levels and to never skip an appointment at the eye specialist. Early diagnosis can help prevent the later complications and protect your vision from further damage.

Types of diabetic retinopathy

There are basically two types of diabetic retinopathy:

1) Non-proliferative diabetic retinopathy:

It is the early stage of the eye condition in which the symptoms are mild and unnoticeable. This is the stage when the small blood vessels in the retina start weakening. The blocking of blood vessels leads to tiny bulges (microaneurysms) that lead to swelling in the macula. These protrusions in the eye cause fluid and blood leakage into the retina. It also causes dilation in the larger vessels in retinal tissue and disturbs their natural diameter. The gradual increase in blood vessel damage then leads to the development of diabetic retinopathy from mild to severe.

2) Proliferative diabetic retinopathy:

This is the advanced stage of diabetic retinopathy when the older blocked blood vessels stimulate the growth of new, abnormal blood vessels in the retina. These atypical new blood vessels also malfunction and leak blood and fluids into the vitreous. It may also eventually lead to retinal detachment and increased pressure in the eye. The abnormal growth of blood vessels can also lead to the damage of the optic nerve and result in glaucoma. At this stage, you need immediate diabetic retinopathy treatment to prevent the eyes from going completely blind.

Diabetic retinopathy grading

To analyze the severity of the eye condition, doctors use diabetic retinopathy grading. Grading classification is based on the features of the existing condition and helps in determining the stage of diabetic retinopathy a patient has reached. Your doctor may employ the following tests to diagnose diabetic retinopathy:

  • Visual acuity test
  • Tonometry
  • Pupil dilation
  • Ophthalmoscopy
  • Fluorescein angiography
  • Optical coherence tomography

With high-quality monitoring and grading, there are broadly four established diabetic retinopathy stages.

Diabetic retinopathy stages

  1. Mild Non-proliferative Retinopathy: Initial stage of the disease, featured by microaneurysms, formation of swellings inside the retina’s tiny blood vessels.
  2. Moderate Non-proliferative Retinopathy: In this stage, the blood vessels supplying to the retina are blocked due to a significant increase in the number and size of microaneurysms.
  3. Severe Non-proliferative Retinopathy: At this stage, a considerable number of blood vessels are damaged, which leads to insufficient blood supply to the retina. This triggers the growth of new abnormal blood vessels to compensate for lost blood supply and nourishment.
  4. Proliferative Retinopathy: This is the most advanced stage of diabetic retinopathy progress, where the new abnormal blood vessels get damaged and cause leakage of blood and fluid inside the retina and the vitreous gel that constitutes the white region of the eye. Such prolonged blood and fluid leakage can cause permanent damage to eyesight or even blindness.

Diabetic Retinopathy Treatment

Is there a way to cure diabetic retinopathy? How to stop diabetic retinopathy? There are multiple ways to reduce and control the progress of diabetic retinopathy.

  • Healthy lifestyle: Diabetic retinopathy treatment and prevention begin with your own lifestyle and routine. Maintaining a healthy lifestyle with regulated levels of blood sugar, blood pressure and cholesterol plays a major role in eye health. Improving your diet and ensuring regular health checkups, especially eye tests, will help you control and counter any signs of this eye condition.
  • Medication: The doctor may recommend Anti-VEGF (anti-vascular endothelial growth factor) therapy in the form of shots (injections) in the eye.
  • Laser Surgery: It is a procedure to seal the leaking retinal blood vessels and reduce retinal swelling. It helps shrink the blood vessels and stops the growth of new abnormal retinal vessels.
  • Vitrectomy: This procedure proves to be most effective in the advanced stages of retinopathy (PDR). It works by removing blood from the leaking vessels in the back of the eye (retinal tissue). It also helps in removing scar tissues from the retina that are responsible for conditions like retinal detachment and glaucoma.

Pick up diabetic retinopathy symptoms as early as possible to prevent diabetes from robbing you of a healthy vision! With premium eye-testing facilities, The Eye Lab is here to help. Book an appointment today and get tested for diabetic retinopathy.

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