Diabetic Retinopathy

Understanding Diabetic Retinopathy

Diabetic retinopathy is a condition that can develop in individuals with diabetes, causing progressive damage to the retina—the light-sensitive lining at the back of the eye. As a serious, sight-threatening complication of diabetes, it can lead to significant vision impairment and even blindness if left untreated.

How Diabetes Affects the Eyes

Diabetes impacts the body's ability to manage and store sugar (glucose), resulting in elevated blood sugar levels. Over time, high blood sugar can damage small blood vessels throughout the body, including those in the retina. Diabetic retinopathy occurs when these tiny blood vessels leak blood and fluids, causing the retinal tissue to swell and leading to cloudy or blurred vision. This condition typically affects both eyes and worsens with prolonged periods of high blood sugar.

Importance of Regular Eye Exams

According to the American Optometric Association (AOA), nearly half of Americans are unaware that diabetic eye diseases often have no visible symptoms in their early stages. A comprehensive dilated eye examination is essential for detecting diabetic retinopathy early and preventing significant vision loss. The AOA recommends that everyone with diabetes have such an exam at least once a year.

Causes and Risk Factors

Diabetic retinopathy results from the damage diabetes causes to the small blood vessels in the retina. These damaged vessels can cause vision loss by leaking fluid into the macula or by forming new, abnormal blood vessels that can bleed into the back of the eye.

Risk factors for diabetic retinopathy include:

• Diabetes: Both type 1 and type 2 diabetes increase the risk, especially if poorly controlled.
• Duration: The longer you have diabetes, the higher the risk.
• Race: Hispanics and African Americans are at greater risk.
• Medical Conditions: High blood pressure and high cholesterol elevate the risk.
• Pregnancy: Pregnant women with diabetes are at higher risk.
• Family History: Genetics can also play a role.

Symptoms

• Seeing spots or floaters
• Blurred vision
• Dark or empty spots in the center of your vision
• Difficulty seeing well at night

Diagnosing Diabetic Retinopathy

Diabetic retinopathy is diagnosed through a comprehensive eye examination that includes:

• Patient history: To determine vision difficulties and overall health.
• Visual acuity measurements: To assess central vision.
• Refraction: To check if new glasses are needed.
• Ocular structure evaluation: Through a dilated pupil examination.
• Eye pressure measurement.

Additional tests may include retinal photography, tomography, and fluorescein angiography to assess abnormal blood vessel growth.

Treatment Options

• Laser treatment (photocoagulation): To seal leaking blood vessels.

• Injections: Anti-VEGF drugs or corticosteroids to reduce inflammation and abnormal blood vessel growth.
• Surgery (vitrectomy): To remove blood and scar tissue from the eye.

Prevention

Preventing or slowing the development of diabetic retinopathy involves:

• Controlling blood sugar levels: Maintaining healthy glucose levels through diet, exercise, and medication.
• Managing blood pressure and cholesterol: Keeping these within healthy ranges.
• Healthy lifestyle choices: Avoiding smoking and excessive alcohol consumption.

Taking Action