Diabetic Retinopathy

Diabetic Retinopathy is a complication of diabetes, especially for those with type 2 diabetes. High blood sugar levels over a period of time can damage the blood vessels in the retina, making them, swell and leak. In some cases it may also happen that they block blood from passing through. These lead to growth of abnormal new blood vessels in the retina. All of these conditions affect the vision adversely leading ultimately to loss of vision.

Although diabetic retinopathy is caused by prolonged high blood sugar level, prolonged high blood pressure has an additive effect. The risk of the condition increases with age and duration of uncontrolled blood sugar. The high glucose levels in the blood vessels damage the sensitive small blood vessels in the retina causing haemorrhages, exudates and even swelling of the retina. When this occurs, the retina is deprived of oxygen which in turn leads to the growth of abnormal blood vessels. A condition known as proliferative diabetic retinopathy. The retina detects light and converts it to signals sent through the optic nerve to the brain. Diabetic retinopathy may stop this process and cause loss of vision.

Symptoms of diabetic retinopathy:

The early stages of diabetic retinopathy are painless and symptomless, and hence can go undetected for a long time. It is therefore recommended for diabetics to have an annual eye fundus examination. As the disease advances certain symptoms may occur like:

  1. Sudden changes in vision
  2. Blurred vision
  3. Having a dark or empty spot in the center of your vision
  4. Reduction in night vision
  5. Distorted vision
  6. Impaired color vision
  7. Eye pain
Risk factors for diabetic retinopathy:

Diabetic retinopathy can attack people with all types of diabetes (i.e. type 1, type 2 or gestational). The following factors may raise your risk of developing retinopathy:

  1. Longer duration of diabetes
  2. Poor blood sugar control
  3. Having high blood pressure
  4. Having high cholesterol levels
  5. Pregnancy
  6. Smoking
Types of Diabetic retinopathy:

Nonproliferative diabetic retinopathy (NPDR) : It is an early stage of diabetic retinopathy. In this stage, tiny blood vessels within the retina leak blood or fluid. The leaking fluid causes the retina to swell or to form deposits.

Proliferative diabetic retinopathy (PDR): or Advanced diabetic retinopathy, is the stage where new blood vessels begin to grow within the retina. These new blood vessels are usually abnormal and grow in the center of the eye. This growth is accompanied by haemorrhages, exudates, occlusions and vision defects.

Prevention of diabetic retinopathy:

There are no scientifically proven way to prevent diabetic retinopathy from occurring, but the onset and progression of the condition can be delayed significantly by maintaining at least a close to normal blood glucose level, having control on blood pressure, maintaining a healthy life style along with a balanced diet and exercise, and reducing stress.

To slow down progression, it is important to identify the condition early and start treatment. A comprehensive dilated eye examination has to be done at least once in a year. This includes a vision acuity test and a detailed fundus examination. Treatment may consist of simply controlling blood sugar and blood pressure, or medicines to reduce intra ocular pressure and vessel growth, to laser therapy or other surgical procedures. It is best to seek the help of a qualified ophthalmologist.

Written by MedPlus