Diabetic retinopathy is a condition that occurs as a result of damaged blood vessels of the retina in people who have diabetes. Diabetic retinopathy can develop whether you have type 1 or type 2 diabetes. While you may start out with only mild vision problems, you can eventually go blind. Retinopathy is one of the most common causes of adult blindness. It is also the most common disease of the eye in diabetics.
Early Diabetic Retinopathy
Early diabetic retinopathy may also be known as nonproliferative diabetic retinopathy (NPDR). It is called “nonproliferative” because during the early stages of diabetic retinopathy the eye is not making new blood vessels. During early retinopathy, damaged blood vessels often leak blood and fluid into the eye. In some cases, the center of the retina, or macula, begins to swell. This causes a condition called macular edema.
Advanced Diabetic Retinopathy
Advanced diabetic retinopathy is sometimes called proliferative diabetic retinopathy because this is the stage of retinopathy in which new blood vessels start growing within the retina. These new blood vessels are usually abnormal, growing in the middle of the eye.
Diabetic retinopathy is caused by excess levels of sugar in the blood. This excess sugar damages the blood vessels that supply the retina with blood.
The retina is a layer of tissue in the back of the eye that changes images that the eye sees into nerve signals that the brain can understand. The blood vessels of the retina can become blocked, cutting off some of the retina’s blood supply. This loss of blood flow can cause partial blindness. When the eye tries to replace the blocked blood vessels with new ones, they often do not form properly. These new blood vessels leak and create scar tissue that can cause you to lose your vision.
The longer you have diabetes, the higher your chances of developing diabetic retinopathy become. Nearly everyone who has diabetes for more than 30 years will show some signs of retinopathy. Keeping your diabetes under control can help slow the progression.
It’s uncommon to have symptoms during the early stages of this condition. Symptoms are most commonly seen in both eyes and can include:
- floaters or dark spots appearing in your vision
- difficulty seeing at night
- blurred vision
- loss of vision
- difficulty distinguishing colors
The symptoms of diabetic retinopathy often don’t appear until there is major damage inside the eye. To prevent unseen damage, you should get eye exams regularly to monitor your eye health.
You can find out if you have diabetic retinopathy by having your doctor perform a dilated eye exam on your eye. This involves the use of eye drops that make your pupils open wide, allowing your doctor to get a good look at the inside of your eye. Some things your doctor will look for during the exam are:
- abnormal blood vessels
- blocked blood vessels
- detachment of your retina
A fluorescein angiography test may be performed. This test injects a dye into your arm, allowing your doctor to see how the blood flows in your eye. Pictures are taken of the dye circulating inside your eye to determine which vessels are blocked, leaking, or broken.
Optical Coherence Tomography
An OCT exam is an imaging test that produces images of the retina that allow your physician to determine its thickness. OCT exams help determine how much fluid, if any, has accumulated in the retina.
In early diabetic retinopathy, there is usually not much that can be done as far as treatment. Your doctor will probably want to perform regular eye exams to monitor your eye health in case you do end up needing treatment. Your endocrinologist can help you get control of your diabetes in order to slow the progression of retinopathy.
In advanced diabetic retinopathy, your treatment will depend on how severe your case is and which retinopathy you have. Treatment might include:
- focal laser coagulation, which uses a laser to control or stop the flow of blood or fluid leaking into the eye
- scatter laser treatment, which uses a laser to shrink abnormal blood vessels in the eye
- vitrectomy, which involves the removal of blood from the vitreous fluid of the eye
If you have diabetes, maintaining healthy blood pressure, blood sugar, and cholesterol levels is a vital part of preventing diabetic retinopathy. Quit smoking if you are a smoker, and be sure to get regular, moderate exercise throughout the week. Be mindful of any changes you may notice in your vision. Yearly eye exams are also recommended so that a doctor can catch any problems in your retina.