What is Diabetic Retinopathy?

Diabetic retinopathy involves changes to blood vessels in the back of the eye called the retina,  that can cause them to bleed or leak fluid. 

Diabetic retinopathy is the most common cause of incident blindness (legal) in people of working age

Diabetic retinopathy typically presents no symptoms during the early stages. This is why it is important see your doctor regularly for diabetic eye checks. 

The condition is often at an advanced stage when symptoms become noticeable. On occasion, the only detectable symptom is a sudden and complete loss of vision.

Signs and symptoms of diabetic retinopathy may include:

• blurred or distorted vision 
• floaters, or transparent and colorless spots and dark strings that float in the patient’s field of vision 
• poor night vision 
• sudden and total loss of vision

Diabetic retinopathy usually affects both eyes. It is important to make sure that the risk of vision loss is minimized. The only way people with diabetes can prevent Diabetic Retinopathy  is to attend every eye examination scheduled by their doctor.

Anybody with diabetes is at risk of developing diabetic retinopathy. However, there is a greater risk if the person:

- Does not control blood sugar levels 

- has uncontrolled high blood pressure

- Has high cholesterol

- Is pregnant 

- Smokes regularly 

- Has had diabetes for a long time

The best things you can do to prevent eye damage are:

-Control your blood sugars

-Control your blood pressure

-Exercise regularly (at least 30 min of cardio activity 5 days a week)

-Eat Healthy - less carbohydrates and processed sugars, lots of veggies and greens

-Stop smoking

Your doctor can diagnose diabetic retinopathy doing a dilated eye exam. This involves the use of eye drops that make the pupils open wide, allowing you doctor to get a good look at the inside of your eye. Your doctor will check for:

• abnormal blood vessels
• swelling in the retina
• leaking of blood 
• Cholesterol deposits
• changes to the lens
• damage to the nerve tissue
• retinal detachment

Your doctor may also take a photo of the back of your eye called an OCT that is able to show swelling in the retina

Nonproliferative diabetic retinopathy (NPDR)

NPDR is also known as background retinopathy. It’s called “nonproliferative” because the eye doesn’t make new blood vessels during the early stages of diabetic retinopathy. During the early stages of 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. The three stages of NPDR are mild, moderate, and severe, which may progress to the other type, or fourth stage, proliferative diabetic retinopathy.

Proliferative diabetic retinopathy (PDR)

Proliferative diabetic retinopathy, or advanced retinopathy, is the stage of retinopathy in which new blood vessels begin to grow within the retina. These new blood vessels are usually abnormal and grow in the center of the eye.

If you have mild diabetic retinopathy then you will not usually require any treatment other than controlling risk factors: blood pressure, blood sugar (glucose) and cholesterol levels

Anti-VEGF therapy for macular edema (swelling in the macula)

Special medication are injected into the eye to reduce swelling and stop vision loss

Laser therapy 

Laser treatment is used mainly if you have new vessels growing (proliferative retinopathy). The laser makes tiny burns that can seal leaks from blood vessels, and stop new vessels from growing further. The burns are so tiny and accurate that they can treat a tiny abnormal blood vessel. Several hundred burns may be needed to treat retinopathy.

Treatment usually works well to prevent retinopathy from getting worse, and so often prevents loss of vision. However, laser treatment cannot restore vision that is already lost.

Vitrectomy surgery for bleeds in the eye