Diabetic Retinopathy

Diabetes is a disease of the body's sugar control system that affects blood vessels throughout the body, particularly vessels in the kidneys and eyes. When the blood vessels in the eyes are affected, this is called diabetic retinopathy.

The retina is in the back of the eye. Like the roll of film in a comera, it detects visual images and transmits them to the brain. Major blood vessels lie on the front portion of the retina. When these blood vessels are damaged due to diabetes, they may leak fluid or blood and grow scar tissue. This leakage, bleeding, or scar tissue affects the ability of the retina to detect and transmit images.

During the early stages of diabetic retinopathy, the damage inside the eye typically progresses silently without any noticeable affect on vision. However, when retinopathy becomes advanced, new blood vessels grow in the retina. These new vessels are the body's attempt to overcome and replace the vessels that have been damaged by diabetes. However, these new vessels are not normal. They may bleed and cause the vision to become hazy, occasionally resulting in a complete loss of vision, and infrequently can even cause loss of the entire eye. In addition, if abnormal blood vessels grow on the iris of the eye, this can lead to a very severe type of glaucoma. Diabetic retinopathy typically also causes your body to form cataracts. more rapidly than usual. The new vessels also may damage the retina by forming scar tissue and pulling the retina away from its proper location. This is called retinal detachment and can lead to total blindness if left untreated.

Symptoms of diabetic retinopathy:

• There are usually NO SYMTOMS in the EARLY STAGES of diabetic retinopathy
• Floaters--usually a sudden onset of specks, spots, wisps, or even large "blobs" floating in the vision
• Difficulty reading or doing close work
• Double vision
• If left untreated, severe vision loss can occur

Causes of diabetic retinopathy:

• Diabetes: Everyone who has diabetes is at risk for developing diabetic retinopathy, but not everyone develops it. Chronic poor control of blood sugar levels increases the risk. Generally, diabetics don't develop diabetic retinopathy until they've had diabetes for at least 10 years.

You can reduce your risk of developing diabetic retinopathy by:

• keeping your blood sugar under continuously excellent control.
• monitoring your blood pressure to ensure it is not elevated 
• maintaining a healthy diet.
• exercising regularly.
• getting an eye exam at least once a year.

Diagnosing diabetic retinopathy:

There are usually no symptoms in the early stages of diabetic retinopathy. Vision may not change until the disease becomes severe. An exam is often the only way to diagnose changes in the vessels of your eyes. This is why regular examinations for people with diabetes are extremely important.

You eye doctor may perform a test called fluorescein angiography. During the test, a harmless orange-red dye called Fluorescein will be injected into a vein in your arm. The dye will travel through your body to the blood vessels in your retina. Your doctor will use a special camera with a green filter to flash a blue light into your eye and take multiple photographs. The pictures will be analyzed to identify any damage to the lining of the retina or atypical new blood vessels.

Treatment for diabetic retinopathy:

Diabetic retinopathy does not usually impair sight until the development of long-term complications, including proliferative retinopathy (when abnormal new blood vessels bleed into the eye). When this advanced stage of retinopathy occurs, pan-retinal photocoagulation is performed. During this procedure, a laser is used to destroy all of the dead areas of retina where blood vessels have been closed. When these areas are treated with the laser, the retina stops manufacturing new blood vessels, and those that are already present tend to decrease or disappear.

If diabetic retinopathy has caused your body to form cataracts, they can be corrected with cataract surgery.