If you have diabetes, your body does not use and store sugar properly. Uncontrolled diabetes can affect the blood vessels in the eye. The damage to these retinal vessels is called diabetic retinopathy.
It’s important to know that with today’s improved methods of diagnosis and treatment, only a small percentage of people with diabetic retinopathy will experience serious vision problems. The best way to lower your risk of vision loss is to maintain and control your blood sugar (as directed by your primary care physician). Also by regularly visiting your ophthalmologist for routine care.
TYPES OF DIABETIC RETINOPATHY
A medical eye examination by an ophthalmologist is the only way to reveal changes inside your eye. If your ophthalmologist finds evidence of diabetic retinopathy during your exam, color photographs of the retina or special testing can be performed to determine if you need treatment. If diagnosed early, treatment for diabetic retinopathy can often be initiated before any visual problems begin to occur.
Nonproliferative diabetic retinopathy (NPDR), also known as background retinopathy, is the first stage of diabetic retinopathy. In this stage, tiny blood vessels in the eye leak blood or fluid. The leaking fluid causes the retina to swell or to form deposits called exudates. Many people with diabetes can have mild NPDR, which usually does not affect their vision. When vision is affected it is usually the result of macular edema and/or macular ischemia.
- Macular edema refers to swelling or thickening of the macula, a small area in the center of the retina that allows us to see fine details clearly. The swelling is caused by fluid leaking from the tiny blood vessels. It is the most common cause of vision loss in diabetes. Vision loss may be mild to severe, but even in the worst cases, peripheral vision is still maintained.
- Macular ischemia occurs when small blood vessels called capillaries close. This may cause blurry vision because the macula no longer receives sufficient blood flow to work properly.
Proliferative diabetic retinopathy (PDR) PDR is caused by widespread loss of retinal blood flow. In an attempt to supply blood to the area where blood loss occurred, the retina begins to grow new blood vessels. The growth of new, abnormal blood vessels on the surface of the retina or optic nerve is a process called neovascularization. Unfortunately, the new, abnormal blood vessels do not supply the retina with normal blood flow. Over time these abnormal blood vessels can lead to scarring, wrinkling or even a detachment of the retina. Because PDR can affect both central and peripheral vision, patients with PDR may experience more severe vision loss than those with NPDR. Additional causes of vision loss occurring with PDR include:
Vitreous hemorrhage occurs when the fragile new vessels bleed into the vitreous, a clear, jelly-like substance thatfills the center of the eye. If the vitreous hemorrhage is small, a person might only see a few new dark floaters, but a very large hemorrhage could block out the majority of vision.
Tractional retinal detachment results when scar tissue from new blood vessel growth contract, causing the retina to pull away from its normal position This can lead to visual distortion or more severe vision loss if the macula or large areas of the retina detach from the back of the eye.
Neovascular glaucoma occurs when the new, abnormal blood vessels grow and block the normal flow of fluid out of the eye. If left untreated, the pressure builds up inside the eye causing damage to the optic nerve, resulting in glaucoma.
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