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Diabetic Retinopathy – Frequently Asked Questions

Diabetic retinopathy is an eye condition caused by diabetes. The elevated blood sugar levels result in damage to the blood vessels at the back of the eye (retina). Read below to find answers to Frequently Asked Questions regarding diabetic retinopathy, including its stages, symptoms, and available treatment options.

What Is Diabetic Retinopathy?

Diabetic retinopathy is a complication of diabetes mellitus. The condition is characterized by damage and deterioration of blood vessels in the retina. If untreated, damaged blood vessels may lead to leaked fluid, growth of abnormal blood vessels, and subsequent central and/or peripheral vision loss as a result. Diabetic retinopathy can affect people with type 1 and type 2 diabetes.

Are There Different Types of Diabetic Retinopathy?

There are two main types of diabetic retinopathy: early diabetic retinopathy and advanced diabetic retinopathy.

  • Early Diabetic Retinopathy – This more common form of the condition is also called nonproliferative diabetic retinopathy (NPDR). With NPDR, the walls of the blood vessels in your retina weaken. Tiny bulges then protrude from the walls of smaller vessels, and can sometimes leak fluid and blood into the retina. Larger retinal vessels may also begin to dilate and become irregular in diameter. Damage to retinal blood vessels can then lead to a buildup of fluid, or edema, in the macula of the retina. If macular edema decreases vision, treatment is required to prevent permanent vision loss.
  • Advanced Diabetic Retinopathy – In this more severe type, also known as proliferative diabetic retinopathy, damaged blood vessels close off, causing the growth of new and abnormal blood vessels in the retina. The newly formed blood vessels are fragile and can leak into the jellylike substance that fills the center of your eye, known as the vitreous. Over time, scar tissue from the growth of new blood vessels can cause the retina to detach from the back of your eye. If these new blood vessels interfere with the normal flow of fluid out of the eye, pressure can build in the eyeball. In turn, this buildup of pressure can damage the optic nerve, and result in glaucoma.

What Are the Four Stages of Diabetic Retinopathy?

The four stages of diabetic retinopathy are as followed: mild, moderate, and severe (nonproliferative and proliferative).

  • Mild – Individuals experience balloon-like swelling in areas of the blood vessels in the retina called microaneurysms. At this stage, individuals should understand the risk factors of diabetes and take the necessary steps to control their blood sugar and diet.
  • Moderate – This stage is characterized by damage to some of the blood vessels in the retina where there is blood and/or fluid leakage.
  • Severe (Non-Proliferative) – At this stage, blood vessels are blocked with even more leakage of edema into the retina which has a much greater impact on vision. While a visit to an eye specialist is almost always needed at this stage, fortunately, the lost vision may be improved with treatment.
  • Severe (Proliferative) – With proliferative diabetic retinopathy, the condition has worsened significantly and can be threatening to one’s vision. As a result of the ongoing damage to the blood vessels in the retina, the eye becomes poorly circulated. The retina then grows new and abnormal blood vessels, which can cause severe damage such as vision loss or blindness.

Who Is at Risk for Diabetic Retinopathy?

Anyone with diabetes is at risk of diabetic retinopathy, and the longer you have diabetes, the more at risk you are of the condition developing. Other risk factors of individuals with diabetes that can attribute to diabetic retinopathy include:

  • Poor control of blood sugar levels
  • High blood pressure
  • Elevated cholesterol
  • Pregnancy
  • Smoking
  • Ethnicity (Hispanic, African-American, and Native American individuals are at a higher risk)

What Are the Symptoms of Diabetic Retinopathy?

Diabetic retinopathy produces a variety of symptoms, which may worsen as the disease progresses or it may be entirely asymptomatic. These can include:

  • Blurry vision
  • Fluctuating vision
  • Dark spots or floaters
  • Difficulty seeing colors
  • Dark areas or empty spots
  • Vision loss

How Is Diabetic Retinopathy Diagnosed?

Diabetic retinopathy can be diagnosed with a diabetic eye  checkup with your eye doctor. This typically requires eye drops to dilate your pupils so that the retina can be imaged and examined.  Eye doctors  will look for things such as abnormal blood vessels, fatty deposits, scar tissue on the retina, bleeding in the vitreous, and other abnormalities on the optic nerve.

Some diagnostic tests an optometrist may run to further attempt to diagnose the disease include fluorescein angiography, which pinpoints blood vessels in the eye, and optical coherence tomography, which is used to measure the retina’s thickness.

How Is Diabetic Retinopathy Treated?

Available treatment options that can slow the progression of diabetic retinopathy include:

  • Medication injections –  This procedure involves injecting medication into an anesthetized  eye that prevents new blood vessels from forming. It also treats the swelling.
  • Focal laser treatment – This procedure is designed to stop or slow blood and fluid from leaking into the eye.
  • Scatter laser treatment –  This is designed to shrink abnormal blood vessels that have formed in the retina.
  • Micro-Incisional VitrectomyMicro-Incisional Vitrectomy is a surgical procedure where a tiny incision to the eye helps remove blood from the vitreous. It also works to remove retina scar tissue to fix retinal detachments.

What is Diabetic Retinopathy Screening?

Diabetic retinopathy screenings are checkups that help determine the presence of the disease. These screenings should include both a visual acuity exam and a retinal examination. Example diagnostic tests and screenings include Fundus Photography, Fluorescein Angiography, Optical Coherence Tomography (OCT), and B Scan Ultrasonography.

What is the First Sign of Diabetic Retinopathy?

Any abnormal changes to your vision can be an initial sign, and a visit to your eye doctor can help determine the causes. This can include floaters, dark spots, blurriness, empty spots, and difficulty seeing colors.

Most importantly, vision threatening diabetic retinopathy may have no symptoms at all and this is the reason why it is important to get an annual diabetic eye exam even when your vision seems normal.

Can Diabetic Retinopathy Be Reversed?

Damage caused by the disease is often permanent. However, some of the damage can be potentially reversed with treatments to bring back lost vision or to control the progression of the disease and keep it from worsening.

How Does Diabetes Cause Blindness?

Diabetes (or elevated blood sugars in the body) can cause blindness by way of diabetic retinopathy, cataracts, glaucoma, and blurred vision. Chances of blindness are reduced with proper blood sugar management.

What Causes Diabetic Retinopathy?

Diabetic retinopathy is caused as a result of complications from diabetes involving elevated blood sugars, in which blood vessels in the retina are damaged or have deteriorated, causing fluid leakage within the inner eye and otherwise abnormally regrown vessels.

Can Diabetic Retinopathy Be Cured?

There are many treatment options available for diabetic retinopathy, but the disease cannot be entirely cured. Instead, these treatments either slow the progression of the disease or restore obscured vision.

For more information on diabetic retinopathy or other retinal diseases, give us a call or visit our website.