If you or a family member have diabetes, then you probably know that diabetics are at risk for several eye conditions, including diabetic retinopathy. Here’s everything you need to know about this diabetic eye disease.
What causes diabetic retinopathy?
People with diabetes—both type 1 and type 2 diabetes—are at risk for developing diabetic retinopathy. You’re at increased risk the longer you’ve had diabetes, especially if your blood sugar is less controlled.
Simply put, diabetic retinopathy is caused by damage to the blood vessels in the retina, which is the part of the eye that is sensitive to light. The retina needs that blood supply to work properly, so when those vessels get blocked, the retina’s nourishment is cut off. The eyes respond by growing new blood vessels—which seems to make sense, except that the new blood vessels don’t develop properly, causing the blood vessels to leak.
Does it affect vision?
It does affect vision, but not so much at first. In the early stages of diabetic retinopathy, you’re not likely to experience any symptoms, and those that you do experience will be mild.
As the disease progresses, symptoms like these become more noticeable.
- Floaters (spots or strings “floating” in your vision)
- Blurry or blurred vision
- Inconsistent vision
- Problems seeing color
- Empty or dark spots in your vision
- Vision loss
How does it progress?
Nonproliferative Diabetic Retinopathy (NDPR)
In its early stages, this condition is known as nonproliferative diabetic retinopathy (NDPR). In this most common form, new blood vessels aren’t developing—or proliferating—at all.
What happens?
First, the walls of your retina’s existing blood vessels start to deteriorate. Smaller blood vessels start to swell and bulge through the weakened vessel walls, leaking fluid and blood into the retina. Larger blood vessels widen and become irregular in diameter.
As more and more of the blood vessels become blocked, NDPR can progress from mild to severe, and other parts of the retina can be affected. The macula—the center of the retina that helps us see color and see in detail—can swell, resulting in a condition called macular edema.
Are there treatments?
In this phase, your doctor will keep a close look at the condition of your retina. The most effective way to control and slow NDPR is through good management of your blood sugar levels.
Proliferative Diabetic Retinopathy (PDR)
This stage is when things get more severe. Those blocked blood vessels close themselves off entirely, which triggers the growth of new blood vessels.
What happens?
The problem with these new blood vessels is that they aren’t healthy. They’re abnormal and leak into the vitreous (a gel-like substance that gives our eyes its shape and attaches to the retina). Called vitreous hemorrhage, this can block your vision, although the condition typically clears up in a few weeks or months.
Scar tissue can even cause retinal detachment, or glaucoma (when blood pressure builds in the eyeball), damaging your optic nerve and also impacting your vision. Eventually, diabetic retinopathy and the conditions that come along with it can lead to total vision loss.
Are there treatments?
Surgery is the best course of action when NDPR progresses to PDR. There are a range of surgeries, depending on the specific eye problems you develop. For example, different laser treatments can slow or stop blood from leaking into the eye or shrink abnormal blood vessels. Your doctor may also treat you by removing blood and scar tissue from your vitreous, or via medicine injected into the eye.
Can diabetic retinopathy be prevented?
It may not be completely preventable, but there are many things you can do to control your risk factors and limit your chances of developing diabetic retinopathy.
Early intervention is the best solution. Routine eye exams are a big key to early detection and treatment that can prevent the complications that come later. Your eye doctor will check your eyes for abnormal blood vessels, swelling or blood in the retina, bleeding in the vitreous, retinal detachment, and new blood vessel growth.
In addition to annual eye exams, here are some other steps you can take:
- Keep your diabetes under control by eating well and staying physically active.
- Manage your blood sugar levels, always following your doctor’s recommendations.
- Maintain healthy blood pressure and cholesterol and manage your weight, again by eating healthfully and choosing physical activity whenever possible.
- Quit smoking.
- Pay close attention to your eyes and vision, letting your doctor know right away if you experience any sudden changes.
