What is Diabetic Retinopathy?
Diabetic retinopathy is a complication of diabetes that occurs from damage to the tiny blood vessels inside the retina. These weak vessels are prone to hemorrhaging. Leaking vessels can cause fluid to accumulate at the center of the retina causes your vision to blur. The leaking vessels also lead to the formation of scar tissue and too much scar tissue can result in
retinal detachment which can lead to visual impairment and blindness.
Your risk of developing diabetic retinopathy increases the longer you have diabetes. This disease affects approximately 40-45% of Americans who have diabetes.
When to See a Doctor
Often, the condition will not cause any noticeable symptoms, even after the retina has sustained damage. While routine eye examinations are important for everyone, comprehensive dilated eye examinations are particularly crucial for diabetics. Many people wait to visit our eye doctors until they experience blurry vision or vision loss yet, you can have diabetic retinopathy without experiencing any symptoms. Early detection through an
eye examination can help prevent serious visual complications.
Symptoms of diabetic retinopathy include usually affecting both eyes:
If you have been previously diagnosed with diabetes you are at an increased risk for developing glaucoma & cataracts. It is especially important for you to keep up with yearly eye exams and discuss any vision concerns with your doctor.
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Spots or floaters in your vision
Difficulty seeing at night
Dark or empty spots in your vision
Doctors consider this condition a serious medical emergency and you should seek treatment right away to help you to guard against permanent and irreversible vision loss.
Stages of Diabetic Retinopathy
There are two main stages of diabetic retinopathy:
Non-proliferative diabetic retinopathy. This early stage of the disease occurs when the blood cells in the back of the eye begin to swell. Various degrees of swelling are possible, ranging from mild to severe. This is the most common stage of the disease.
Proliferative diabetic retinopathy. This advanced stage occurs when the eye starts to produce abnormal blood vessels. These new blood vessels are prone to leaking fluid into your eye which can distort your vision. Scar tissue can also develop during this stage and this scar tissue may later shrink and cause retinal detachment which can lead to permanent vision loss.
In the earliest stage of the condition blood vessels damaged by poor circulation begin to leak and these leaks go on to form very small hemorrhages. NPDR results when this leakage causes retinal tissue to swell. If insufficient delivery of oxygen to the retina persists, the body may grow new blood vessels (PDR) to try and compensate. These weak vessels are prone to hemorrhaging as the vessels burst and fluid leaks into the center of the retina. Once this occurs more severe vision loss and even blindness is a risk
How is Diabetic Retinopathy Diagnosed?
During a comprehensive eye examination, our doctors will use advanced diagnostic methods to check for signs of diabetic retinopathy. After dilating the eyes to gain a better view of the retina, testing technology such as fundus photography, optical coherence tomography (OCT), or fluorescein angiography are often used. Doctors use fundus photography to compare images of the retina over time as it helps them check for noticeable changes in the tissue. OCT provides cross-section images of the retina and its circulation. Fluorescein angiography is a process of injecting a special dye into the bloodstream. This allows your doctor to observe blood flow in the retina using a special camera.
These tests help determine when diabetic retinopathy treatment is right for you.
Treatments for Diabetic Retinopathy
During the earliest stages of diabetic retinopathy treatment might not be necessary unless you also suffer from macular edema. If this is the case for you your doctor will track your condition for changes. Once the retinopathy becomes proliferative, or macular edema develops, your doctor will discuss treatment options with you.
The treatment for diabetic retinopathy varies based on the severity of the disease. In the early stages, regular eye examinations and good control of your blood pressure and blood sugar can help manage the progression of the disease.
There are several treatment options available if the condition becomes more severe:
Our ophthalmologists may use injectable medication. This helps to decrease inflammation and the production of abnormal blood cells.
Laser surgery is another popular treatment. It allows your blood vessels to seal preventing them from leaking fluids that impair your vision.
Surgery may be needed to replace the gel-like fluid in the back of your eye, or to repair retinal detachment.
If you have diabetic retinopathy, our ophthalmologists will discuss all your treatment options.
Laser Surgery Treatment
Proliferative retinopathy and macular edema are most treated with laser surgery. During the procedure, the laser shrinks abnormal blood vessels and stops their growth. This laser treatment completed in less than 30 minutes can improve your vision and prevent further vision loss. Before the procedure, an anesthetic will numb the eye, and to dilate your pupil. Doctors then use a precise laser to treat the entire retina (laser scatter treatment). They can also apply it to the affected blood vessels (focal photocoagulation). You may feel a slight stinging sensation or see brief flashes of light, but treatment is not painful.
Steroid Injection Treatment
In some cases, doctors can recommend steroid injections. Doctors administer them either alone or in conjunction with laser treatment. Medicated injections help the body shrink abnormal blood vessels and prevent new ones from forming.
After treatment, your vision may be blurry and you will need a friend or family member to drive you home. You will also need to wear sunglasses since your dilated eyes will be sensitive to light. You may experience some slight discomfort for a day or two after your appointment. You doctor will schedule follow-up appointments to ensure your healing is progressing. Maintaining your blood sugar levels in the future can ensure you reap the full benefits of your laser surgery.
Recovery & Aftercare
Depending on the severity of your condition, particularly if macular edema is present, you may need extra treatment sessions. Some patients suffering from advanced PDR may need up to three or four laser treatment sessions.
Risks of Avoiding Treatment
Left untreated, diabetic retinopathy can lead to blindness. Regardless of whether you are experiencing symptoms, if you suffer from diabetes, your ocular health may already be affected. Regular comprehensive examinations are important for everyone’s ocular health and they are especially important for our diabetic patients. Choosing an experienced and credentialed ophthalmologist can help you take charge of your ocular health protecting your vision in the future.
Contact SightMD today to schedule an appointment with one of our doctors to discuss your vision health at one of our convenient locations!