Diabetic Retinopathy
What is diabetic retinopathy?
Diabetic retinopathy is an ocular condition that can lead to vision impairment and even blindness in individuals diagnosed with diabetes. This condition impacts the blood vessels located in the retina, which is the light-sensitive tissue layer situated at the back of the eye.
If you are living with diabetes, it is crucial to undergo a thorough dilated eye examination at least once a year. Initially, diabetic retinopathy may not present any noticeable symptoms; however, early detection is vital as it allows you to take proactive measures to safeguard your eyesight.
Effectively managing your diabetes—by maintaining an active lifestyle, consuming a nutritious diet, and adhering to your prescribed medications—can also assist in preventing or postponing vision deterioration.
Other types of diabetic eye disease
While diabetic retinopathy is the leading cause of vision loss among individuals with diabetes, the condition can also increase the likelihood of developing various other eye disorders:
Cataracts. Individuals with diabetes are 2 to 5 times more susceptible to developing cataracts, and they may experience them at a younger age. Learn more about cataracts.
Open-angle glaucoma. The presence of diabetes nearly doubles the risk of acquiring a specific type of glaucoma known as open-angle glaucoma. Learn more about glaucoma.
What are the symptoms of diabetic retinopathy?
In the initial phases of diabetic retinopathy, symptoms are often absent. Some individuals may experience alterations in their vision, such as difficulty reading or seeing distant objects. These visual changes may fluctuate.
As the disease progresses, blood vessels in the retina may begin to leak into the vitreous, the gel-like substance that fills the eye. This leakage can result in the appearance of dark, floating spots or streaks resembling cobwebs. Occasionally, these spots may resolve on their own, but it is essential to seek immediate treatment. Without intervention, scarring can occur at the back of the eye, and blood vessels may bleed again or the bleeding may intensify.
What other problems can diabetic retinopathy cause?
Diabetic retinopathy can lead to additional serious eye conditions:
Diabetic macular edema (DME). Over time, approximately 1 in 15 individuals with diabetes will develop DME. This condition arises when blood vessels in the retina leak fluid into the macula, a region of the retina essential for sharp, central vision, resulting in blurred vision.
Neovascular glaucoma. Diabetic retinopathy can trigger the growth of abnormal blood vessels from the retina, obstructing fluid drainage from the eye. This blockage can lead to a type of glaucoma, which encompasses a group of eye diseases that may result in vision loss and blindness.
Retinal detachment. Scarring caused by diabetic retinopathy can pull the retina away from the back of the eye, a condition known as tractional retinal detachment.
Learn more about types of retinal detachment
Am I at risk for diabetic retinopathy?
Anyone diagnosed with any form of diabetes can develop diabetic retinopathy, including those with type 1, type 2, and gestational diabetes (a type of diabetes that may occur during pregnancy).
The risk of developing this condition increases the longer an individual has diabetes. Over time, more than half of those with diabetes will experience diabetic retinopathy. The positive aspect is that you can reduce your risk of developing this condition by effectively managing your diabetes.
Women with diabetes who become pregnant or those who develop gestational diabetes are at a heightened risk for diabetic retinopathy. If you have diabetes and are expecting, it is advisable to schedule a comprehensive dilated eye exam as soon as possible. Consult your healthcare provider regarding the need for additional eye examinations throughout your pregnancy.
What causes diabetic retinopathy?
Diabetic retinopathy is primarily caused by elevated blood sugar levels associated with diabetes. Over time, excessive sugar in the bloodstream can harm the retina, the part of the eye responsible for detecting light and transmitting signals to the brain via the optic nerve located at the back of the eye.
Diabetes can damage blood vessels throughout the body. In the eyes, this damage begins when elevated blood sugar levels induce changes in the tiny blood vessels supplying the retina. These alterations hinder blood flow, resulting in blocked vessels that may leak fluid or bleed. In response to these blockages, the eyes attempt to compensate by forming new blood vessels that are often ineffective and prone to leaking or bleeding.
How will my eye doctor check for diabetic retinopathy?
Eye care professionals can assess for diabetic retinopathy during a dilated eye examination. This procedure is straightforward and painless; your doctor will administer eye drops to dilate (enlarge) your pupils and then examine your eyes for signs of diabetic retinopathy and other potential eye issues.
If you have diabetes, it is crucial to have regular eye examinations. If diabetic retinopathy develops, early intervention can halt the progression of damage and prevent blindness.
Should your eye doctor suspect severe diabetic retinopathy or DME, they may perform a test known as a fluorescein angiogram. This test allows the doctor to visualize images of the blood vessels in your retina.
What can I do to prevent diabetic retinopathy?
The most effective way to reduce your risk of diabetic retinopathy is by managing your diabetes. This involves maintaining your blood sugar levels within a healthy range. You can achieve this through regular physical activity, a balanced diet, and diligently following your healthcare provider's recommendations for insulin or other diabetes medications.
To monitor the effectiveness of your diabetes management plan, you will need a specific laboratory test called an A1C test. This test provides insight into your average blood sugar levels over the past three months. Collaborate with your doctor to establish a personal A1C target. Achieving your A1C goal can aid in preventing or managing diabetic retinopathy.
Having high blood pressure or elevated cholesterol levels in conjunction with diabetes increases your risk for diabetic retinopathy. Therefore, managing your blood pressure and cholesterol is also essential in reducing your risk of vision loss.
What’s the treatment for diabetic retinopathy and DME?
In the early stages of diabetic retinopathy, your eye doctor will likely monitor your condition closely. Some individuals may require a comprehensive dilated eye exam as frequently as every 2 to 4 months.
In the later stages, it is crucial to initiate treatment promptly, especially if you notice changes in your vision. While treatment may not reverse any existing damage to your eyesight, it can prevent further deterioration. Additionally, it is vital to take measures to control your diabetes, blood pressure, and cholesterol levels.
Injections. Medications known as anti-VEGF drugs can help slow or even reverse the progression of diabetic retinopathy. Other medications, such as corticosteroids, may also provide assistance.
Laser treatment. To alleviate swelling in the retina, eye care professionals can utilize lasers to shrink the blood vessels and halt any leakage.
Eye surgery. If there is significant bleeding in your retina or extensive scarring in your eye, your eye doctor may suggest a surgical procedure called a vitrectomy.