Diabetic Retinopathy - What It Is And How To Treat It
Diabetes and Eye Disease
Diabetic Retinopathy is an eye disease that occurs in patients with diabetes. Diabetes is a chronic health condition that affects millions of people every year. You can develop type II diabetes late in life or you can experience type I diabetes early on. People with diabetes either do not produce the hormone insulin or have difficulty processing insulin in the body correctly. This important hormone helps regulate blood sugar levels in the body by taking sugar from the blood, thus allowing cells from our liver, muscle and fat tissue to convert it into energy. Patients who have diabetes are more likely to experience vision problems resulting from cataracts or glaucoma. They also experience a serious eye condition known as diabetic retinopathy.
The term diabetic retinopathy is used to describe changes occurring in the retina over an extended period of time, up to 20 years in many patients. The retina is the tissue behind the eye responsible for processing light and transferring that information to your brain to portray an image. In diabetic retinopathy specifically, damage occurs in the small blood vessels or capillaries in the retina that provide nourishing blood and circulation to the eye.
Diabetes often affects the circulatory system in the body, which can affect blood flow to the retina. In the earliest stages of diabetic retinopathy, arteries in the retina are weakened. They often leak, which results in small hemorrhages in the eye. This can lead to swelling of the retina and reduced vision in patients. In the worst case scenario, diabetic retinopathy can result in complete loss of vision. This risk however, is greatly reduced when diabetic retinopathy is diagnosed and treated during the early stages of the disease.
Proliferative Diabetic Retinopathy
During the next stage of diabetic retinopathy, referred to as the proliferative stage, circulation around the retina becomes worse, depriving the retina of oxygen causing fragile blood vessels to develop as the circulatory system tries to re-establish equilibrium within the retina. This process is often referred to as "neovascularization." The small blood vessels that form often hemorrhage resulting in blood leaking into the retina and surrounding areas. This can cause severe vision problems such as black/grey blotches of missing central vision.
Later stages of diabetic retinopathy are associated with scar tissue growth and further blood vessel growth within the eye. This can result in serious complications including glaucoma or retinal detachment. Many of these serious conditions can result in permanent vision loss. Diabetic retinopathy, no matter the type, is worthy of notice and immediate treatment when available.
Signs and Symptoms of Diabetic Retinopathy
There are many warning signs of diabetic retinopathy, though they vary significantly from person to person. If you continue having routine eye exams throughout your life, an optometrist or ophthalmologist is likely to catch the disease during its earliest stages.
Some of the more commonly reported symptoms include:
- Decreased vision
- Blurry vision often in both eyes
- Appearance of floaters or spotters, typically resulting from hemorrhaging
- Sudden flashes or spots in line of sight
- Sudden or unexpected loss of vision
- The appearance of fine lines in the eye or when looking straight ahead at blank objects or space
- Spots of darkness where you cannot see or periodic blindness in certain areas of the eye
- Sensitivity to or difficulty switching from light to dark rooms without having some visual impact
Naturally, the symptoms of diabetic retinopathy will vary depending on the severity of the condition and your overall health and wellness. You may notice other symptoms unrelated to your vision, like increasing headaches or fatigue. If you experience any of these symptoms you should talk with your doctor as soon as possible. Remember permanent changes may occur in the eyes if you do not treat diabetic retinopathy promptly.
Diagnosis and Treatment of Diabetic Retinopathy
It is important patients who are diabetic seek routine care from a certified eye care professional so eye problems including diabetic retinopathy can be detected early. They will usually work closely with an endocrinologist or other specialist to help tailor treatments for diabetic patients. Sometimes a family practitioner will diagnose diabetic retinopathy and then refer their patient to a specialist for further testing and treatment. Most providers work in tandem with others so they can coordinate the physical and emotional care of patients with chronic illnesses like diabetes.
Typically diabetic retinopathy is diagnosed with a dilated fundus exam. Many patients will require treatment by surgeons who specialize in diabetic retinopathy.
Treatment often depends on the stage when the disease is diagnosed. Early signs of diabetic retinopathy is simply treated by proper medication management to lower blood sugar to a more appropriate target range. Advanced diabetic retinopathy may require laser surgery. A focal laser may be used to help address the growth of tiny blood vessels within the retina. This type of surgery is called pan retinal photocoagulation or PRP.
The PRP laser destroys damaged tissue affecting the patient's vision and helps seal other vessels that may be leaking and obstructing the central vision. Typically the goals of treatment for patients include stopping the progression of diabetic retinopathy.
Yet another surgery alternative is vitrectomy. Using this procedure surgeons remove the gel in patients who have developed bleeding in the vitreous. This procedure can help repair retinal detachments and severe scar tissue. If retinal detachment does occur surgery is required to reattach the retina.
The best treatment for diabetic retinopathy is prevention. Doctors will often recommend patients maintain their blood sugar levels to help minimize their risk for complications associated with disease.
Diet and exercise can also promote a healthier lifestyle and fewer complications for patients with diabetic retinopathy. Routine check ups are also recommended, as the earlier a problem is suspected, the more likely surgeons are to treat it successfully and prevent future complications.
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