Diabetes affects more than 20 million Americans, and is a leading cause of blindness in adults ages 20 to 74. As the disease progresses, if not controlled, small blood vessels in the retina can become damaged, and this is known as diabetic retinopathy.
Almost half of all patients with diabetes will eventually have some form of retinopathy,” explains Joseph Hazen MD, a family practice physician with The Family Medical Group. “If caught early, 90 to 95 percent of blindness with diabetes is preventable.”
Diabetic Retinopathy: What is it?
Diabetic retinopathy affects the retina, the back portion of the eye. It is important to understand that whether you have type 1 or type 2 diabetes, everyone who is diagnosed with diabetes is at risk to develop retinopathy.
There are two types of retinopathy, including:
- Nonproliferative: This is the first stage of retinopathy. It occurs once blood vessels in the eye begin to change, typically due to small blockages. As more blood vessels are affected, retinopathy progresses.
- Proliferative: This is the more severe stage of retinopathy, and occurs once blood vessels proliferate and try to compensate. Since they are weakened, they are at risk of leaking or rupturing.
Dr. Hazen explains, “Diabetic retinopathy often takes time to develop, so it’s a later manifestation with diabetes.
Diabetic Retinopathy: Symptoms
A vast majority of the time, diabetic retinopathy is asymptomatic until you have an event, such as a rupture. Even once the disease progresses to the proliferative form, often times there is still no decrease in vision or associated pain, so it is hard rely on symptoms alone.
If you do experience symptoms, they may include:
- Blurred vision
- Vision loss over time
- Shadows or missing areas of vision
- Trouble seeing at night
Dr. Hazen says, “Think of it as a stroke of the eye. You’re at risk of stroke, but you don’t have symptoms until you actually have the stroke, and the severity of an event is different for every person."
Diabetic Retinopathy: Diagnosis
Currently, diabetic retinopathy can be diagnosed through a regular eye examination with dilation. The exam can be performed by either your regular physician who treats your diabetes, or by an eye doctor who specializes in diabetic eye diseases. From there, if your doctor suspects you have retinopathy, he or she will determine if it is nonproliferative or proliferative by evaluating the following characteristics:
- Blood vessels enlarged in certain spots
- Blocked blood vessels
- Bleeding and fluid leaking into retina
- New blood vessels forming that are weak and can bleed
- Formation of small scars
Diabetic Retinopathy: Treatments
If you’ve been diagnosed with diabetic retinopathy, you may need no treatment at all, but if required, eye surgery is the most common treatment form.
In some cases, your doctor may recommend laser eye surgery, which is a method used to shrink abnormal blood vessels and to keep them from leaking. Small burns are created where there are abnormal blood vessels in the retina. Vitrectomy is another form of surgery used with bleeding in the eye, and also for retinal detachment.
Injections are also used as a treatment option to help with abnormal blood vessel growth.
Diabetic Retinopathy: Prevention
It is important to catch the disease early and control it, to delay or prevent complications from developing as the disease progresses. “We can delay progression through controlling sugar, but also blood pressure and cholesterol have been found to play a role in making diabetic retinopathy worse when they are uncontrolled, so we monitor those closely as well,” Dr. Hazen says. It is recommended that diabetics visit their doctor every three months, to ensure their sugar is controlled and they are maintaining healthy blood pressure and cholesterol levels.
Also, maintain a healthy lifestyle by:
- Eating nutritious foods
- Exercising regularly
- If on medication or insulin, taking them as prescribed
Dr. Hazen reminds those with diabetes, “The sugar itself is not so much the issue, it’s the complications the sugar causes.”