Are you or someone you know at risk for diabetes?
You are at risk if you:
- are over the age of 45
- are overweight
- do not exercise regularly
- have a family history of diabetes
- delivered a baby weighing over 9 pounds
- are African-American, Hispanic or Native American
If you have diabetes, you probably know that your body can't use or store sugar properly. When your blood sugar gets too high, it can damage the blood vessels in your eyes. This damage may lead to diabetic retinopathy.
In later stages, the disease may lead to new blood vessel growth over the retina. The new blood vessels can cause scar tissue to develop, which can pull the retina away from the back of the eye. This is known as retinal detachment, and can lead to blindness if untreated. In addition, abnormal blood vessels can grow on the iris, which can lead to glaucoma.
Signs of Diabetic Retinopathy
Everyone who has diabetes is at risk for developing diabetic retinopathy, but not everyone develops it. In its early stages, you may not notice any change in your vision, but it can lead to the later, sight-threatening form of the disease.
Floaters can be a sign of diabetic retinopathy. Sometimes difficulty reading or doing close work can indicate that fluid is collecting in the macula, the most light-sensitive part of the retina. This fluid build-up is called macular edema. Another sign is double vision, which occurs when the nerves controlling the eye muscles are affected. If you experience any of these signs, see your eyecare practitioner immediately.
Your eyecare practitioner may diagnose retinopathy using a special test called fluorescein angiography. In this test, dye is injected into the body and then gradually appears within the retina due to blood flow. Your eyecare practitioner will photograph the retina with the illuminated dye. Evaluating these pictures tells your doctor how far the disease has progressed.
What Causes Diabetic Retinopathy?
Changes in blood sugar levels increase your risk of diabetic retinopathy, as well as long-term diabetes. Generally, diabetics don't develop diabetic retinopathy until they've had diabetes for at least 10 years.
High blood sugar can damage blood vessels in the retina, and when they are damaged, they can leak fluid or bleed. This causes the retina to swell and form deposits. This is an early form of diabetic retinopathy called nonproliferative or background retinopathy.
In a later stage, called proliferative retinopathy, new blood vessels grow on the surface of the retina. These new blood vessels can lead to serious vision problems because they can break and bleed into the vitreous, the clear, jelly-like substance that fills the center of the eye. Proliferative retinopathy is a much more serious form of the disease and can lead to blindness.
Fortunately, you can significantly reduce your risk of developing diabetic retinopathy by using common sense and taking good care of yourself.
Keep your blood sugar under good control
Monitor your blood pressure and keep it under good control, or seek appropriate care.
Maintain a healthy diet.
See your eye doctor for a dilated eye exam at least once a year.
If you notice blurring of your vision, or have difficulty doing close work such as reading, or if your vision becomes spotty or hazy, see your eye doctor right away.
Diabetic Retinopathy Treatment
Diabetic retinopathy can be treated with laser photocoagulation to seal off leaking blood vessels and destroy new growth. Laser photocoagulation doesn't cause pain because the retina does not contain nerve endings.
In some patients, blood leaks into the vitreous humor and clouds vision. The eye doctor may choose to simply wait and see if the clouding will dissipate on its own, a period called "watchful waiting." A procedure called a vitrectomy removes blood that has leaked into the vitreous humor. The body gradually replaces lost vitreous humor, and vision usually improves.
If diabetic retinopathy has caused your body to form cataracts, they can be corrected surgically. Patients who have developed glaucoma should see a glaucoma specialist.