DIABETIC RETINOPATHY
Diabetic retinopathy affects half of all Americans diagnosed with diabetes. At first, you may notice no changes in your vision. But don't let diabetic retinopathy fool you. It could get worse over the years and threaten your vision. With timely treatment, 90 percent of those with advanced diabetic retinopathy can be saved from going blind.What is Diabetic Retinopathy?
Diabetic
retinopathy is a potentially blinding complication of diabetes that damages the
eye's retina.
What are the stages of diabetic retinopathy?
Diabetic retinopathy has four stages:
- Mild Nonproliferative Retinopathy. At this earliest
stage, microaneurysms occur. They are small areas of balloon-like
swelling in the retina's tiny blood vessels.
- Moderate Nonproliferative Retinopathy. As the disease progresses, some blood vessels that nourish the retina are blocked.
- Severe Nonproliferative Retinopathy. Many more blood vessels
are blocked, depriving several areas of the retina with their blood
supply. These areas of the retina send signals to the body to grow new
blood vessels for nourishment.
Proliferative Retinopathy. At this advanced stage, the signals sent by the retina for nourishment trigger the growth of new blood vessels. This condition is called proliferative retinopathy. These new blood vessels are abnormal and fragile. They grow along the retina and along the surface of the clear, vitreous gel that fills the inside of the eye.
By themselves, these blood vessels do not cause symptoms or vision loss. However, they have thin, fragile walls. If they leak blood, severe vision loss and even blindness can result.
Does Diabetic Retinopathy Have any Symptoms?
Diabetic retinopathy often has no early warning signs. Don't wait for symptoms. Be sure to have a comprehensive dilated eye exam at least once a year.
How are Macular Edema and Diabetic Retinopathy Detected?
Macular edema and diabetic retinopathy are detected during a comprehensive eye exam that includes:
- Visual acuity test. This eye chart test measures how well you see at various distances.
- Dilated eye exam. Drops are placed in your eyes to widen, or
dilate, the pupils. Your eye care professional uses a special
magnifying lens to examine your retina and optic nerve for signs of
damage and other eye problems. After the exam, your close-up vision may
remain blurred for several hours.
- Tonometry. An instrument measures the pressure inside the eye. Numbing drops may be applied to your eye for this test.
How is Diabetic Retinopathy Treated?
During the first three stages of diabetic retinopathy, no treatment is needed, unless you have macular edema. To prevent progression of diabetic retinopathy, people with diabetes should control their levels of blood sugar, blood pressure, and blood cholesterol.
Proliferative retinopathy is treated with laser surgery. This procedure is called scatter laser treatment. Scatter laser treatment helps to shrink the abnormal blood vessels. Your doctor places 1,000 to 2,000 laser burns in the areas of the retina away from the macula, causing the abnormal blood vessels to shrink. Because a high number of laser burns are necessary, two or more sessions usually are required to complete treatment. Although you may notice some loss of your side vision, scatter laser treatment can save the rest of your sight. Scatter laser treatment may slightly reduce your color vision and night vision.
Scatter laser treatment works better before the fragile, new blood vessels have started to bleed. That is why it is important to have regular, comprehensive dilated eye exams. Even if bleeding has started, scatter laser treatment may still be possible, depending on the amount of bleeding.
If the bleeding is severe, you may need a surgical procedure called a vitrectomy. During a vitrectomy, blood is removed from the center of your eye.