A Step-by-Step Guide to Diabetic Retinopathy
Diabetic retinopathy is an eye disease that can result in vision loss and blindness in people with diabetes. It affects the retina’s blood vessels (the light-sensitive layer of tissue in the back of your eye).
If you have diabetes, a dilated eye exam should be done at least once a year. Diabetic retinopathy may not present symptoms at first, but detecting it early might help protect your vision.
Diabetes management, which includes remaining physically active, eating a balanced diet, and taking your medication, can help you avoid or delay vision loss.
Diabetic Retinopathy Symptoms
You may not be aware that you have diabetic retinopathy. This is because, in its early phases, it frequently exhibits no symptoms. You’ll notice symptoms like these when your diabetic retinopathy worsens:
- an increase in the number of floaters
- having a hazy vision
- having eyesight that shifts from fuzzy to clear at times
- seeing regions of your range of vision that are blank or black,
- a lack of night vision, and
- seeing fading or washed-out colors
- Loss of vision
The symptoms of diabetic retinopathy usually affect both eyes.
Diabetic Retinopathy Diagnosis
A complete dilated eye exam is the best way to diagnose diabetic retinopathy. Drops in your eyes expand (dilate) your pupils to enable your doctor a better view of your eyes during this test. The drops might produce blurry vision in close quarters until they wear off, which can take several hours.
During the examination, your eye doctor will check the inside and exterior of your eyes for any abnormalities.
- Angiography With Fluorescein
A dye is injected into a vein in your arm after dilating your eyes. The dye is then circulated into the blood vessels in your eyes, and photographs are taken. Blood vessels that are closed, damaged, or leaking can be identified using these photos.
- Optical Coherence Tomography Is A Type Of Imaging That Uses Light To Create Images (OCT)
The images produced by this test provide cross-sectional images of the retina, which reveal the thickness of the retina. This will assist in identifying how much fluid has leaked into the retinal tissue. OCT tests can then track how well the treatment is functioning.
Diabetic Retinopathy Treatment
Your ophthalmologist’s diagnosis is based on what they see in your eyes. Among the treatment options available are:
Blood sugar and blood pressure control can help prevent eyesight loss. Follow your nutritionist’s diet recommendations in the letter. Take the diabetes medication that your doctor prescribed for you. Sugar control can sometimes even help you regain a part of your vision. Blood pressure control maintains the blood vessels in your eyes healthy.
Anti-VEGF medication is one sort of treatment. Avastin, Eylea, and Lucentis are among them. Anti-VEGF therapy reduces macula swelling, slowing vision loss and even improving vision. This medication is administered through eye injections (shots). Another approach for reducing macular swelling is to take steroid medication. This can also be given as an eye injection. Your doctor will advise you on how many pharmaceutical injections you’ll require overtime.
Laser surgery may be used to help stop bleeding blood vessels from opening.
This can help to minimize retinal edema. Blood vessels can be shrunk and prevented from sprouting again via laser surgery. Occasionally, more than one treatment is required.
If you have advanced PDR, your ophthalmologist may suggest vitrectomy surgery. Vitreous gel and blood from leaking vessels at the rear of your eye are removed by an ophthalmologist. Light rays can now focus properly on the retina once more. The retina’s scar tissue may also be removed.
Preventing Diabetic Retinopathy Related Visual Loss
- High blood sugar affects the blood vessels in the retina. This results in visual loss. If you have diabetes, talk to your primary care physician about controlling your blood sugar.
- Do you suffer from high blood pressure or kidney disease? Consult your doctor for advice on how to manage and treat these issues.
- Have dilated eye exams with your ophthalmologist regularly. Diabetic retinopathy can be detected before any vision problems arise.
- Contact your ophthalmologist immediately if you detect visual changes in one or both eyes.
- Seek treatment as soon as possible if you have diabetic retinopathy. This is the most effective strategy to avoid visual loss.
Types Of Diabetic Retinopathy
Let’s talk about the different varieties of diabetic retinopathy: ‘Nonproliferative Diabetic Retinopathy (NPDR)’ or early Diabetic Retinopathy,’ and ‘Proliferative Diabetic Retinopathy (PDR)’ or Advanced Diabetic Retinopathy.’
Nonproliferative Diabetic Retinopathy is the first type of diabetic retinopathy (NPDR)
The most prevalent kind of diabetic retinopathy, known as ‘Nonproliferative Diabetic Retinopathy,’ is the early stage of the illness. There is no abnormal blood vessel growth (proliferation).
The walls of your retinal blood vessels get weaker due to NPDR. This causes microaneurysms’ to protrude from the walls of tiny blood vessels, causing fluid and blood leaking into the retina.
NPDR progresses from mild to severe when more blood vessels become blocked. This can cause swelling of the retina’s tiny nerve fibers, which causes the macula (the centralmost portion of the retina) to enlarge. It also causes more prominent retinal veins to dilate, disrupting their average diameter.
Proliferative Diabetic Retinopathy is the second kind of diabetic retinopathy (PDR)
Diabetic retinopathy can evolve to this advanced stage, known as proliferative diabetic retinopathy, when the severity of the disease worsens. By this point, the previously damaged blood vessels have closed shut, allowing new, aberrant blood vessels to form within the retina, which is more prone to leak blood and fluid into the clear, jelly-like substance that fills the central part of the eye (vitreous).
Glaucoma can arise from injury to the optic nerve, the central nerve that connects your eye to your brain. This aberrant proliferation of blood vessels inside the retina also drives the growth of scar tissue, leading to retinal detachment from the back of the eye. There’s also a chance that the new blood vessels will obstruct the normal flow of ocular fluid, resulting in increased eyeball pressure.
Diabetic Retinopathy Causes
Diabetes causes elevated blood sugar, which leads to diabetic retinopathy. Too much sugar in your blood can damage your retina, which detects light and sends signals to your brain through a nerve at the back of your eye over time (optic nerve).
Diabetes wreaks havoc on the body’s blood vessels. Sugar obstructs the tiny blood vessels that go to your retina, causing them to leak fluid or bleed, causing damage to your eyes. Your eyes generate new blood vessels that don’t operate adequately to compensate for the blocked blood vessels. These young blood vessels are prone to leaking or bleeding.
Is there anything I can do to avoid diabetic retinopathy?
Diabetic retinopathy is not always preventable. On the other hand, regular eye checkups, proper blood sugar, blood pressure control, and early care for vision disorders can help prevent severe vision loss.
Reduce the risk of diabetic retinopathy if you have diabetes by doing the following:
- Take control of your diabetes. Make a healthy diet and exercise a regular part of your day. Each week, aim for at least 150 minutes of moderate aerobic activity, such as walking. Follow the directions on your diabetes medicine or insulin.
- Keep an eye on your blood sugar levels. You may need to check and record your blood sugar level many times a day — or even more often if you’re sick or stressed. Inquire with your doctor about how often you should test your blood sugar.
- Request a glycosylated hemoglobin test from your doctor. The glycosylated hemoglobin test, often known as the hemoglobin A1C test, measures your average blood sugar level over the previous two to three months. The A1C aim for most persons with diabetes is to keep it under 7%.
- Maintain healthy blood pressure and cholesterol level. Eating well-balanced meals, exercising regularly, and decreasing weight can all help. Medication is sometimes required as well.
- If you smoke or use other tobacco products, talk to your doctor about quitting. Smoking raises your chances of developing diabetes problems, including diabetic retinopathy.
- Pay alert to any changes in your vision. If your eyesight suddenly changes or becomes blurry, spotty, or hazy, see your eye doctor straight once.
Keep in mind that diabetes does not always result in eyesight loss. Taking a proactive approach to diabetes treatment can help you avoid complications.
What other complications might diabetic retinopathy bring about?
Diabetic retinopathy can lead to a variety of significant eye problems, including:
- Diabetic macular edema (diabetic macular edema) (DME). DME develops in around half of the diabetic retinopathy patients over time. DME occurs when fluid leaks from blood vessels in the retina, creating enlargement in the macula (a part of the retina). Because of the additional fluid in your macula, your vision will become hazy if you have DME.
- Diabetic retinopathy causes aberrant blood vessels to develop out of the retina, obstructing fluid drainage from the eye. This results in the form of glaucoma. Glaucoma is caused by neovascularization.
- Detachment of the retina. Tractional retinal detachment occurs when scars pull your retina out from the back of your eye. Spots in the back of your eye might develop due to diabetic retinopathy.
What methods will my optometrist use to check for diabetic retinopathy?
During a dilated eye exam, eye specialists can screen for diabetic retinopathy. The exam is straightforward and painless: your doctor will dilate (widen) your pupil with eye drops before checking your eyes for diabetic retinopathy and other eye disorders.
It’s critical to have frequent eye exams if you have diabetes. If you get diabetic retinopathy, getting therapy as soon as possible helps you avoid blindness.
Fluorescein angiography may be performed if your eye doctor suspects you have severe diabetic retinopathy or DME. This exam allows your doctor to see images of your retina’s blood vessels.