Diabetes can take a toll on your entire body, if not properly managed, and your eyes are no exception. Diabetic retinopathy is the most common cause of vision loss in adults with diabetes. With this incurable condition, high blood sugar levels damage the tiny blood vessels in your retina, the part that converts light into images, allowing us to see.
Research shows that diabetic retinopathy develops in more than half of all people with diabetes, whether you have type 1 or 2 or gestational, occurring with pregnancy. But proper diabetes management and a healthy lifestyle may help you to slow or stop its progression. Should it worsen, we perform a variety of treatment options at Retina Consultants of Charleston that may help to reduce additional damage.
A Definition Of Diabetic Retinopathy
Located in the back of the eye, the retina is a photosensitive layer of tissue. When light enters the eye’s lens, the retina has the task of converting them into nerve signals. They then travel along the optic nerve to the brain, which interprets these signals and transforms them into an image.
But diabetes — a disease affecting your body’s ability to control blood sugar, or glucose — raises glucose levels, and over time, can harm your body’s blood vessels. In the case of diabetic retinopathy, high blood sugar weakens the walls of the retina’s blood vessels. Small red bulges called microaneurysms form, leaking fluid and blood into the retina. Blisters may also form along the vessel walls, and when they burst, retinal hemorrhages, or excessive bleeding, can occur. Diabetic retinopathy typically affects both eyes.
With this condition, there are two main stages: 1. nonproliferative diabetic retinopathy (NPDR), the earlier, more common form; and 2. proliferative diabetic retinopathy (PDR), the more serious form.
What Is Nonproliferative Diabetic Retinopathy?
In the earlier stages, nonproliferative diabetic retinopathy (NPDR), the more common form may develop. There may be no symptoms, and you may not even be aware you have this condition. However, as it worsens and more vessels are blocked, certain symptoms may become more noticeable and come and go, including:
- Blurred vision
- Decreased clarity
- Fluctuating vision quality, such as trouble seeing distant objects or reading
- Cotton wool spots, which are white retinal areas
- Retinal swelling or bleeding
- Exudate, or pus
What Is Proliferative Diabetic Retinopathy?
The more advanced form, proliferative diabetic retinopathy (PDR) may require immediate medical treatment. PDR is characterized by the development of new, abnormal, delicate blood vessels growing in the retina. They also grow within the vitreous gel, the clear, jelly-like substance filling most of the eye. With PDR, you may experience such symptoms as floaters, hazy vision, and problems with night vision and Iighting changes.
Can PDR Lead To Serious Complications?
PDR is a major health concern, and without immediate treatment, a host of serious complications may develop. You may be at risk for permanent blindness or the loss of an eye, as well as:
- Neovascular glaucoma, in which new blood vessels grow on the iris, the part of the eye that controls pupil size and the amount of light allowed in. This new vessel growth can interfere with the eye’s normal fluid flow, raising pressure. You may also have vision loss, eye redness, and severe pain.
- Retinal detachment can occur, as the fragile new blood vessels bleed easily, leading to scar tissue formation. This may cause eye tissue to pull back, moving your retina out of position.
- Vitreous hemorrhage, heavy bleeding in the vitreous gel, can occur, causing floaters and vision blockages, although this may go away once the blood clears.
How Important Are Eye Screening Exams For Diabetic Retinopathy?
Due to the fact that nonproliferative diabetic retinopathy can convert into a more dangerous form, regular eye exams are crucial. The longer you’ve lived with diabetes, the greater your likelihood of developing this condition. Therefore, if you’re an adult with diabetes, you need a comprehensive dilated eye examination at least once a year.
When you visit your retina specialist, you can expect them to inspect your eyes for abnormal blood vessels, bleeding, leakage, swelling, and retinal detachments. You should mention any visual changes, like sudden changes or blurry, spotty or hazy vision. The exceptions are seeing dark, floating spots or cobweb-like streaks; if so, immediate medical treatment is needed.
How Is Diabetic Retinopathy Diagnosed?
When it comes to diagnosing diabetic retinopathy, the diagnostic methods may depend on your condition and its severity. However, most diabetic eye exams typically start with a dilated eye exam. Eye dilation involves widening the eye by applying special eye drops to keep the pupil open, allowing a closer look at the retina. Your doctor may use an instrument called an ophthalmoscope to observe and assess any retinal damage.
Retina specialists may also use optical coherence tomography (OCT), in which infrared light captures cross-sectional retinal images. OCT allows them to check if fluid has leaked into the retinal tissue, causing macular swelling.
Another commonly used imaging technique used by retina specialists is fluorescein angiography, in which yellow dye is injected into your bloodstream to highlight the eye’s blood vessels. A special camera then takes photos of the retina, showing abnormal growth of any blood vessels, as well as blocked or leaking vessels.
How is Diabetic Retinopathy Treated?
In the event diabetic retinopathy is diagnosed, your ophthalmologist may initially monitor your eyes’ health. But should you have vision changes, there may be the need for treatments to reduce further damage, including:
- Injectable medications known as anti-vascular endothelial growth factor (anti-VEGF) drugs may slow this condition’s progression. However, your retina specialist may decide to use injectable corticosteroids instead.
- Laser treatments may be effective, as they can reduce retinal swelling, shrink blood vessels, and stop any leaking.
- A vitrectomy, a surgical procedure in which part or all of your vitreous gel is removed, may be needed, in the event excessive retinal bleeding has resulted in scarring in your eye.
Proper Diabetes Management Can Benefit Diabetic Retinopathy
With diabetic retinopathy, one of the best ways to slow or prevent any vision loss is to never develop it at all. You must continue to properly manage your diabetes by regularly taking your insulin and other medications, as well as consistently testing your glucose levels as per your doctor’s directions.
You must also properly control your cholesterol and blood pressure levels. For adults with diabetes, try to maintain a blood pressure of less than 130/80 mm Hg. Beyond this, following a healthy lifestyle is vital, and you should engage in regular physical activity, eat a healthy diet and avoid smoking.
What Is A Glycosylated Hemoglobin Test?
If you have diabetes, request that your primary care doctor prescribe a glycosylated hemoglobin test, also called a hemoglobin A1C. This test details your average blood sugar levels for the previous 2-3 months, and you should aim for an average level of below 7 percent
Schedule a Diabetic Retinopathy Consultation in South Carolina
Diabetic retinopathy is a manageable condition, and you can take preventive steps to reduce or even stop the progression of vision loss. Should you have any questions or concerns, please contact Retina Consultants of Charleston for an appointment with our retina specialists.