Aditya Jyot Eye Hospital

What Is Diabetic Retinopathy?

Diabetic retinopathy is an eye disease which can affect people with Diabetes. This is when high blood sugar levels cause damage to blood vessels in the retina. These blood vessels can swell and leak. Or they can close, stopping blood from passing through. Sometimes abnormal new blood vessels grow on the retina. All of these changes can steal your vision.

Stages of Diabetic Eye Disease

There are two main stages of diabetic eye disease.

NPDR (non-proliferative diabetic retinopathy)

This is the early stage of diabetic eye disease. Many people with diabetes have it.

If you have NPDR, your vision may become become blurry or decrease due to 2 reasons:

1. Swelling of the central area of retina called macula due to leakage from tiny blood vessels (ie. Macular edema)

2. Decreased blood supply to the macula (ie. Macular ischemia)

PDR (proliferative diabetic retinopathy)

PDR is the more advanced stage of diabetic eye disease. It happens when the retina starts growing new blood vessels called neovascularization.

If you have PDR, in addition to the above, your vision may decrease due to another 2 reasons:

1. Bleeding from new vessels (ie. Vitreous Haemorrhage)

2. Pulling-up of the retina due to abnormal tissue growth (fibro-vascular proliferation) leading to retinal detachment (ie. Tractional Retinal detachment)

PDR is very serious, and can steal both your central and peripheral (side) vision.

Diabetic Retinopathy Symptoms

You can have diabetic retinopathy and not know it. This is because it often has no symptoms in its early stages. As diabetic retinopathy gets worse, you will notice symptoms such as:

seeing an increasing number of floaters,
having blurry vision,
having vision that changes sometimes from blurry to clear,
seeing blank or dark areas in your field of vision,
having poor night vision, and
noticing colors appear faded or washed out losing vision.

Diabetic retinopathy symptoms usually affect both eyes.

Drops will be put in your eye to dilate (widen) your pupil. This allows your ophthalmologist to look through a special lens to see the inside of your eye.

Your doctor may ask you to do couple of tests like;

Fundus fluorescein angiography (FFA) to see if any blood vessels are blocked or leaking fluid. It also shows if any abnormal blood vessels are growing.

Optical coherence tomography (OCT) is another test where a machine scans the retina and helps your doctor find and measure swelling of your macula.

Your treatment is based on what your ophthalmologist sees in your eyes. Treatment options may include:

Medical control

Controlling your blood sugar and blood pressure can delay vision loss.

Carefully follow the diet your nutritionist has recommended.

Take the medicine your diabetes doctor prescribed for you.

Sometimes, good sugar control can even bring some of your vision back.

Controlling your blood pressure keeps your eye’s blood vessels healthy.

Medicine

Medical treatment inculdes anti-VEGF/steroid injections which are given directly into the eye.

They help to reduce swelling of the macula, slowing vision loss and perhaps improving vision.

These injections need to be repeated regularly in the initial few months of treatment as directed by your ophthalmologist.

Laser therapy

Laser therapy might be used to help seal off leaking blood vessels and reduce swelling of the retina.

It can also help shrink abnormal blood vessels and prevent them from growing again. Sometimes more than one treatment is needed.

Preventing vision loss from diabetic retinopathy

Talk with your primary care doctor about controlling your blood sugar appropriately as high blood sugar damages retinal blood vessels leading to diabetic retinopathy.
Ask your doctor about ways to manage and treat high blood pressure or kidney problems if you have them.
Diabetic retinopathy may be found before you even notice any vision problems visit your ophthalmologist regularly for dilated eye exams.
Visit your ophthalmologist right away if you notice vision changes in one or both eyes.
This is the best way to prevent vision loss is to treat diabetic retinopathy as soon as possible.

Do you have diabetes and need an exam for eyeglasses?

Changes in blood sugar levels can affect your vision.

Make sure your blood sugar is under control for at least a week before an eye exam.

Eyeglasses prescribed when your blood sugar levels are stable work best!

Dr Jaydeep Walinjkar

Vitreo-Retina Consultant,