Diabetic Retinopathy

diabetic retinopathy

People with long-term diabetes and fluctuations in blood sugar levels are at greater risk of getting the disease.
No, diabetic retinopathy is not curable. Early detection and treatment can only slow down the disease progression.
Some evidence shows that habitual smoking increases the risks for diabetic retinopathy disease progression.

What is Diabetic Retinopathy?

Diabetic retinopathy is an eye disease due to a long history of type 1 and 2 diabetes and can cause vision loss, blindness, or even be life-threatening if left untreated.

Diabetic retinopathy is a serious eye complication that mainly affects the blood vessels of the retina.

People with prolonged diabetes mellitus, uncontrolled diabetes, or high blood sugar levels are mainly affected by this disease. The high levels of sugar in the blood can damage or choke the blood vessels of the retina causing them to swell, bleed, leak fluid, or even result in the growth of new blood vessels.

The retina is a very sensitive area in the eye and diabetes retinopathy can cause serious damage to this area or even cause blindness. Vision loss or blindness is one of the most common side effects of diabetes.

Causes

Diabetic retinopathy causesDiabetic retinopathy is caused due to the damage of the blood vessels in the retina of the eye. This can cause temporary vision loss or even blindness. Prime causes for diabetic retinopathy are:

  • The macula is located in the middle of the retina and is responsible for detecting light and helping the brain interpret images. Leakage of fluid from the blood vessels in the retina can seep into the macular region and cause blurred vision.
  • The blockage of blood vessels disrupts blood circulation in the eye. To improve blood circulation, new blood vessels grow in the area surrounding the retina. These blood vessels may grow abnormally and are weak. They may cause leakage of blood that may block the vision in the eye.
  • The growth of new blood vessels results in the accumulation of scar tissue. This may cause excess pressure in the retina causing it to detach or tear.
  • Blocked blood vessels can cause cataracts or glaucoma that may result in a loss of vision.

Symptoms

Diabetic retinopathy symptomsThe early stages of diabetic retinopathy usually do not have any symptoms so it is hard to detect the disease. However, as the disease progresses, you may experience the following symptoms:

  • Dark spots or floating dark strings.
  • Blurry vision.
  • Difficulty in identifying colors.
  • Vision loss.
  • Difficulty in vision especially at night.
  • Empty patches on the eye block the vision.

Symptoms may affect both eyes.

Types of Diabetic Retinopathy

Nonproliferative Diabetic Retinopathy or NPDR

Nonproliferative diabetic retinopathy or NPDR can be mild to severe. This occurs usually during the early stages of the disease when there is no growth of new blood vessels in the eye. During this time, microaneurysms of tiny bulges can occur on the walls of the eye that may protrude into the eye. This may cause leakage of fluid and blood that may seep into the center of the retina and even the macula region causing blurred vision or swelling.

NPDR may cause dilation or even change the size of the retina causing irregular vision or loss of vision. The swelling of the macular nerves may cause macular edema which may require further investigation.

Proliferative Diabetic Retinopathy or PDR

Proliferative diabetic retinopathy occurs during the advanced stage of diabetic retinopathy. It is a more progressive and severe form of diabetic retinopathy and occurs when there is a growth of new or abnormal blood vessels in the center of the eye or retina.

This may cause leakage of blood in the eye or the formation of scar tissue that may cause a rupture in the retina of the eye. The new blood vessels grow abnormally and may put pressure on the eye causing damage to the optic nerves causing eye conditions like glaucoma or loss of vision.

Who is at risk of developing the disease?

Anyone who has long-term diabetes can develop the disease. However, you are at a greater risk of developing diabetic retinopathy if you have the following conditions:

  • Uncontrollably high blood sugar.
  • High cholesterol.
  • High blood pressure.
  • A chain smoker.
  • Long-term diabetes.
  • Pregnancy.
  • Regular use of tobacco.

Diagnosis

If you had diabetes for a long time, it is recommended that you go for an eye exam at least twice a year to detect the disease.

It is believed that individuals who had diabetes for more than 30 years may develop diabetic retinopathy at some point in their life.

Here are a few methods that your doctor may use to detect diabetic retinopathy:

The Dilated Eye Exam

A dilated eye exam is one of the best ways to examine your eyes for detecting diabetic retinopathy. During this exam, the doctor will put some drops in the eye of the patient to dilate the pupils. The doctor then takes photographs of the eye to detect:

  • Abnormal growth of blood vessels.
  • Any abnormality in the optic nerve, blood vessels, or the retina.
  • Increase in eye pressure.
  • Loss of vision.
  • Scar tissue.
  • Tear or detachment of the retina.
  • Swelling in the retina.
  • Any blockage of the blood vessels.
  • Changes in the lens of the eyes.
  • Leakage of blood or fluid.
  • Nerve tissue damage.

Risks

  • The drops may cause a stinging sensation and the patient may feel uncomfortable during the exam.
  • While taking photographs during the examination, the patient may get startled.
  • The drops may increase ocular pressure.

Fluorescein Angiography

In Fluorescein angiography, doctors use a dye called fluorescein to detect the abnormalities of the eye.

The doctor injects the dye into the patient’s arm. The dye then moves into the eye and circulates. The doctor then takes the photographs. The dye will stain the abnormal blood vessels or leak into the eye. The test helps to detect:

  • Leakage of blood vessels.
  • Blockage of blood vessels.
  • Abnormal growth of the blood vessels.

Based on the results of the fluorescein angiography, the doctor can do further tests or laser treatment. The dye will pass out of your body within 24 hours through urination. Your urine may turn dark orange due to the presence of the dye, but there is nothing to worry about. It is completely normal.

Optical Coherence Tomography or OCT

Optical Coherence Tomography or OCT provides additional information about the retina and its surrounding areas that might be useful in detecting the condition. OCT can detect the thickness of the retina and also other changes of the optic nerves.

Treatment

diabetic retinopathy treatmentTreatment depends on the stage and progression of the disease. In case you have early diabetic retinopathy, the goal is to control the disease and slow the process of degeneration of the eye. Doctors will advise diet control and control of the blood sugar levels to minimize the progression of the disease.

In the advanced stage of diabetic retinopathy, the aim is to stop the formation of abnormal blood vessels that will slow down the leakage of blood and fluid into the retina.

Laser beam treatment of photocoagulation is used to seal the leaks and prevent leakage into the retina.

Photocoagulation surgery is mainly of three types:

  • Scatter photocoagulation where the laser beam burns and seals the tiny holes that have formed in the retina.
  • Focal photocoagulation tries to seal the vessels that are oozing blood or fluid in the macula region of the eye. This is usually done to prevent macular edema. Patients undergoing this surgery may experience blurry vision for a day and small spots initially but it will go away after some time.
  • This is done to remove the fluid or the scar tissue that has formed in the eye. After vitrectomy surgery, the patient will wear an eye patch for some time. Recovery of normal vision may take a few weeks or even months.

Injections are also used to treat diabetic retinopathy. VEGF is a protein that may result in swelling of the macular or leakage from blood vessels. Anti-VEGF drugs like Avastin, Lucentis, Eylea can be administered to control the condition. The injections are generally given once a month. The treatment may continue for 3 months, but some patients may require more injections depending on the severity and progression of the disease.

Corticosteroid implants are also used for treating the disease. Corticosteroids are known to reduce macular degeneration. Doctors may implant a corticosteroid device into the eye which will release the medicine in regular dosages. However, some patients have also complained about certain side effects.

Risk factors of corticosteroids include the development of glaucoma or cataracts.

Complications

diabetic retinopathySome common complications of diabetic retinopathy are listed below:

Vitreous hemorrhage 

Vitreous hemorrhage occurs when the new blood vessels leak into the center of the retina. Initially, you can see floaters or small dark spots but as the bleeding progresses, you can lose your vision completely. However, your vision may return after a few weeks or months.

The Detachment of the Retina

Due to the abnormal growth of new blood vessels, scar tissue can occur which may put pressure on the retina causing a tear or detachment. Retinal detachment can cause vision loss. People may also experience seeing light flashes or spots or floaters in the eyes.

Glaucoma

The abnormal blood vessels can restrict the flow of fluid in the eye and also put excessive pressure resulting in the formation of glaucoma. These nerve tissues can be damaged and cause an obstruction in vision.

Complete Blindness

Retinal detachment, glaucoma, and obstruction of blood vessels can cause complete loss of vision.

Diabetic Retinopathy during Pregnancy

The severity of diabetic retinopathy can increase during pregnancy. It has been noticed that pregnant women with mild-to-moderate diabetic retinopathy have more chances to develop a more severe form of the disease.

Even pregnant women with long-term diabetes, but no history of retinopathy have developed the disease during the second trimester of pregnancy. Since the progression of the disease is fast, once diagnosed, patients should immediately go for laser photocoagulation therapy mostly for severe cases of Nonproliferative diabetic retinopathy. The patient might require multiple sittings of the therapy.

Pregnant women going through laser treatment should inform their doctor about their pregnancy. Doctors may administer fewer drops for the dilation of the pupil. However, it must be noted that the drops are completely safe and there are hardly any side effects.

Patients whose blood sugar levels are under control and with no history of retinopathy are advised to go for eye screenings at least thrice a month. They should consult their diabetologist and strictly follow their diet regime. The dietary regime completely prohibits smoking and drinking alcohol.

Women with retinopathy who are planning to get pregnant are advised to delay their pregnancy and go for ocular treatment to prevent complications.

Prevention

Prevention of diabetic retinopathy involves maintaining a healthy diet, management of blood sugar levels, and doing regular eye checkups.

Here are a few ways through which you can manage the disease:

  • Maintaining a healthy diet.
  • Regular checkups of blood sugar levels.
  • Maintain healthy cholesterol and blood pressure level to prevent heart ailments.
  • Quit smoking.
  • Reduce alcohol intake.
  • Exercise regularly.
  • Control body weight.
  • Test urine to check ketone levels.
  • Do a yearly dilated eye exam.
  • Inform your doctor if you experience any vision changes.

 

Facts

At first, patients may not have any symptoms of diabetic retinopathy. Look out for early-stage symptoms like vision changes, trouble seeing things at a distance, reading books, etc.

Facts

Diabetic retinopathy can cause blindness or vision loss.

Facts

Early detection of the disease lowers the risk of getting blind almost by 95%.

Related Conditions

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People with long-term diabetes and fluctuations in blood sugar levels are at greater risk of getting the disease.
No, diabetic retinopathy is not curable. Early detection and treatment can only slow down the disease progression.
Some evidence shows that habitual smoking increases the risks for diabetic retinopathy disease progression.

 

Dos and Don'ts

Dos
  • Exercise regularly.
  • Regular checkups on blood sugar levels.
  • Eye checkups at least once a year.
  • Check your blood pressure and cholesterol levels.
  • Follow a healthy diet.
Don'ts
  • Smoking regularly.
  • Not following dietary restrictions.
  • Eating unhealthy foods.
  • Uncontrolled blood sugar levels.
  • Consume alcohol.

 

 

 

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Bromelain: 11 reasons why you should start adding pineapple to your pizza! If you didn't love pineapples already, here are some of the top health benefits that bromelain can bring…
Coconut sugar: What is it and is it healthier than table sugar? In the long list of things that the wonderful coconut gives us, coconut sugar is another remarkable addition.…
Experts reveal the safest ways to perform an enema at home The idea of pushing some up your rectal area might make you queasy but an enema could actually…
Is bronchitis contagious? And how to prevent this infection? It is acute bronchitis that is contagious which means you can contract it from another person or you…
Oxalates: How healthy greens can sometimes be bad news for your kidneys Oxalates are compounds present in a majority of healthy foods. However, at times an overconsumption of these could…
The Cabbage Soup Diet: The healthiest way to instant weight loss Cabbage soup diet rapid weight loss diet for those who want to shed those extra pounds in less…
Surgery or home-remedy; what is the right way to treat a burn The treatment of a burn injury depends on its severity. You can save a life by offering the…
Bubble Tea: Bubbling with nutrition or a hidden sugar mine? The tapioca pearls present in the tea looks like bubbles and hence the name bubble tea became popular.…
Glucose-6-Phosphate Dehydrogenase (G6PD) test Glucose-6-phosphate dehydrogenase (G6PD) is an enzyme that is found in every cell of the body and it plays…
anoscopy
Anoscopy Anoscopy is an invasive diagnostic procedure where a small device known as anoscope will be inserted in the…
apolipoprotein a1 test
Apolipoprotein -A1 (APO-A1) Test Apolipoprotein A-I (Apo-A1) constitutes 70% of protein content in high-density lipoprotein (HDL) and helps in lipid metabolism.
sugar toxic health
Sugar: 7 new shocking truths revealed about the sweet poison Can drinking soda bring you closer to death? Is sugar slowly poisoning you and your family? You would…
Plexus Slim: Is this pink slimming drink the ultimate one-stop fat burner? How effective is Plexus Slim in helping people lose weight? What are its ingredients? Can it be safely…
11 unbelievable health benefits of thyme you didn’t know! Thyme is a herb that has been used in alternative medicine.It is a well known seasoning in the…
lose weight fast
12 easy and instant steps to successful weight loss Do you want to lose weight without losing your mind? Does weight loss always mean saying goodbye to…
nutritional yeast bread
Nutritional Yeast : How can a fungi culture be good for your body? Nutritional yeast: How a simple culture of fungi can transform your skin, digestion, immunity , and much more.…
avocado benefits
Avocado: 15 reasons why this fruit should be a staple in your diet Did you know that the word avocado literally means "testicles". Don't get grossed out as this power-packed fruit…
DHEA wrinkles
DHEA: Now get unbelievable age defiance with this wonder hormone! DHEA is known popularly as the age-defying hormone. This supplement is widely used to slow down aging and…
Cottage cheese: What can you find in this healthy chunk of fresh milk cheese? Love cheese but scared of putting on extra pounds? With cottage cheese, you can get the best of…
Hydroquinone: Is it the best topical treatment for hyperpigmentation? Darkening of the skin due to high melanin levels is called hyperpigmentation.  Hydroquinone interferes with melanin production thus treating…
EEG
Electroencephalogram – EEG EEG or electroencephalogram is a diagnostic tool used to access the functioning of neurons and brain activity to…
LFT-test
Liver Function Test – LFT LFT or Liver Function Test is a blood test used to determine the levels of hepatic enzymes which…
CEA_test
Carcinoembryonic antigen (CEA) test CEA or carcinoembryonic test detects the presence of CEA antigen in your blood mainly & determines the effectiveness…
Rubella IgM test
Rubella IgM Test The Rubella IgM test is a blood test that is performed to diagnose the presence of the rubella…
Isagenix diet weight loss
How are BMI and BMR different and what do these numbers mean? BMI and BMR are two important metrics that provide a clear picture of your body's metabolism and also…
Hepatitis A virus infected liver
Hepatitis A Virus (HAV) Total Blood test to look for IgM antibodies to know if you are infected with Hepatitis A virus (HAV),…
alcohol toxic
7 startling facts that will make you quit alcohol today Does drinking really make you friendly and happy? How many calories does a can of cold beer add…
sleep deprivation
Don’t let your sleep deficit grow into memory loss or heart attack Why is sleep important for us? How could sleep deprivation harm you? We bet you didn't know about…
Jack in the box fast food
Jack In the Box : The perils of surging fast food culture in the USA Jack in the Box - How a culture of fast-food can clog your arteries, weaken your heart, fatten…
improve digestion weight loss
Power up your gut: 8 proven steps on how to improve your digestion Did you know you have a colony of bacteria in your gut that help you in digesting food?…
General adaptation syndrome: Understanding stress, one step at a time The struggle of the body to produce hormones during a stressful situation is the main theme of general…
Sciatica pain relief: Get rid of the pain with these easy daily tips Researchers have claimed that not only heat but icing the area too helps relieve sciatica pain. Find out…
sodium chloride
Halotherapy: How inhaling salt can work wonders for your body Halotherapy is quickly gaining popularity amongst those with respiratory diseases. It has shown promise in its treatment.
How to scrub away stress and fatigue with an Epsom salt bath? Epsom salt is a popular home remedy for many skin ailments. Though there is a lack of scientific…
Balneotherapy jacuzzi
5 things you didn’t know about balneotherapy and how you can do it at home Sauna baths have been popular since a long time. But how much more beneficial can balneotherapy be as…
Vitamin-D-blood-test
25-Hydroxy Vitamin D test 25-hydroxy Vitamin D test is a blood test used to measure the level of vitamin D in the…
BoneMarrow-Biopsy
Bone Marrow Biopsy Bone marrow biopsy is a diagnostic procedure where a small amount of bone marrow is extracted from hip…
Strep throat pain
Anti-Streptolysin-O Test The ASO or Anti-Streptolysin-O is a blood test designed to check for the presence of streptococcus bacterial infection…
phenytoin test
Phenytoin test Phenytoin is a drug that is administered mainly to epilepsy patients. The phenytoin blood test measures the level…
free psa test
Free PSA Test The free PSA test is used to detect the level or percentage of free PSA in the body…
HSV-1_IGG
Herpes Simplex Virus I (HSV)-IgG Test Herpes simplex virus I(HSV)-IgG is an Immunoglobulin protein that acts as an antibody & stays in the blood…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
piles fissure fistula
Allopathy vs homeopathy vs ayurveda treatment for piles, fissures, and fistula Read to know the best form of treatment among allopathy, homeopathy,or ayurveda for piles, fissures, and fistula
Tight phimosis ring
Phimosis Read to know everything about phimosis, types, symptoms, treatment, risks and prognosis for patients with this condition.
Jicama: A fiber-rich tuber for your weight loss goals Pronouced as HEE-kah-ma, Jicama is the "new kid on the block" that has taken the world by the…