Diabetes impairs the body’s ability to use and store sugar. Elevated blood sugar levels and excessive thirst and urination are the indicators of diabetes. It can affect vision by causing damage to the blood vessels of the retina, or a higher incidence of cataract and glaucoma. Changes are also seen in blood vessels all over the body.
WHAT IS DIABETIC RETINOPATHY?
It is an advanced stage of the diabetic disease process in which the blood vessels in the retina are damaged and leak fluid or blood. The longer a person has diabetes, the more the risk of developing diabetic retinopathy. People with type I diabetes [diabetes since childhood] are more likely to develop diabetic retinopathy at a younger age.
WHAT ARE THE SYMPTOMS OF DIABETIC RETINOPATHY?
Early diabetic retinopathy usually has no symptoms. Gradual blurring of vision may occur if fluid leaks in the central part of the retina [the macula]. In late stage diabetic retinopathy [proliferative stage], new abnormal blood vessels begin growing on the surface of the retina or the optic nerve. These vessels have weak walls and leak blood out into the retina and vitreous [jelly that fills most of the eye]. Presence of blood in the path of light entering the eye blocks vision.
HOW IS DIABETIC RETINOPATHY DIAGNOSED?
A complete eye examination is required for the detection of diabetic retinopathy. If there is evidence of diabetic retinopathy other special investigations will be done to assess the stage of the diabetic retinopathy. These include an OCT examination which scans the different layers of the retina allowing early detection of diabetic related retinal involvement. A OCT angiogram may be indicated if there is fluid and blood on the macula area.
HOW IS DIABETIC RETINOPATHY TREATED?
In early cases only regular follow-up may be necessary. More advanced cases require treatment to control the damage of diabetic retinopathy and improve sight. Laser photocoagulation involves the focusing of a powerful beam of laser light on the damaged retina to seal leaking retinal blood vessels and stop abnormal blood vessel [neovascularization] growth. The treatment of choice is anti-VEGF injections of the eye. Not only does the anti-VEGF prevent visual loss, but it also improves vision.
Vitrectomy – In the event of the patient presenting with very advanced diabetic retinopathy, a microsurgical procedure known as vitrectomy is recommended. Blood-filled vitreous gel of the eye is replaced with a clear solution to aid in restoring vision. Sometimes the retina may also be detached. Vitrectomy surgery is then performed to reattach the retina. Silicon oil or gas can be used at the end of the procedure.
HOW TO PREVENT VISUAL LOSS IN DIABETES?
Prevention of diabetic retinopathy and accompanying visual loss is a team effort involving the patient and our team of diabetic eye specialists. Early detection of diabetic retinopathy is the best protection against loss of vision. Diabetics must have their retinas examined at least once a year. Diabetics should be managed by endocrinologists, physicians or GPs passionate about diabetes. If you already have complications of diabetes in other areas of your body, you likely have Diabetic Retinal damage.