Diabetic retinopathy is an eye condition that may develop in patients with diabetes (type 1, type 2, and gestational) and can lead to vision loss and blindness. It is the leading cause of blindness among adults in the US and usually affects both eyes.
When left untreated or when not under control, high blood sugar levels damage the blood vessels in the retina (the light sensitive part of the eye). Blood and fluids then leak into the eye, which then hinder light from reaching and focusing onto your retina.
In early stages, you may not show any symptoms and not know that you have diabetic retinopathy. As the disease progresses, you will experience:
- Spots or floaters
- Blurred or cloudy vision
- Seeing a dark or blank spot in your center field of vision
- Poor night vision
- Faded or washed-out colors
If you or your family has a history of diabetes, it is important for you to have regular annual eye exams. Our optometrist will use optomap® retinal imaging to detect early signs of blood or fluid leakage, giving you an overview of the general health of your retina.
Based on clinical findings, he or she may also require an OCT/OCTA scan (ultrasound of your eye) to review how much blood or fluid has leaked into your eye. Our Optovue AngioVue® OCTA features the latest angiography technology to view blood vessel changes at the micron level without dye injection to your eye, which helps our doctor detect risks to your vision much earlier than before.
Diabetic retinopathy will progress in stages:
- Mild non-proliferative retinopathy: At this earliest stage, microaneurysms occur, which are small areas of balloon-like swelling in the retina’s tiny blood vessels.
- Moderate non-proliferative retinopathy: As the disease progresses, some blood vessels that nourish the retina are blocked, swell and change shape. You may develop diabetic macular edema (DME) which is when your retina gets deformed because it is swollen with blood and fluids, therefore potentially affecting vision.
- Severe non-proliferative retinopathy: Many more blood vessels are blocked, depriving several areas of the retina with their blood supply. These areas of the retina send signals to the body to grow new blood vessels for nourishment.
- Proliferative retinopathy: At this advanced stage, abnormal new blood vessels grow inside your retina and into the vitreous humor, the clear gel that fills the inside of your eye. By themselves, these blood vessels do not cause symptoms or vision loss. However, being thin with fragile walls, they leak blood and cause scar tissue to form, which then leads to vision loss from vitreous hemorrhage and also puts you at high risk of retinal detachment, causing blindness.
The goal of having regular eye exam is for our eye doctors to catch and monitor any microaneurysm formations early to avoid potential vision impairment. Our optometrist would prefer you keep your diabetes under control with preventive care over having you undergo invasive procedures like anti-VEGF eye injections or laser treatments to stop vision loss.
Even though laser treatments are effective at stopping internal eye bleeding, they are also known to scar the retina.
For additional information, please visit one of the following resources and references:
- American Diabetes Association, “Eye Complications“
- American Optometric Association, “Diabetic Retinopathy“
- American Academy of Ophthalmology, “What is Diabetic Retinopathy“
- National Eye Institute, “At a glance: Diabetic Retinopathy“
- Review of Optometry, Oct 2019, Wellness Essentials for Clinical Practice, see “The Nuts and Bolts of Nutrients” pg 8, “The Virtues of Vitamin C” pg 14, “Carotenoids: Front to Back Ocular Protection” pg 21, “Put Wellness on the Menu” pg 34