Diabetic retinopathy (die-uh-BET-ik ret-ih-NOP-uh-thee) is a complication of diabetes that affects the eyes. It's caused by damage to the blood vessels of the light-sensitive tissue at the back of the eye (retina).
At first, diabetic retinopathy may cause no symptoms or only mild vision problems. Eventually, however, diabetic retinopathy can result in blindness.
Diabetic retinopathy can develop in anyone who has type 1 diabetes or type 2 diabetes. The longer you have diabetes, and the less controlled your blood sugar is, the more likely you are to develop diabetic retinopathy.
To protect your vision, take prevention seriously. Start by carefully controlling your blood sugar level and scheduling yearly eye exams.
It's possible to have diabetic retinopathy and not know it. In fact, it's uncommon to have symptoms in the early stages of diabetic retinopathy.
As the condition progresses, diabetic retinopathy symptoms may include:
Diabetic retinopathy usually affects both eyes.
Diabetic retinopathy may be classified as early or advanced, depending on your signs and symptoms.
When to see a doctor
Contact your eye doctor right away if you experience sudden vision changes or your vision becomes blurry, spotty or hazy.
Too much sugar in your blood can damage the tiny blood vessels that nourish the retina. It may even block them completely. As more and more blood vessels become blocked, the blood supply to more of the retina is cutoff. This can result in vision loss. In response to the lack of blood supply, the eye attempts to grow new blood vessels. But, these new blood vessels don't develop properly and can leak easily. Leaking blood vessels can cause a loss of vision. Scar tissue may also form, which can pull on the retina. Sometimes, this can cause the retina to detach.
Elevated blood sugar levels can also affect the eyes' lenses. With high levels of sugar over long periods of time, the lenses can swell, providing another cause of blurred vision.
In the early stages of diabetic retinopathy, the walls of the blood vessels in your retina weaken. Tiny bulges protrude from the vessel walls, sometimes leaking or oozing fluid and blood into the ...
Diabetic retinopathy can happen to anyone who has diabetes. These factors can increase your risk:
Diabetic retinopathy involves the abnormal growth of blood vessels in the retina. Complications can lead to serious vision problems:
Preparing for your appointment
People with type 1 or type 2 diabetes should have a dilated eye exam performed by an eye doctor (ophthalmologist) every year. The American Diabetes Association (ADA) recommends that anyone who's older than 10 with type 1 diabetes have his or her first eye exam within five years of being diagnosed with diabetes. For people with type 2 diabetes, the ADA advises getting the initial eye exam soon after you've been diagnosed with diabetes, because you may have had diabetes for some time without knowing it.
After the initial exam, the ADA recommends that people with either type 1 or type 2 diabetes get an annual eye exam. Some people who've had repeated normal exams may be able to extend the time between exams to two to three years. Ask your eye doctor what he or she recommends.
Women with diabetes who become pregnant need to have an eye exam during the first trimester of pregnancy and possibly again later in the pregnancy, depending on the results of the first exam. The reason for this is that pregnancy can sometimes worsen diabetic retinopathy.
Because appointments can be brief, and there's often a lot of ground to cover, it's a good idea to arrive prepared. Here's some information to help you get ready for your eye appointment and what to expect from your eye doctor.
What you can do
Preparing a list of questions can help you cover all of the points that are important to you. For diabetic retinopathy, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask additional questions.
What to expect from your doctor
Tests and diagnosis
Diabetic retinopathy is best diagnosed with a dilated eye exam. For this exam, your eye doctor will place drops in your eyes that make your pupils open widely. This allows your doctor to get a better view inside your eye. The drops may cause your close vision to be blurry until they wear off several hours later.
During the exam, your eye doctor will look for:
In addition, your eye doctor may:
Optical coherence tomography
Treatments and drugs
Treatment depends largely on the type of diabetic retinopathy you have. Your treatment will also be affected by how severe your retinopathy is, and how it has responded to previous treatments.
Early diabetic retinopathy
It may also be helpful to work with your diabetes doctor (endocrinologist) to find out if there are any additional steps you can take to improve your diabetes management. The good news is that when diabetic retinopathy is in the mild or moderate stage, good blood sugar control can usually slow the progression of diabetic retinopathy.
Advanced diabetic retinopathy
Surgery often slows or stops the progression of diabetic retinopathy, but it's not a cure. Because diabetes is a lifelong condition, future retinal damage and vision loss are possible. Even after treatment for diabetic retinopathy, you'll need regular eye exams. At some point, additional treatment may be recommended.
Researchers are studying new treatments for diabetic retinopathy, including medications that may help prevent abnormal blood vessels from forming in the eye. Some of these medications are injected directly into the eye to treat existing swelling or abnormal blood vessels. These treatments appear promising, but they haven't been studied in long-term trials yet.
You may hear or read about natural cures or home remedies, but currently there are no proven alternative or complementary therapies than can cure diabetes or diabetic retinopathy. It's important not to delay standard treatments to try unproven therapies. Early treatment is the best way to prevent vision loss.
Several alternative therapies have shown some benefits for people with diabetic retinopathy, but more research is needed to understand whether or not these treatments are effective and safe. Potential alternative therapies include:
Be sure to let your doctor know if you are taking any herbs or supplements. They have the potential to interact with other medications, or cause complications in surgery, such as excessive bleeding.
Coping and support
The thought that you might lose your sight can be frightening, and you may benefit from talking to a therapist. Your doctor can provide a referral. Or, you may find the camaraderie and encouragement that a support group can offer is helpful to you. Ask your doctor about support groups for people with diabetic retinopathy in your area.
If you've already lost some vision, ask your doctor about low vision products and services that can help make daily living easier. For example, special lenses, magnifiers and video magnifiers are available.
If you have diabetes, reduce your risk of getting diabetic retinopathy by doing the following:
Remember, diabetes doesn't necessarily lead to poor vision. Taking an active role in diabetes management can go a long way toward preventing complications.
Last Updated: 2012-03-27
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