About Diabetic Retinopathy
Patients suffering from either type 1 or type 2 diabetes are at an increased risk of developing health complications related to the disease. These complications can effect several of the body’s organ systems. One such complication that may develop is diabetic retinopathy. This particular disorder effects the light-sensitive portion of the eye, called the retina. The symptoms of diabetic retinopathy usually occur in both eyes.
The longer patients live with diabetes, especially those with diabetes that began during youth or adolescence, the higher the likelihood of developing diabetic retinopathy. According to the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR), the second decade of the disease carries a significant rise in prevalence in retinopathy.
The disease manifests itself in four stages. In the early stages, most patients do not experience any symptoms. During the first stage, blood vessels in the retina leak blood and other fluids causing swelling of the retinal tissues; this becomes progressively worse in the second stage.. The third stage involves small blood vessels in the retina becoming blocked and depriving the tissues of blood supply. These first three stages are referred to as non-proliferative diabetic retinopathy (NPDR). In the last stage, called proliferative diabetic retinopathy (PDR), the retina sends signals to the body to begin growing new blood vessels in the retina to pick up the slack in blood flow (neovascularization). However, these new blood vessels grow abnormally and are fragile; they can grow into the edge of the vitreous gel that fills the eye. The fragility of these blood vessels allows them to break and blood to leak, which can cause severe damage and loss of vision.
One of the earliest symptoms of diabetic retinopathy is seeing spots or lines in your vision. Specks of blood pool along the retina and in the vitreous gel causing patients to experience these “floaters.” Often, they will heal on their own, however, the bleeding that causes them is apt to reoccur.
As more blood and fluid leaks into the retina, it effects the portion of the retina that allows humans to distinguish color and fine details, the macula. The added fluid and the deposit of fatty deposits, called exudate, cause the macula to swell in a condition known as macular edema. This condition causes the patient’s central vision to appear blurry and undefined.
Changes in Vision
As diabetic retinopathy progresses, patients' vision can regress. This can include changes, such as dim or empty portions of overall vision, or visual acuity that fluctuates. Vision at night or in dark rooms tends to diminish quickly, and the patient’s ability to detect spectrum of colors shows signs of deterioration.
The last—and generally irreversible—symptom of diabetic retinopathy is loss of vision. Should the loss of vision become severe enough and untreated, total blindness may result. Patients can slow the loss through proper blood sugar management.
Diabetic patients, particularly those who have lived with the disease for several years, should schedule to have a complete dilated eye exam at least once a year. Through diligent care, you and your physician can help prevent diabetic retinopathy. It is important to remember that proper diabetes management plays an active role in prevention of complications. If you experience any sudden vision changes, schedule an appointment with your eye doctor.
Mayo Clinic: Diabetic Retinopathy: Symptoms
National Eye Institute: Facts About Diabetic Eye Disease
American Optometric Association: Diabetic Retinopathy
The University of Michigan Kellogg Eye Center: Diabetic Retinopathy: Definition, Symptoms, and Treatment
Diabetes Care: Diabetic Retinopathy
Fong, Donald S., MD, MPH et al.
American Academy of Ophthalmology Eye Smart: What is Diabetic Retinopathy?