- Severe diabetes over the course of a longer period of time increases the chance of getting retinopathy.
- Blindness is the number one complication of people with diabetes.
- Retinopathy is also more likely to occur earlier and be more severe if your diabetes has been poorly controlled.
- Almost everyone who has had diabetes for more than 30 years will show signs of diabetic retinopathy.
Non-proliferative diabetic retinopathy develops first. Blood vessels in the eye become larger in certain spots (called microaneurysms). Blood vessels may also become blocked. There may be small amounts of bleeding (retinal hemorrhages), and fluid may leak into the retina. This can lead to noticeable problems with your eyesight.
Proliferative retinopathy is the more advanced and severe form of the disease. New blood vessels start to grow in the eye. These new vessels are fragile and can bleed (hemorrhage). Small scars develop, both on the retina and in other parts of the eye (the vitreous). The end result is vision loss, as well as other problems.
Symptoms
People with nonproliferative diabetic retinopathy may not need treatment. However, they should be closely followed-up by an eye doctor trained to treat diabetic retinopathy.
Treatment usually does not reverse damage that has already occurred, but it can help keep the disease from getting worse. Once your eye doctor notices new blood vessels growing in your retina (neovascularization) or you develop macular edema, treatment is usually needed.
- Most often, diabetic retinopathy has no symptoms until the damage to your eyes is severe, making it very important that diabetics have regular eye exams with dilated retinal exams.
- Blurred vision and gradual vision loss
- Shadows or missing areas of vision
- Difficulty seeing at nighttime
- At your comprehensive eye exam, the doctor will carefully view the retina through your dilated pupil. The doctor will look for any currently leaking blood vessels or evidence of past vessel leakage.
- Fluorescein Angiography may be indicated if leakage is seen.
- Digital Photos may be taken to document the retinal changes to make it easier to monitor future changes.
People with nonproliferative diabetic retinopathy may not need treatment. However, they should be closely followed-up by an eye doctor trained to treat diabetic retinopathy.
Treatment usually does not reverse damage that has already occurred, but it can help keep the disease from getting worse. Once your eye doctor notices new blood vessels growing in your retina (neovascularization) or you develop macular edema, treatment is usually needed.
- Laser eye surgery, called photocoagulation is generally used to treat diabetic retinopathy. It is used to keep vessels from leaking or to get rid of abnormal, fragile vessels. It creates small burns in the retina where there are abnormal blood vessels.
- Focal laser photocoagulation is used to treat macular edema.
- Scatter laser treatment or panretinal photocoagulation treats a large area of your retina. Often two or more sessions are needed.
- Tight control of blood sugar (glucose), blood pressure, and cholesterol is important
- Smoking cessation
- A surgical procedure called vitrectomy is used when there is bleeding (hemorrhage) into the eye.
- Drugs that prevent abnormal blood vessels from growing, and corticosteroids injected into the eyeball are being investigated as new treatments for diabetic retinopathy.