What is diabetic retinopathy?
Diabetic retinopathy is an eye condition that can cause vision loss and blindness in people who have diabetes. It affects blood vessels in the retina (the light-sensitive layer of tissue in the back of your eye).
Diabetic retinopathy is an eye condition that can cause vision loss and blindness in people who have diabetes. It affects blood vessels in the retina (the light-sensitive layer of tissue in the back of your eye).
You might not have symptoms in the early stages of diabetic retinopathy. As the condition progresses, you might develop:
Careful management of your diabetes is the best way to prevent vision loss. If you have diabetes, see your eye doctor for a yearly eye exam with dilation — even if your vision seems fine. Developing diabetes when pregnant (gestational diabetes) or having diabetes before becoming pregnant can increase your risk of diabetic retinopathy. If you're pregnant, your eye doctor might recommend additional eye exams throughout your pregnancy. Contact your eye doctor right away if your vision changes suddenly or becomes blurry, spotty or hazy
Early diabetic retinopathy: In this more common form — called Nonproliferative diabetic retinopathy (NPDR) — new blood vessels are no;t growing (proliferating). When you have nonproliferative diabetic retinopathy (NPDR), the walls of the blood vessels in your retina weaken. Tiny bulges protrude from the walls of the smaller vessels, sometimes leaking fluid and blood into the retina. Larger retinal vessels can begin to dilate and become irregular in diameter as well. NPDR can progress from mild to severe as more blood vessels become blocked.
Diabetic macular edema: Sometimes retinal blood vessel damage leads to a buildup of fluid (edema) in the center portion (macula) of the retina. If macular edema decreases vision, treatment is required to prevent permanent vision loss.
Diabetic retinopathy can progress to this more severe type, known as proliferative diabeticretinopathy. In this type, damaged blood vessels close off, causing the growth of new, abnormal blood vessels in the retina. These new blood vessels are fragile and can leak into the clear, jellylike substance that fills the center of your eye (vitreous). Eventually, scar tissue from the growth of new blood vessels can cause the retina to detach from the back of your eye. If the new blood vessels interfere with the normal flow of fluid out of the eye, pressure can build in the eyeball. This buildup can damage the nerve that carries images from your eye to your brain (optic nerve), resulting in glaucoma.
What are the risk factors for diabetic retinopathy?Anyone who has diabetes can develop diabetic retinopathy. The risk of developing the eye condition can increase as a result of:
You can not always prevent diabetic retinopathy. However, regular eye exams, good control of your blood sugar and blood pressure, and early intervention for vision problems can help prevent severe vision loss. If you have diabetes, reduce your risk of getting diabetic retinopathy by doing the following:
Remember, diabetes doesn’t necessarily lead to vision loss. Taking an active role in diabetes management can go a long way toward preventing complications.
Diabetic retinopathy involves the growth of abnormal blood vessels in the retina.Complications can lead to serious vision problems:
In the early stages of diabetic retinopathy, your eye doctor will probably just keep track of how your eyes are doing. Some people with diabetic retinopathy may need a comprehensive dilated eye exam as often as every 2 to 4 months. In later stages, it’s important to start treatment right away — especially if you have changes in your vision. While it won’t undo any damage to your vision, treatment can stop your vision from getting worse. It’s also important to take steps to control your diabetes, blood pressure, and cholesterol.
InjectionsInjections don’t change your vision right away. Most people can go back to their normal activities right after the treatment. You may have short-term side effects, but they should clear up in a day or 2.
You may feel:In certain eye diseases, the body makes too much of a protein called vascular endothelial growth factor (VEGF), which can cause blood vessels to leak, leading to swelling in the retina (the light-sensitive layer of tissue at the back of the eye). Too much VEGF can also cause blood vessels to grow abnormally, which could damage the eye. Anti-VEGF drugs block VEGF and can improve vision. Your eye doctor may prescribe anti-VEGF injections if you have:
Most people who get anti-VEGF injections will need injections once a month at first. Overtime, you may need injections less often. Some people can eventually stop getting the injections, but others need to keep getting injections to protect their vision.
If you have macular edema, DME, uveitis, or another eye disease that causes swelling in the retina or inflammation in the eye, your doctor may suggest a medicine called a steroid as a treatment. Steroids can help reduce swelling and inflammation. Common steroid injections include:
Other ways to take steroids for eye conditions People often take steroids as injections or eye drops — or your doctor can put a special device called an implant in your eye. The implant gives you constant small doses of the medicine over time. If you get the implant, you may be able to stop getting monthly steroid injections.
Common steroid implants include:
Laser surgery might be used to help seal off leaking blood vessels. This can reduce swelling of the retina. Laser surgery can also help shrink blood vessels and prevent them from growing again. Sometimes more than one treatment is needed.
You can get this laser treatment at your eye doctor’s office. Your eye doctor will:
During the treatment, you may see flashes of light and your eye may sting or feel uncomfortable. Your vision will be blurry for the rest of the day, so you’ll need someone to drive you home. You may need more than 1 session of scatter laser surgery.
Is laser treatment right for me?Like any surgery, this treatment has risks. It can cause loss of peripheral (side) vision, color vision, and night vision. But for many people, the benefits of this treatment outweigh the risks. Talk with your doctor to decide if scatter laser surgery is right for you.
If you have advanced PDR, your ophthalmologist may recommend surgery called vitrectomy. Your ophthalmologist removes vitreous gel and blood from leaking vessels in the back of your eye. This allows light rays to focus properly on the retina again. Scar tissue also might be removed from the retina.
Vitrectomy can help doctors treat several different eye conditions. For example, vitrectomy may be part of the treatment plan for:
Like any surgery, this treatment has risks. Talk with your doctor about the risks and benefits of vitrectomy.
During vitrectomy surgery, your eye doctor will make very small openings in your eye wall and remove most of the vitreous from your eye with a suction tool. Depending on your treatment plan, your doctor may also:
Doctors can either use numbing eye drops or shots so you won’t feel pain during the surgery, or they can use general anesthesia to put you to sleep for the surgery. Before your vitrectomy surgery, talk with your doctor about your anesthesia options. If you need vitrectomy in both eyes, you’ll only get surgery on 1 eye at a time. Your doctor can schedule surgery on the second eye after the first eye has recovered.
Most people go home the same day of surgery. You’ll need someone to drive you home from the hospital. Your eye may be swollen and red for several weeks after the surgery. While your eye is healing, you may have some eye pain and your vision may be blurrier than before the surgery. You’ll have follow-up appointments so your eye doctor can check your vision and make sure your eye is healing.
After the surgery, you’ll need to:
Ask your doctor when it’s safe to go back to work and start driving and exercising
again.
If the doctor puts a gas bubble in your eye, you’ll need to:
