Diabetic Retinopathy

Diabetic Retinopathy: Protecting Your Sight with Diabetes

What is diabetic retinopathy? Diabetic retinopathy is a complication of diabetes that damages the retina, the light-sensitive layer at the back of the eye responsible for vision. High blood sugar levels weaken the blood vessels in the retina, leading to leakage, bleeding, and abnormal growth of new blood vessels.

Prevalence and significance for people with diabetes: Diabetic retinopathy is a leading cause of blindness in adults. Nearly all people with type 1 diabetes and up to 80% of people with type 2 diabetes will develop some degree of diabetic retinopathy over time.

Importance of early detection and management: The good news is that early detection and proper management of diabetes and diabetic retinopathy can significantly reduce the risk of vision loss. Regular eye exams are crucial for identifying and treating diabetic retinopathy before it progresses to a more serious stage.

Understanding Diabetic Retinopathy

How diabetes affects the eyes: Chronically high blood sugar levels can damage the delicate blood vessels in the retina. This damage weakens the vessels, causing them to leak fluid or blood into the retina. New, abnormal blood vessels may sometimes grow on the retina's surface. These changes can disrupt normal vision.

Stages of diabetic retinopathy: Diabetic retinopathy progresses through different stages:

• Background diabetic retinopathy (early stage): This is the initial stage, often with no noticeable symptoms. However, during a dilated eye exam, your doctor may see tiny blood spots or swelling in the retina.
• Proliferative diabetic retinopathy (advanced stage): In this stage, the abnormal blood vessel growth becomes more prominent. These new vessels are fragile and can bleed into the vitreous humour (the jelly-like substance filling your eye's centre). Bleeding or scar tissue formation from these vessels can significantly impair vision.
• Diabetic macular edema (DME): This is a complication of diabetic retinopathy that occurs when leaking fluid from damaged blood vessels accumulates in the macula, the central part of the retina responsible for sharp, central vision. DME can cause blurred or distorted vision, especially when reading or performing close-up tasks.

Risk Factors for Diabetic Retinopathy

Several factors can increase your risk of developing diabetic retinopathy:

• Duration of diabetes: The longer you have diabetes, the higher your risk of developing diabetic retinopathy.
• Poor blood sugar control (HbA1c levels): Keeping your blood sugar levels under control is crucial for preventing or slowing the progression of diabetic retinopathy. HbA1c is a test that measures your average blood sugar control over the past 2-3 months.
• High blood pressure: Uncontrolled high blood pressure can further damage the blood vessels in the retina.
• High cholesterol: High cholesterol levels can contribute to the development and progression of diabetic retinopathy.
• Pregnancy: Pregnancy can cause hormonal changes that worsen diabetic retinopathy. Women with diabetes need to be especially vigilant about eye exams during pregnancy.
• Smoking: Smoking significantly increases your risk of developing and worsening diabetic retinopathy.

Symptoms of Diabetic Retinopathy

Diabetic retinopathy can be a cunning thief of sight, often stealing vision gradually without causing immediate problems. Here's what to watch out for, though it's important to remember that there might not be any noticeable symptoms in the early stages:

• Often no symptoms in the early stages: Regular eye exams are crucial for catching diabetic retinopathy before it progresses.
• Gradual loss of peripheral vision: This is a common symptom that develops as diabetic retinopathy advances. You may not notice it initially, but over time, your side (peripheral) vision may start to diminish.
• Blurred or distorted vision: This can be a sign of diabetic macular edema (DME), a complication of diabetic retinopathy. Blurred or wavy vision, especially when reading or focusing on close objects, can indicate fluid buildup in the macula, the central part of the retina responsible for sharp central vision.
• Seeing floaters or dark spots: These are specks or spots that float across your field of vision. Floaters are a common eye phenomenon but can also be a sign of bleeding in the vitreous humour (the jelly-like substance that fills the centre of your eye).
• Difficulty seeing at night: As diabetic retinopathy progresses, it can affect your ability to see in low-light conditions. This can make activities like driving at night more challenging.

Diagnosis and Treatment of Diabetic Retinopathy

Early detection is key to preventing vision loss from diabetic retinopathy. Here's what to expect:

Importance of regular comprehensive eye exams, including dilated pupil exams: Schedule regular eye exams with your ophthalmologist (eye doctor). These exams should include dilated pupil exams, which allow the doctor to see the back of your eye in more detail.

Diagnostic tests: In addition to a comprehensive eye exam, your doctor may use various tests to diagnose and assess the severity of diabetic retinopathy:

• Visual acuity test: This standard test measures your ability to see at various distances.
• Retinal photographs: These pictures capture detailed retina images, allowing the doctor to identify abnormalities.
• Fluorescein angiography: A special dye is injected into your bloodstream, and pictures are taken as the dye reaches the blood vessels in your retina. This test helps identify leaking or blocked blood vessels.
• Optical coherence tomography (OCT): This imaging test uses light waves to create detailed cross-sectional images of the retina, allowing for a more precise evaluation of the macula and other retinal layers.

Treatment options

The good news is that effective treatments are available to manage diabetic retinopathy and prevent vision loss. The most important factor is:

Strict blood sugar control: Maintaining healthy blood sugar levels through diet, exercise, and medication is the cornerstone of treatment for diabetic retinopathy. Good blood sugar control can slow the progression of the disease and reduce the risk of complications.

Living with Diabetic Retinopathy

A diagnosis of diabetic retinopathy doesn't have to limit your life. Here's how to manage it effectively:

• Importance of ongoing management and monitoring: Regular follow-up exams and continued monitoring are crucial once diagnosed. The frequency of these exams will depend on the severity of your condition.
• Maintaining healthy lifestyle habits: A healthy lifestyle that includes a balanced diet, regular exercise, and smoking cessation can significantly benefit your overall health and contribute to managing diabetic retinopathy.
• Regular eye exams are crucial: Don't skip your scheduled eye exams! Early detection and treatment are essential for preventing vision loss from diabetic retinopathy. By working with your doctor and following a proper treatment plan, you can take charge of your eye health and maintain good vision.