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Diabetic Retinopathy

Posted by Dr. Carolina Navarrete 09/02/2016 0 Comment(s) Eye Diseases,

If you have diabetes, your blood glucose, or blood sugar, levels are too high. Over time, this can damage your eyes. The most common problem is diabetic retinopathy. It is a leading cause of blindness in Canadian adults. At Grande Prairie Eye Care we take care to examine your eyes thoroughly.

Your retina is the light-sensitive tissue at the back of your eye. You need a healthy retina to see clearly. Diabetic retinopathy damages the tiny blood vessels inside your retina.

You may not notice it at first. Symptoms can include

  • Blurry or double vision
  • Rings, flashing lights, or blank spots
  • Dark or floating spots
  • Pain or pressure in one or both of your eyes
  • Trouble seeing things out of the corners of your eyes

Treatment often includes laser treatment or surgery, with follow-up care. Two other eye problems can happen to people with diabetes. A cataract is a cloud over the lens of your eye. Surgery helps you see clearly again. Glaucoma happens when pressure builds up in the eye, damaging the main nerve. Eye drops or surgery can help. If you have diabetes, you should have a complete eye exam every year. Finding and treating problems early may save your vision.

 

What is retinopathy?

Over time, diabetes can cause changes in the retina at the back of the eye. Your retina helps you see by acting like a film projector in the back of your eye, projecting the image to your brain. The change is called retinopathy and there are a couple of different types that affect people with diabetes. The macula, which is the part of your retina that helps you to see colour, becomes swollen (macular edema) and this can cause blindness. A second complication is the growth of new weak blood vessels that break and leak blood into your eye so the retina cannot project images to your brain (proliferative diabetic retinopathy). The result is a loss of sight.

Diabetes causes changes in the tiny blood vessels that nourish the retina. In the early stages, known as nonproliferative or background retinopathy, the arteries in the retina weaken and begin to leak, forming small, dot-like hemorrhages (blood flow from the ruptured blood vessel). These leaking vessels often lead to swelling (edema) in the retina and decreased vision. At this stage, vision may be normal or it may have started to blur or change. About one in four people with diabetes experience this problem.

When retinopathy advances, the decreased circulation of the blood vessels deprives areas of the retina of oxygen. Blood vessels become blocked or closed, and parts of the retina die. New, abnormal, blood vessels grow to replace the old ones. They grow along the retina and along the surface of the vitreous (the transparent gel that fills the inner portion of the eyeball). Unfortunately, these delicate vessels hemorrhage easily. Blood may leak into the retina and vitreous, causing “floaters” (spots that appear to drift in front of the eyes), along with decreased vision.

This is called proliferative retinopathy, and it affects about one in 20 people with diabetes. It can lead to severe visual loss or blindness. In the later phases of the disease, continued abnormal vessel growth and scar tissue may cause retinal detachment and glaucoma.

 

Effect of retinopathy

The effect of retinopathy on vision in people with diabetes varies widely, depending on the stage of the disease. Common symptoms can include blurred vision (often linked to blood glucose levels), flashes or sudden loss of vision. However, diabetes may cause other eye symptoms.

Fluid can leak into the center of the macula, the part of the eye where clear, detailed vision occurs. The fluid swells the macula and blurs the vision. Called macular edema, it can occur at any stage, although it is more likely to occur as the disease progresses. About one-half of people with proliferative retinopathy also have macular edema.

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