What is Diabetic Retinopathy?

Diabetic retinopathy is a condition that results from diabetes that, without the proper care, can lead to blindness. Not only can this vision condition start at any time after you become diabetic, but it can also occur as a side effect of both type-1 and type-2 diabetes. Type-1 diabetes is caused by a complete lack of insulin, while type-2 diabetes is a result of the body's inability to utilize insulin correctly or because the body does not have enough insulin.

Stages of Diabetic Retinopathy

Diabetic retinopathy progresses in four stages (if left untreated) and usually occurs in both eyes. The stages are:

1. Mild Nonproliferative: The blood vessels of the retina start swelling in small, distinct areas, known as microaneurysms or outpouchings.
2. Moderate Nonproliferative: The swollen blood vessels start to become blocked.
3. Severe Nonproliferative: As the retina is increasingly deprived blood, it sends a signal to the brain to produce more blood vessels so the eye can start to function properly again.
4. Proliferative: New blood vessels grow to replace blocked blood vessels in the retina. If these new blood vessels leak, which they can easily do because they are abnormal and have thin walls, you will experience loss of vision that ultimately could lead to blindness.

During the early stages of diabetic retinopathy, you might not be aware of any symptoms.

Symptoms of Diabetic Retinopathy

While the early stages of diabetic retinopathy are asymptomatic (they don't generally produce any noticeable symptoms), you may start to experience some symptoms of diabetic retinopathy as it progresses, including:

• blurred vision as a result of macular edema (Macular edema can occur during any of the stages of diabetic retinopathy as a result of fluids leaking into the macula (the area of the eye that helps you see clearly and crisply), leading to swelling.)
• double vision
• seeing "spots" or "floaters" in your vision, which are actually bits of blood.

Diabetic Retinopathy Statistics

Diabetic retinopathy is the leading cause of blindness for adults. Here are some other interesting facts and statistics about diabetic retinopathy:

• The American Academy of Ophthalmology maintains that those with diabetes are likely to loose their sight 25 times more often than people who do not suffer from diabetes.
• Eight percent of the people who are legally blind in the U.S. have lost their vision because of diabetes.
• Most people can avoid blindness by getting regular eye exams and following the advice of their physicians.
• In general, diabetic retinopathy does not develop for at least 10 years after the onset of diabetes.

Preventing Diabetic Retinopathy

Diabetic retinopathy can be treated and controlled if caught before your eyes are permanently damaged. Keeping your blood sugar low and eating a healthy, reduced fat diet helps contribute to your overall health, as well as the health of your eyes.

The first part of treating diabetic retinopathy is getting properly diagnosed. While everyone should have regular eye checkups with an optometrist, diabetics need to be even more consistent in seeing their eye doctors, as they are at a far greater risk of developing serious eye conditions.

If you have type-1 diabetes, expect to have annual exams within the first five years of diagnosis. People with type-2 diabetes should have eye exams yearly. Regardless of the type of diabetes you suffer from, these eye exams should include dilating the eyes so the doctor can examine your eyes' inner structures.

Diabetic Retinopathy Therapy

In the early stages of diabetic retinopathy, no treatments are generally required other than controlling the levels of blood sugar, cholesterol and blood pressure.

If your diabetic retinopathy progresses to the proliferative level, the condition may be treated with scatter laser surgery, a procedure that shrinks the abnormal blood vessels in your eyes. Scatter laser surgery generally takes more than one session to be effective.

If diabetic retinopathy induces macular edema, another type of laser surgery, called focal laser treatment, is needed to reduce the amount of fluids in that area. Like scatter laser surgery, focal laser treatments may require multiple sessions to be effective.

In some cases, diabetic retinopathy results in blood gathering in the center of one or both eyes. In this case, a vitrectomy will remove the gel in the center of your eye that is contaminated with blood. The fluids removed would be replaced with a salt solution.

While these procedures will help stop your diabetic retinopathy from proceeding to blindness, they may not necessarily be a "cure." Only a small percentage of those who are treated with focal laser surgery will actually experience improved vision after their treatment is completed.