What is diabetic retinopathy?

Diabetic retinopathy is a complication arising out of diabetes that affects the eyes. The retina is the light-sensitive tissue in the eye. When the blood vessels in the retina are damaged, the condition is called diabetic retinopathy. At first, there may be only mild problems with vision, but there are chances that diabetic retinopathy can eventually cause blindness.

What are the symptoms of diabetic retinopathy?

There are usually no symptoms of diabetic retinopathy until it starts to change your vision. When this happens, the disease is already severe. Having your eyes checked regularly can find the disease early enough to treat it. Treatment can help prevent vision loss. Symptoms of diabetic retinopathy and its complications may include:

• Blurred, double, or distorted vision or trouble reading.
• Floaters or spots in your vision.
• Partial or total loss of vision. Or you might have a shadow or veil across your field of vision.
• Pain, pressure, or constant redness of the eye.

How diabetes can affect the eyes?

The retina is the light-sensitive layer of cells at the back of the eye. It converts light into electrical signals. The signals are sent to the brain which turns them into the images you see.The retina needs a constant supply of blood. It receives this through a network of tiny blood vessels. Over time, a high blood sugar level can damage these blood vessels in 3 main stages:

Stage 1: Background retinopathy
Tiny bulges develop in the blood vessels. These may bleed slightly but do not usually affect your vision.

Stage 2: Pre-proliferative retinopathy
More severe and widespread changes affect the blood vessels. These include more significant bleeding into the eye.

Stage 3: Proliferative retinopathy
Scar tissue and new blood vessels, which are weak and bleed easily, develop on the retina. This can result in some loss of vision.If a problem with your eyes is picked up early, lifestyle changes and treatment can stop it getting worse.

Who is at risk of diabetic retinopathy?

Anyone who has diabetes can develop diabetic retinopathy. The risk of developing the eye condition can increase as a result of:

• Having diabetes for a long time
• Poor control of your blood sugar level
• High blood pressure
• High cholesterol
• Pregnancy
• Tobacco use
• Being Black, Hispanic or Native American

WHAT IS THE Complications OF diabetic retinopathy?

Diabetic retinopathy involves the growth of abnormal blood vessels in the retina. Complications can lead to serious vision problems:

• Vitreous hemorrhage. The new blood vessels may bleed into the clear, jellylike substance that fills the center of your eye. If the amount of bleeding is small, you might see only a few dark spots (floaters). In more-severe cases, blood can fill the vitreous cavity and completely block your vision. Vitreous hemorrhage by itself usually doesn't cause permanent vision loss. The blood often clears from the eye within a few weeks or months. Unless your retina is damaged, your vision will likely return to its previous clarity.
• Retinal detachment. The abnormal blood vessels associated with diabetic retinopathy stimulate the growth of scar tissue, which can pull the retina away from the back of the eye. This can cause spots floating in your vision, flashes of light or severe vision loss.
• Glaucoma. New blood vessels can grow in the front part of your eye (iris) and interfere with the normal flow of fluid out of the eye, causing pressure in the eye to build. This pressure can damage the nerve that carries images from your eye to your brain (optic nerve).
• Blindness. Diabetic retinopathy, macular edema, glaucoma or a combination of these conditions can lead to complete vision loss, especially if the conditions are poorly managed.

WHAT ARE THE Symptoms of diabetic retinopathy?

You will not usually notice diabetic retinopathy in the early stages. It does not tend to have any obvious symptoms until it's more advanced.Early signs of the condition can be picked up during diabetic eye screening.

• Gradually worsening vision.
• Sudden vision loss.
• Shapes floating in your field of vision (floaters).
• Blurred or patchy vision.
• Eye pain or redness.
• Blurred vision.
• Fluctuating vision.
• Impaired color vision.
• Dark or empty areas in your vision.
• Vision loss.

WHAT ARE Diabetic eye screening?

People with diabetes aged 12 years and older are regularly invited to attend screening.
Screening is offered because:

• Diabetic retinopathy does not tend to cause any symptoms in the early stages
• The condition can cause permanent blindness if not diagnosed and treated promptly
• Screening can detect problems in your eyes before they start to affect your vision
• If problems are caught early, treatment can help prevent or reduce vision loss

The screening test involves examining the back of the eyes and taking photographs. Depending on your result, you may be advised to:

• Return for another appointment a year later
• Attend more regular appointments
• Discuss treatment options with a specialist

HOW TO Reduce your risk of diabetic retinopathy

You can reduce your risk of developing diabetic retinopathy, or help stop it getting worse, by:

• Controlling your blood sugar, blood pressure and cholesterol levels
• Taking your diabetes medication as prescribed
• Attending all your screening appointments
• Getting medical advice quickly if you notice any changes to your vision
• Maintaining a healthy weight
• Eating a healthy balanced diet, exercising regularly and stopping smoking

Treatments for diabetic retinopathy

Treatment is only necessary if screening detects your vision is at risk.If the condition has not reached this stage you should continue to manage your diabetes.The main treatments for more advanced diabetic retinopathy are:

• Laser treatment
• Injections of medication into your eyes
• An operation to remove blood or scar tissue from your eyes