Diabetic Retinopathy Symptoms, Causes, Treatment and Prevention

As the name suggests, it is a retinal disorder triggered by diabetes. When blood glucose levels remain high for prolonged periods, the delicate blood vessels in the retina get damaged. It is characterized by visual problems that worsen with time. In severe cases, the disrupted retinal vessels may leak blood, gradually leading to complete vision loss. But do not worry—we will guide you on current treatment approaches and preventive measures to manage such a condition. Read on to learn more!

Diabetic Retinopathy: A General Overview

Diabetic retinopathy is a progressive optical disorder affecting the retina. We know that the retina is the light-sensitive region of the eyes that helps with vision. However, high blood sugar may cause its blood vessels to swell and rupture. Sometimes, obstruction to the blood flow occurs. This can trigger macular edema, potentially resulting in retinal detachment, tissue scarring etc. Also, new blood vessels may grow on the retinal surface in some individuals, complicating the condition even more. Common ways of treatment involve controlling blood sugar and pressure levels. However, the best way is to have laser surgery done!

How common is Diabetic Retinopathy?

According to recent reports published by the World Health Organization, diabetic retinopathy accounts for about five per cent of blindness cases globally, regardless of gender and age. However, older people are more vulnerable to such a condition due to their disrupted insulin-producing mechanism. As more diabetes cases come up, the graph of this eye condition also spikes, which is obviously unfortunate. It has been estimated that by 2035, around 592 million individuals will have diabetic retinopathic eyes.

Diabetic Retinopathy: What are the stages?

Depending on the extent of progress, diabetic retinopathy is classified into three distinct stages. These are as follows:

  • Stage one: Known as 'mild non-proliferative diabetic retinopathy', it is characterized by small bulges in the retinal blood vessels. Since it is an early stage, no significant changes in sight occur. However, a small amount of blood leakage is expected, which can pave the path for further vision deterioration.
  • Stage two: This is the pre-proliferative stage, during which one experiences more intense microaneurysms and retinal bleeding. During this phase, one must have an eye checkup and regularly go for follow-ups.  
  • Stage three: This is the severe proliferative phase, associated with new blood vessel formation on the retina (known as neovascularization). These delicate capillaries often exude blood into the vitreous chamber. If this happens little, floaters appear on the eyes, but with excessive bleeding, vision blockage occurs. You are at high risk of developing scar tissue, retinal detachment, and, worst of all, complete blindness.

Signs and symptoms associated

At first, there is hardly any sign denoting diabetic retinopathy. With gradual progression, you will notice the following symptoms.

  • Appearance of floaters (increased numbers)
  • Blurry sight, which may fluctuate frequently  
  • Visualizing blank or dark regions around your vision field  
  • Night-blindness
  • Problems with color recognition, often associated with fading
  • Poor eyesight

The symptoms mentioned above generally affect both eyes. Therefore, it is crucial to obtain routine visual checkups. Several specialized technologies, like optical coherence tomography and fluorescein angiography, help detect and manage diabetic retinopathic eyes. Above all, maintaining blood sugar levels by making dietary changes is a must!

Diabetic Retinopathy: Possible Causes Explained

As mentioned, high blood sugar is the one and only cause of this condition's development. Also known as hyperglycemia, it can negatively affect vital body organs, including the eyes. Unregulated glucose levels disrupt blood flow to the eyes, gradually leading to edema and hemorrhage in the retina. In a typical scenario, it proliferates slowly, taking several years to exhibit symptoms. Here's a list of some risk factors that you must pay heed to.

  • Obesity
  • Sedentary lifestyle and poor eating habits
  • Clogged arteries
  • Hypertension
  • Breathing difficulties
  • Unhealthy habits like smoking and taking alcohol
  • Pregnancy

Possible complications for a prolonged untreated Diabetic Retinopathy

Upon leaving a diabetic retinopathy case for a long time, you may suffer from the following consequences.

  • Vitreous hemorrhage: Vitreous fluid constitutes the central part of the eye. It contains a thick, semi-solid gel substance that maintains the eye's elasticity. Also, it is responsible for reducing light scattering. In untreated diabetic retinopathy, new blood vessels swell and rupture, causing blood to spill on the vitreous matter. In minor scenarios, you will see floaters, but excessive bleeding will completely damage your eyesight.
  • Glaucoma: The formation of new blood vessels causes a massive pressure build-up over the eyes, especially on the optic nerve. This interferes with the regular fluid flow, gradually making you visually incapable.  
  • Retinal detachment: The term explains all! In this, the damaged capillaries cause the retina to separate from the nearby supporting tissues. You will likely see floaters and little luminous flashes around your eyes. Over time, vision will completely get obscure.

Diagnostic procedures for Diabetic Retinopathic eyes

Overall visual health checkup

After going to an eye clinic, the concerned ophthalmologist will inquire about your symptoms and lifestyle. These comprise questions like:  

  • How long have you been facing discomfort?
  • Do you have any pain surrounding the eyes? If yes, how is the sensation?
  • Did you previously have an eye infection?
  • What does your current blood test report show?
  • Is your BP higher than normal?
  • How frequently do you smoke and drink?
  • Are you pregnant?

These questions help obtain a deeper insight into your visual health and plan a subsequent management plan for this condition.

Procedures that are implemented

After the question-answer stage is completed, your eye specialist will use specific sophisticated tools to determine the severity of your condition. But before proceeding, he will put an eyedrop to dilate your pupil. This facilitates a better view of the internal optical structures. Here's a list of some standard diagnostic procedures.

  • Optical coherence tomography (or OCT): This method helps scan the retinal thickness plus obtain detailed and precise representations. Thus, the ophthalmologist can find and measure the extent of macular swelling.
  • Fluorescein angiographyIt aids the doctor to visualize the internal blood capillaries of the retina. A yellow-colored dye called fluorescein is injected intravenously (preferably in the arm). It thereafter traverses through the blood vessels to reach the intended eye region. During this, a special camera is implemented that clicks images throughout the process. It helps show any abnormality, such as fluid leakage, new vessel outgrowths, or blockages.
  • OCT angiography: A new and advanced diagnostic technique that does not use dyes to determine blood vessel conditions. OCT is an entirely noninvasive procedure that offers the advantage of 3-D imaging. This helps detect early neovascularization, promoting timely treatment.

How do you treat Diabetic Retinopathy?

The most preferred treatment for diabetic retinopathy is medication. However, the ophthalmologist will decide this after assessing the intensity of your symptoms. The early stages of this condition are treatable with medicines and will not cause any complications. However, the best possible way we recommend is to obtain surgical intervention. We will discuss each of them in detail below.

Pro tip: Frequent follow-ups help monitor eye changes and determine whether your treatment is producing positive results. Suppose your eyes do not respond sufficiently to a prescribed treatment. In that case, the ophthalmologist can step up to provide a more effective one!

Medication

Anti-vascular endothelial growth factor (or anti-VEGF) drugs are a class of medicines that block the vascular endothelial growth factor (VEGF) protein. By injecting this medicine, new blood vessel growth in the retinal layer can be prevented. As a result, macular swelling reduces, thus gradually improving vision.

Steroids are another type of drug that helps combat macular edema. They are anti-inflammatory medicines that suppress inflammation. Your ophthalmologist will clarify the number of shots required over time.

Laser surgery

It can seal off ruptured blood capillaries in your eyes, thus managing the swelling. It is also beneficial to prevent the reoccurrence of neovascularization. Worry not—old people can conveniently proceed with this treatment. Generally, more than one session is required.

Vitrectomy

In this procedure, the ophthalmologist surgically removes the vitreous humor and leaked blood from your eye's back. It is then replaced with silicone oil or a synthetic fluid. This facilitates enough incoming light rays and optimal focusing on the retina. Some scarred tissue may also be removed. The best part is that it infers minimal to negligible pain.

If you find trouble to see things clearly, we are more than happy to help. Arrange an appointment with our optometrist and get early treatment.

Is it possible to correct it completely?

Although it is not possible to cure diabetic retinopathy completely, proper treatment can slow its progression. The earlier you can obtain an early diagnosis, the easier it is to save vision.

How frequently do you need optical exams to prevent Diabetic Retinopathy?

Getting an optical examination at least once a year would be best. The doctor will thoroughly examine your retina by dilating the eyes, thus preventing future complications. However, the frequency of these checkups will depend on the severity of your diabetic condition and preexisting eye damage. So, we advise you to consult a certified ophthalmologist for personalized guidance.  

Homely Tips for Preventing Diabetic Retinopathy

Since diabetic retinopathy is caused due to high blood sugar, controlling its levels is crucial. Here are some good tips that you can follow for managing diabetes.

  • Taking insulin as directed
  • Having a nutritious and well-balanced diet (comprising seasonal fruits and green vegetables enriched in Vitamin A)
  • Maintaining an active lifestyle (half an hour of brisk walking or any cardio workout is enough)
  • Obtaining routine blood sugar tests (preferably after every three months)
  • Testing hemoglobin A1c levels regularly
  • Getting urine tests for the presence of ketone bodies
  • Quitting cigarettes (smoking triggers body cells to get inflamed, including the eyes)
  • Giving the eyes pause at fixed intervals (better to follow the 20-20-20 rule)
  • Attending frequent follow-ups

 When do you need to visit the doctor?

Treat diabetic retinopathy as an emergency if you experience a sudden change in your eyesight, such as visual blurriness, the appearance of an increased number of floaters, dark spots or lines around your vision field, glares and halos, etc. In extreme cases, you may have partial vision loss, too. Regular dilated eye exams are helpful for mild symptoms as they facilitate early detection and prompt management.

Conclusion: Unfold a new visual dimension with the best ophthalmologists!

Most eye disorders are age-related - diabetic retinopathy is one of them. As people age, they become more prone to suffer from a weakened metabolism, in turn giving rise to diabetes. Additionally, specific processes like high oxidative stress and changes in blood vessels aggravate such a condition. As mentioned previously, diabetic retinopathy cannot be reversed or cured fully. But there is good news, too; guess what? You can prevent or manage it with routine visual checkups. At Vision Cure Clinic, you can contact globally renowned eye specialists to guide you towards obtaining a better perspective!

Frequently Asked Questions (FAQs)

Yes, you can live normally, provided you manage your diabetic condition on time. This is possible with an appropriate diagnosis comprising routine eye exams and treatment.

Avoiding sugary foods may help control glucose spikes in your blood. However, it does not guarantee a permanent solution. Thus, it is better to maintain a nutritious and healthy diet with all food types adequately proportioned. Also, try including a good workout regime for effective weight management.

Depending on how well you manage your blood sugar levels, the time it takes for diabetes to affect the eyes is different. Typically, diabetic retinopathy is a slowly progressive disorder, taking a few to several years to fully appear. If your glucose levels are considerably high for more than five years, the first sign you will experience is blurred vision. To avert such a condition, you must go for regular optical checkups.

Of course you can! Exercise is well known to control hyperglycemia and maintain normal blood pressure. Just ensure you are doing it in moderation, under the guidance of a certified ophthalmologist. He can guide you on which exercises to do and which to avoid.

Diabetic patients with retinopathy must not perform hardcore activities, as they exacerbate the chances of retinal damage. For example, lifting heavy weights and sudden and intense head jerks increase intraocular pressure and hemorrhage, followed by the dismantling of the retina. Thus, we recommend that you consult a certified eye specialist before starting any of these activities.

Generally, flying in such a condition is safe. However, you must check your sugar level to see whether it fluctuates frequently. If you experience severity, do ask for permission from your ophthalmologist.

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