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Diabetic Retinopathy

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Diabetic retinopathy is a type of nerve damage to the eyes occurring in relation to uncontrolled diabetes. When blood glucose levels are allowed to remain uncontrolled for some time, retinopathy can occur because there is too much glucose in the blood. Diabetic retinopathy can progress quickly in patients who are not controlling their blood glucose levels.

The retina is a type of light-sensitive tissue found in the back of the eye, and when the blood vessels in the retina become damaged, diabetic retinopathy is the result. It is common for no symptoms to appear at first, but this does not mean that there is not currently damage to the eye. As long as diabetes remains uncontrolled, the retinopathy will progress, causing permanent damage to the eye.

Causes, Risk Factors and Complications

Having too much glucose in the blood can lead to damage in the tiny blood vessels responsible for nourishing the retina. These tiny blood vessels may even become completely blocked, cutting off the blood supply to the retina entirely in places. As more vessels become blocked, more blood supply is cut off which can lead to short or long term vision loss. In a response to the blocked blood supply, the eye naturally tries to grow brand new blood vessels, but because these are not typical blood vessels, they can develop improperly and can leak and cause other issues. This can also lead to partial or complete vision loss.

Untreated retinopathy can lead to a number of very serious conditions. As long as diabetic retinopathy is allowed to develop, scar tissue can form, pulling on the retina. This can cause a detached retina, which is a serious problem. Elevated blood sugar levels may also affect the lenses of the eyes, causing lens swelling and blurred vision. Other complications of diabetic retinopathy include vitreous hemorrhage, glaucoma and blindness. It is important to seek help for diabetic retinopathy as soon as possible to prevent further damage to the eye.

Signs, Symptoms and Tests

It is quite possible for a patient to have diabetic retinopathy without realizing it. In the earliest stages of the condition, there may be no symptoms at all. As this condition progresses, however, symptoms include spots or strings floating in the field of vision, fluctuating vision, blurred vision, dark or empty spots in the vision, difficulty perceiving colors and vision loss. Diabetic retinopathy can affect only one eye, though it is most commonly found in both eyes. Depending on the signs and symptoms at diagnosis, a physician may classify the retinopathy as being either early diabetic retinopathy or advanced diabetic retinopathy.

Physicians will generally begin an examination by dilating the pupils using special drops. They will examine the eye closely looking for abnormal blood vessels, presence of cataracts, retinal retachment, bleeding in the vitreous fluid and abnormalities in the optic nerve. They may also measure the pressure of the eye, test vision and take photos of the retina in a test called fluorescein angiography. Optical coherence tomography or OCT is another examination the physician may use, which images the eye in cross-sections to show retina thickness.

Treatment, Drugs and Prevention

Treatment for diabetic retinopathy will depend largely on the progression of the symptoms. Early diabetic retinopathy may not require immediate treatment, but it will require close monitoring as well as steps to relieve the high blood sugar levels. For advanced diabetic retinopathy, physicians will recommend focal laser treatment, vitrectomy and scatter laser treatment. These procedures can stop the progression of diabetic retinopathy, but they will not serve as a cure. While some vision may return with healing of the eyes, there is no cure for the damage that diabetic retinopathy causes