Diabetes is a disease that occurs when the pancreas does not secrete enough insulin or the body is unable to process it properly, thereby the person's blood sugar is elevated beyond normal levels. Insulin is the hormone that regulates the level of sugar (glucose) in the blood. Diabetes can affect both children and adults.

What is Diabetic Retinopathy?

Diabetic retinopathy, a complication of diabetes, is caused by changes in the blood vessels of the retina, the light-sensing nerve layer in the rear of the eye. These damaged blood vessels may leak fluid or blood, and develop fragile brush-like branches and scare tissue. The images, which the retina sends to the brain, become blurred, distorted or partially blocked. The longer the duration of diabetes greater are the chances of developing diabetic retinopathy.

How does Diabetes affect the Retina?

Patients with diabetes are more likely to develop eye problems such as cataracts and glaucoma, but the disease's affect on the retina is the main threat to vision. Most patients develop diabetic changes in the retina after approximately 10 to 15 years after the onset of diabetes. The effect of diabetes on the retina is called Diabetic Retinopathy.

The earliest phase of the disease is known as Non-Proliferative Diabetic Retinopathy. In this phase, the arteries in the retina become weakened and leak, forming small, dot-like hemorrhages. These leaking vessels may lead to swelling or edema in the retina and decreased vision.

With time this stage may progress to Proliferative Diabetic Retinopathy, when circulation problems cause areas of the retina to become oxygen-deprived or ischemic. New, fragile, vessels develop as the circulatory system attempts to maintain adequate oxygen levels within the retina. This is called Neovascularization. Unfortunately, these delicate vessels bleed easily. Blood may leak into the retina and vitreous, causing spots or floaters, along with decreased vision. In the later phases of the disease, continued abnormal vessel growth and scar tissue may cause serious problems such as Vitreous Haemorrhage, Retinal Detachment and Glaucoma, causing complete loss of vision.

What are the Signs and Symptoms?

The affect of diabetic retinopathy on vision varies widely, depending on the stage and extent of the disease.Some common symptoms of diabetic retinopathy are listed below; however, diabetes may cause other eye symptoms also.

Blurred Vision
Distortion of Vision
Floaters
Sudden Loss of Vision

How to Detect ?

Diabetic patients require routine eye examinations so related eye problems can be detected and treated as early as possible. Most diabetic patients are frequently examined by an internist or endocrinologist, who in turn work closely with the eye specialists. The diagnosis of diabetic retinopathy is made following a comprehensive eye examination wherein the retina, among other things, is checked thoroughly and a Fluorescein Angiography may be done to evaluate the extent of retinal damage due to diabetes.

How is Diabetic Retinopathy Treated?

Diabetic retinopathy is treated in many ways depending on the stage of the disease and the specific problem that requires attention. The eye surgeon will rely on several tests to monitor the progression of the disease and to make decisions for the appropriate treatment. These may include: Retinal Photography, Fundus Fluorescein Angiography and Ultrasound imaging of the eye.

The abnormal growth of tiny blood vessels and the associated complication of bleeding is one of the most common problems treated by eye specialists. Laser surgery called Pan Retinal Photocoagulation (PRP) is usually the treatment of choice for this problem. With PRP, the surgeon uses laser to destroy oxygen-deprived retinal tissue outside of the patient's central vision. While this creates blind spots in the peripheral vision, PRP prevents the continued growth of the fragile vessels and seals the leaking ones. The goal of this treatment is to arrest the progression of the disease. It should be noted that not all patients respond or show an improvement with laser treatment.

Vitrectomy is another surgery commonly needed for diabetic patients who suffer a bleeding inside the eye, called vitreous hemorrhage. During a vitrectomy, the retina surgeon carefully removes blood and vitreous from the eye.

Patients with diabetes are at greater risk of developing Retinal Tears and Detachment. Tears are often sealed with laser surgery. Retinal detachment requires surgical treatment to reattach the retina to the back of the eye. The prognosis for visual recovery is dependent on the severity of the detachment.

How to Prevent?

Clinical studies have found that diabetic patients who are able to maintain appropriate blood sugar levels have fewer eye problems than those with poor control. Diet and exercise play important roles in the overall health of those with diabetes. Diabetics can also greatly reduce the possibilities of eye complications by scheduling routine examinations with an eye specialist. Many problems can be treated with much greater success when caught early.