Diabetic retinopathy is a sight-threatening condition that complicates diabetes mellitus. Diabetes mellitus leads to many complications that can affect the whole body organs, but retinopathy is the most commonly diagnosed. It is the most common cause of blindness among diabetic patients and all adults under 65 years old.
Diabetes mellitus is a metabolic disease in which the blood glucose levels become high. This high glucose can cause damage throughout the whole body by damaging the blood vessels that supply the various organs. It can affect the kidneys, brain, nerves, and eyes. It may affect the eyes in many ways; it may cause retinopathy, cataract, and paralysis of ocular muscles.
As we said, diabetic retinopathy is the most commonly diagnosed and the leading cause of vision loss; thus, let’s discuss it.
First, let’s know what the retina is. It is the light-sensitive layer of your eyes and lies a the back of your eye. It receives the light and changes it into signals that the optic nerve carries to the brain. Then, the brain translates these signals into the images that you see. The retina contains a part for sharp central vision, which is the macula.
In diabetic retinopathy, the high sugar damages and blocks the minute blood vessels that supply your retina. These blocked vessels will swell and leak fluids into the retina. Here, there are two problems: the swelling around the retina and the reduced blood supply (ischemia). Your body will respond to this by forming new vessels on the retina. But these new vessels are fragile and more liable to bleed.
Diabetic retinopathy takes several years to threaten your vision. But, you may not notice any symptoms until you reach an advanced stage. It develops gradually and ends in blindness. It also affects both eyes.
Any patient with diabetes can develop retinopathy, but the risk increases with the duration of diabetes. 20% of patients with type-1 DM will have retinal changes after ten years up to 90% after 20 years. About 20-30% of patients with type-2 DM have retinopathy at diagnosis. Also, prolonged poor control of diabetes increases the risk. We will discuss the other risk factors later.
Diagnosing retinopathy occurs by a detailed eye examination after taking a history of your symptoms. Your doctor may use some investigations to take images of your retina to see the abnormal findings and blood vessels in more detail.
Treating diabetic retinopathy depends on at which stage you are. In the early stages, you may not need any treatment, and it’s enough to manage your diabetes better and examine your eye regularly to assess the progression. In the advanced stage, your doctor will start active treatment to save your vision. The treatment depends on the problem in your retina, and we will discuss the options later.
Diabetic patients are at high risk, but they can take a role in preventing (or delaying) retinopathy and other complications. They can do this by following a good management plan for diabetes and regularly monitoring blood glucose. Also, regular eye exams (diabetic eye annual screening) help pick up the disease early and prevent (or reduce) its effect on vision.
Now, let’s dig deeper into the details of this condition -that is common among diabetic patients and impacts their lives-. We will answer the following questions:
- Who is at risk of diabetic retinopathy?
- How does this disease progress, and what are its symptoms and complications?
- How can your doctor diagnose retinopathy and assess its severity?
- How can your doctor treat you, and what are the available treatments?
- Can you protect yourself from vision loss by this disease, and how can you do this?