Diabetic Retinopathy
Diabetes and vision health go hand in hand. If either is neglected, complications can occur. One example is diabetic retinopathy, an eye problem that may lead to vision impairment or blindness. Learn more about diabetic retinopathy, including the diagnosis, stages, causes, and more below.
What Is Diabetic Retinopathy?
Diabetic retinopathy is an eye disease that can occur as a complication of diabetes. It is a common complication that can affect anyone with either type 1 or type 2 diabetes, and it is more likely to develop the longer a person has diabetes or the less controlled their blood sugar is.
Diabetic retinopathy affects the retina, the area of the eye that receives light and converts it into neural signals, which the brain interprets into visual recognition. Consistently high blood sugar levels can damage blood vessels and tissue at the back of the eye, causing abnormal blood vessels to form on the retina. Once the retina stops receiving the proper amount of blood flow, vision problems and even blindness can occur.
Someone with diabetic retinopathy may see dark spots, webbed streaks, blurred vision, or experience other abnormal vision changes. Diabetic retinopathy is likely to worsen when blood sugar levels aren’t controlled and eye health isn’t monitored.
Types of Diabetic Retinopathy
There are two stages of diabetic retinopathy.
- Non-Proliferative Diabetic Retinopathy – Also known as early diabetic retinopathy, this is the most common stage of this eye condition. At this stage, diabetic retinopathy may go undetected, as the person may not have any obvious symptoms. Others experience blurry vision as the blood vessels in the eyes weaken or leak. The condition can quickly worsen if left untreated.
- Proliferative Diabetic Retinopathy – Also called advanced diabetic retinopathy, this stage is identified by neovascularization—when the retina begins to grow new and abnormal blood vessels. These blood vessels often bleed and cause dark floaters or block vision completely. They might also create scar tissue or even cause the retina to detach. This much more serious stage of diabetic retinopathy can cause blindness.
Causes
Diabetic retinopathy is often caused by high blood sugar levels, which damage the tissue at the back of the eye, known as the retina. This area is responsible for receiving light and converting it into neural signals, which are sent to the brain to be interpreted into visual recognition.
These damaged blood vessels can become swollen, leaky, or closed off. New or abnormal blood vessels can begin to form on the retina in an attempt to compensate for blocked blood vessels. As the retina stops receiving normal blood flow, a person may experience eye impairment and eventually go blind.
Diabetic retinopathy is more likely to occur the longer a person has had diabetes or has blood sugar levels that haven’t been controlled. Other risk factors include high blood pressure, high cholesterol, pregnancy, or tobacco use. African Americans, Hispanics, and Native Americans also have a higher risk of developing diabetic retinopathy.
You may wonder whether high blood sugar can cause double vision. An isolated episode of high blood sugar in a person without diabetes shouldn’t cause eyesight changes like double vision. It is the sustained high blood sugars of uncontrolled diabetes that can cause visual changes and lead to diabetic retinopathy.
Symptoms
Someone with diabetic retinopathy may not experience any symptoms at the onset of the disease, so it is important to have yearly eye exams to monitor eye health.
Once the condition worsens and blood vessels begin to swell or abnormal vessels begin to form, a person may experience:
- Seeing floaters or dark strings
- Blurry vision
- Vision changes that seem to come and go
- Poor night vision
- Impaired color perception
- Blind spots
- Blindness
It is important to catch symptoms before they become severe. Early treatment saves vision!
Complications
Though these are the most common symptoms of diabetic retinopathy, the condition can lead to other vision complications as abnormal blood vessels form in the retina. Complications include:
- Vitreous hemorrhage – In this condition, the newer blood vessels leak a clear gel in the middle of the eye. This may cause floaters, dark spots, or complete vision blockage. This condition usually clears up within a few weeks or months, but in rare cases, it may cause permanent vision loss.
- Retinal detachment – Sometimes, the abnormal blood vessels create scar tissue, which pulls the retina away from the eye and causes floaters, light flashes, or extreme vision loss.
- Glaucoma – When new blood vessels start growing in the front of the eye, this disrupts the regular flow of fluid and creates pressure, which is known as glaucoma. This can cause nerve damage and stop the eye from sending images to the brain.
- Blindness – In the most severe or prolonged cases of diabetic retinopathy, a person experiences total blindness.
If you have diabetes, it’s important to stay on top of managing it and visit a doctor regularly. See an eye doctor near you every year for an eye exam, including dilation, even if you do not have any vision impairment.
If you experience any of these symptoms, contact your doctor immediately. Remember that pregnant women have a higher risk of developing diabetic retinopathy, so any woman who has diabetes and is pregnant should see her eye doctor throughout the pregnancy.
Diagnosis
Eye doctors most commonly diagnose diabetic retinopathy with a dilated eye exam. Dilation is a key part of a diabetes eye exam, but your doctor may perform additional tests.
Dilated Eye Exam
During this exam, the doctor places drops in the eye to dilate the pupil and give a better look inside the eye. The doctor then looks for symptoms of diabetic retinopathy, including:
- New and abnormal blood vessels
- Scar tissue around the retina
- Swelling of the retina
- Retinal detachment
- Blood around the retina
- Clear, gelatinous substance in the center of the eye
If you’re wondering whether Visionworks does diabetic eye exams, the answer is yes! Dilated eye exams are critical in checking for diabetes-related conditions, and our eye doctors can perform dilation.
Digital Retinal Imaging
Diabetic retinopathy affects the retina, so ask your doctor about digital retinal imaging at your next eye exam. Digital retinal imaging is a quick, non-invasive new technology used in Visionworks’ Premier Eye Exams that captures 3-D images spanning 80% of the retina, including layers below the surface.
Traditional eye exams only reveal around 10% of the retina at one time. Seeing more of the retina allows your doctor to detect the earliest signs of vision changes that might be caused by systemic diseases like diabetes, high cholesterol, and high blood pressure.
Fluorescein Angiography
The eye doctor might take pictures of the inside of the eye using fluorescein angiography. Dye is injected into the arm and circulates up to the eyes, allowing the optometrist to identify blood vessels that are closed or leaking.
Optical Coherence Tomography
The eye doctor might also request optical coherence tomography (OCT), a method of taking pictures of key parts of the eye. The images show an eye doctor how thick the retina is and reveal how much fluid has leaked into the retina tissue (if any). OCT exams are also used to monitor whether treatment for diabetic retinopathy is working.
Treatment and Management Options
In the beginning stages of diabetic retinopathy, your optometrist might only monitor the eye and track the condition's progress. If the disease gets worse, they may use one of the following diabetic retinopathy treatments:
- Injections – Every 1-3 months, the doctor may inject a corticosteroid or a protein called VEGF. These injections can slow or reverse the condition.
- Laser treatment – Eye doctors may use laser treatment to reduce retina swelling or shrink the blood vessels.
- Eye surgery – In severe cases with a lot of retinal bleeding, a patient may opt for an eye surgery known as a vitrectomy.
If you experience any symptoms of diabetic retinopathy, it’s important to schedule an eye exam near you as soon as possible so an optometrist can monitor the condition or provide treatment.
Prevention
Diabetic retinopathy isn’t always preventable, but you can minimize the risks. Diabetes and vision need to be monitored and treated to help prevent diabetic retinopathy. If you have diabetes, these precautions may help reduce the chance of getting diabetic retinopathy:
- Monitor and manage blood sugar levels with the help of a doctor.
- Get a regular eye exam.
- Watch out for any vision impairment or changes.
- Manage blood pressure and cholesterol levels.
- Avoid smoking or using tobacco.
Generating Awareness
National Diabetes Month, which takes place in November each year, was established to raise awareness of the disease, share stories about it, offer advice for preventing and managing it, and unite efforts to combat it. The American Diabetes Association (ADA) reports that it is the eighth leading cause of death and the basis for dozens of other health conditions.
World Diabetes Day is on November 14th. This day also marks the birthday of Dr. Frederick Banting, who co-discovered insulin with Dr. Charles Best in 1921.
Protect Your Eye Health with Visionworks
Take good care of your diabetes and your vision for a brighter future. Schedule an appointment at your local Visionworks today.
Frequently Asked Questions
Does Diabetic Retinopathy Lead to Blindness?
Am I at Risk of Diabetic Retinopathy?
Does Visionworks Do Diabetic Eye Exams?
Can High Blood Sugar Cause Double Vision?
Can an Eye Exam Detect Diabetes?
