Diabetic Retinopathy - Diabetes and Vision Loss
Diabetic Retinopathy: What You Need to Know to Protect Your Eyesight
Diabetes can damage the eyes over the years. In fact, a common condition known as diabetic retinopathy is the leading cause of blindness in working-age adults, according to the Centers for Disease Control and Prevention (CDC).
This is a rather frightening revelation, particularly when you consider that diabetic retinopathy impacts both those with Type 1 and Type 2 diabetes.
However, there is a bright side. Successfully managing your blood sugar and getting regular eye exams can dramatically reduce the risk for developing diabetes-related eye issues, including retinopathy.
What is diabetic retinopathy?
Diabetic retinopathy is condition in which the blood vessels of the retina are damaged. The retina is a light-sensitive layer of cells located in the back of the eye that takes in light and turns it into images that the optic nerve transmits to the brain.
In cases of diabetic retinopathy, uncontrolled blood sugar weakens the vessels of the retina causing them to swell and leak, leading to blurry vision and in some instances stopping blood flow to the eye. Diabetic retinopathy can also cause new and abnormal blood vessels to begin growing in the retina, which can lead to further vision problems. Another aspect of diabetic retinopathy worth noting is that in most cases it usually impacts both eyes.
The two stages of diabetic retinopathy
Diabetic retinopathy develops in two primary stages:
The early stage
Blood vessels in the retina begin to weaken and bulge. You probably won’t notice any symptoms in this stage, however, during an exam your eye doctor can identify the beginnings of diabetic retinopathy. Eventually, the damaged vessels begin to leak blood and other fluid and the macula begins to swell. This swelling is known as macular edema, and it can distort your vision. According to the CDC, about half of all people diagnosed with diabetic retinopathy will also develop macular edema. If left untreated, macular edema is what leads to blindness. Since you are unlikely to experience any symptoms in the early stage of retinopathy, but your doctor can identify the disease through examination – it’s important to get a dilated eye exam at least once a year if you’ve been diagnosed with diabetes.
The advanced stage
This is the stage when diabetic neuropathy has been present for some time and the retina begins to grow new blood vessels. These vessels, however, do not function normally and are extremely fragile. They often begin to leak causing blood to enter the vitreous layer of the eye – an area of clear gel between the eye lens and the retina. This leakage initially leads to spotty vision as drops known as “floaters” occasionally interfere with the line of sight. However, when the leakage becomes too extreme, it can actually block vision entirely. Unlike in the early stage of retinopathy, you may notice symptoms as the advanced stage develops. These include:
– Blurry vision
– Floaters (dark shapes entering the field of vision)
– Difficulty making out colors
– Dark areas or areas that feel “empty” in your vision
Who gets diabetic retinopathy?
Anyone who has Type 1 or Type 2 diabetes is at some risk for developing diabetic retinopathy. The longer you’ve been living with diabetes, the more likely you are to develop the condition.
Type 1 diabetes begins earlier in life, but young people rarely develop the disease before puberty and it’s rare to see it anyone with Type 1 diabetes diagnosed with retinopathy who hasn’t been living with diabetes for at least five years. The CDC recommends that everyone diagnosed with Type 1 diabetes gets checked for retinopathy within five years of the diagnosis.
If you’re someone living with Type 2 diabetes, which tends to be diagnosed later in life, your risk of developing diabetic retinopathy is directly related to how long you’ve had the disease, as well as several other factors, such as whether you smoke, your cholesterol level, and whether you have uncontrolled high blood pressure.
Here's the catch with Type 2 diabetes and retinopathy. Because Type 2 diabetes develops so gradually, there’s a chance that retinopathy is already present when a person is diagnosed. For this reason, this CDC recommends that everyone diagnosed with Type 2 diabetes be checked for retinopathy right away and have their eyes checked at least once every year following the diagnosis.
How is diabetic retinopathy diagnosed?
Diabetic retinopathy is diagnosed with an eye exam during which the doctor will study how well you see the details of letters or symbols from a distance. The retina will also be examined, often using a dye to identify leaky blood vessels, a key indicator of diabetic retinopathy. If you do have diabetic neuropathy, you’ll likely need to visit your eye doctor more than once a year.
Treating diabetic retinopathy
There are different treatments that can help both repair damage and prevent blindness in most cases of diabetic retinopathy. They include:
– Laser therapy to slow the growth of new and abnormal blood vessels
– Medications known as VEGF inhibitors that can slow the disease’s progression and, in some instances, reverse it.
– Vitrectomy, a procedure that removes all or part of the vitreous.
– Corticosteroid injections to reduce inflammation
What can I do to prevent diabetic retinopathy?
The bad news is there is no way to eliminate the risk of diabetic retinopathy altogether. The longer you live with diabetes, the higher the risk becomes.
However, because diabetic retinopathy develops due to damaged caused by high blood sugar, the best thing you can do to lower your risk is to effectively manage your Type 1 or Type 2 diabetes and keep blood sugar levels under control.
– Test your blood sugar daily according to your doctor-prescribed schedule. You can use a glucose meter and test strips or a continuous glucose monitoring device (CGM), often prescribed for those with Type 1 diabetes and individuals who struggle to keep blood sugar in check.
– Administer insulin according to your prescribed dosage schedule. Insulin can be injected manually using a syringe or an insulin pen. It can also be delivered by an insulin pump or a tubeless patch system, often prescribed to those with Type 1 diabetes and individuals who have difficulty managing their insulin treatments.
– Eat a diabetes friendly diet and get plenty of physical activity in order to better control blood sugar.
See your eye doctor at least once a year.
Remember, there are usually no telltale symptoms of diabetic neuropathy until it has reached the advanced stage. This is why it’s so important for anyone with diabetes to have their eyes examined at least once a year. The earlier it is detected; the sooner treatment can begin and the better the prognosis becomes. If you experience any unusual changes in your vision, such as blurriness or dark spots, see your doctor right away. It just might save your eyesight.