Diabetic Retinopathy 

Overview

Diabetic retinopathy is a damage of the sensory layer in the back of the eye (retina) secondary to the damage to small vessels because of longstanding poorly controlled diabetes. 

Symptoms

 

Although Diabetic Retinopathy is asymptomatic at the beginning, it may eventually cause any of the following symptoms:

  • Blurred vision

  • Dark spaces in the field of vision (scotoma)

  • Fluctuations of vision

  • Floaters

  • Loss of vision

Normal view

Diabetic Retinopathy 

Early (Non-Proliferative) Diabetic Retinopathy

 

In Non-Proliferative Diabetic Retinopathy (NPDR) the walls of small vessels in the retina weaken and leak lipid material and fluid to the surrounding tissue. This causes swelling of retinal tissue and when it happens in the centre of macula, it can cause vision loss and needs treatment. The nerve fibre layer of retina may also swell (Cutton Wool Spots) and multiple bleeding spots may happen in the retina. In the more severe form of the disease, large vessels of the retina may become dilated and irregular.

Advanced (Proliferative) Diabetic Retinopathy 

 

In Proliferative Diabetic Retinopathy (PDR), small new vessels grow in the retina which may bleed into the clear jelly-like material fills the eye (vitreous) and cause a severe visual loss. Without treatment, these new vessels eventually may cause glaucoma or scar tissue resulting in retinal detachment and may lead to blindness.

Prevention

It is not always possible to prevent Diabetic Retinopathy, however with regular eye examination, good control of blood sugar and cholesterol level and hypertension the risk of developing Diabetic Retinopathy decreases significantly. If you smoke, you definitely need to discuss with your doctor the options to quit.

Diagnosis

 

Diabetic Retinopathy is best diagnosed with an eye exam when the pupil is dilated. For this exam drops are put in your eye to make the pupil wider, but this will cause a blurred near vision for about 6 hour and you will not be able to derive after the exam for this period. Your ophthalmologist will then examine your retina for signs of Diabetic Retinopathy and check the pressure of your eyes to exclude glaucoma.

Optical Coherence Tomography (OCT)

Your ophthalmologist may request an OCT for further assessment of your retina. This is a special image which shows different layers of retina and helps to exclude swelling of retina.

Treatment

While Non-Proliferative Diabetic Retinopathy only needs  better control of diabetes, hypertension and hypercholestrolemia, for Proliferative Diabetic Retinopathy you need an intervention by your ophthalmologist. This can be injecting of a medicine into your eye or doing retina laser treatment. In very advanced form of the disease you may need a vitrectomy surgery.

Effect of injection medicine into the eye on Diabetic Macular Oedema

For Further information about Diabetic Retinopathy click the image

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