Diabetic Retinopathy And Blindness

This week is a continuation of Diabetic Eye Disease Awareness Month with emphasis on Diabetic Retinopathy (DR). We briefly spoke about DR in an earlier article this month. DR is a form of diabetics that damage the blood vessels in the tissue at the back of the eye, the retina. Uncontrolled blood sugar is a risk factor that facilitates Diabetic Retinopathy. As a result, the following occurs:

• The retina does not get enough oxygen and nutrients
• Blood vessels can leak blood into the retina

Diabetic Retinopathy is the leading cause of new cases of blindness in people 20 to 74 years of age in the United States. It is the most common form of diabetic eye disease and can lead to vision loss. Early detection, timely treatment, and appropriate follow-up care have the potential to reduce the severity of Diabetic Retinopathy disease.

People that have diabetes are more likely to come down with blinding eye diseases like diabetic retinopathy, glaucoma, and cataracts. Nevertheless, recent studies have discovered low awareness of this issue and especially among ethnicities at higher risk for diabetes. As a result, the findings illustrate that many Americans may not be defending themselves against diabetes-related vision loss, and therefore inspiring the American Academy of Ophthalmology to encourage those with diabetes to take proactive steps to protect their vision.

Early Symptoms Includes:

• Floaters
• Blurriness
• Dark areas of vision
• Difficulty perceiving colors
• Poor night vision
• Loss of vision
• Change in colors

Mild cases may be treated with careful diabetes management. Advanced cases may require laser treatment or surgery.

During the early stages of Diabetic Retinopathy:

• The current blood vessels in the eye can become swollen and blocked, and leak blood and fluid into the retina, and there may be no visual symptoms.
• If undetected and not managed, Diabetic Retinopathy can get worse over time. Once it reaches the moderate stages, the bleeding continues and visual symptoms may begin to appear.

If allowed to reach the advanced stage, proliferative, there will be an increased number of new blood vessels that are fragile and easily damaged resulting in swelling and leaking.  The non-proliferative and proliferative phases are (Source: Healthline.com):

Proliferative And Nonproliferative Diabetic Retinopathy Stages

Stage 1: Mild nonproliferative diabetic retinopathy

This is the earliest stage of diabetic retinopathy, characterized by tiny areas of swelling in the blood vessels of the retina. These areas of swelling are known as microaneurysms.

Small amounts of fluid can leak into the retina at this stage, thus triggering swelling of the macula. This is an area near the center of the retina.

Stage 2: Moderate nonproliferative diabetic retinopathy

Increased swelling of tiny blood vessels starts to interfere with blood flow to the retina, preventing proper nourishment. This causes an accumulation of blood and other fluids in the macula.

• It is important to note that Diabetic Macular Edema(DME) is a complication of DR, and occurs if the macula, the area of the retina at the back of the eye responsible for sharp central vision. DME currently affects more than 28 million people with diabetes.

• DME is caused by disruption of the blood-retinal barrier due to long-term hyperglycaemia (high blood glucose), leading to retinal thickening around the fovea.

Stage 3: Severe nonproliferative diabetic retinopathy

A larger section of blood vessels in the retina becomes blocked, causing a significant decrease in blood flow to this area. At this point, the body receives signals to start growing new blood vessels in the retina.

Stage 4: Proliferative diabetic retinopathy

This is an advanced stage of the disease, in which new blood vessels form in the retina. Since these blood vessels are often fragile, there’s a higher risk of fluid leakage. This triggers different vision problems such as blurriness, reduced field of vision, and even blindness.

If you believe you are experiencing any of the above symptoms it is imperative that you contact us immediately. We can evaluate the following to determine if you are suffering from DR:

• Visual acuity
• Eye muscle movement
• Peripheral vision
• Depth perception
• The curvature of the cornea

 

Happy Thanksgiving To You And Your Family!