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Diabetic Retinopathy?

Diabetic Retinopathy

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It is damage to the retina that occurs as a result of a poorly controlled diabetes. Diabetic retinopathy is the leading cause of blindness in Americans in productive age. People with diabetes type 1 and type 2 are at risk for this condition. Having more severe diabetes for a longer period increases the possibility of developing retinopathy. Also is more likely that retinopathy occurs when diabetes has been poorly controlled and can be more severe. Almost everyone who has had diabetes for more than 30 years displayed signs of diabetic retinopathy.

Causes

Diabetic retinopathy is caused by damage to blood vessels in the retina. The retina is the layer of tissue in the back of the eye. The retina transforms the light and images into nerve signals that are sent to the brain to for interpretation.

There are two types or retinopathy stages: not proliferative or proliferative.

Non-proliferative diabetic retinopathy occurs first. The blood vessels in the eye become larger in certain points (called microaneurismas). Blood vessels can also have obstruction to the flow. There may be small amounts of bleeding (retinal hemorrhages) and fluid may escape into the retinal tissue, which can lead to visual loss. 

Proliferative retinopathy is the most severe and advanced disease stage. New blood vessels start developing in the eye, it which are fragile and can bleed (bleeding). Small scars can occur both in the retina and in other parts of the eye (the vitreous humor). Hence, visual loss can occur. 

Other problems that can develop are:

Macular edema: the macula is the area of the retina responsible for fine vision and color. Frequently and as result of the lack of diabetic control, fluid can leak in this area and vision becomes blurred.

Retinal detachment: excessive scarring can cause retinal detachment resulting in permanent visual loss. 

Glaucoma: It occurs when there is an increased eye pressure. It is one of the most sight threatening manifestation that can rapidly cause severe visual impairment a without treatment, can lead to total blindness. 

Cataract: Cataract occurs frequently in patients with diabetes to younger than average ages. 

Symptoms

Most often, diabetic retinopathy does not cause symptoms until that eye damage is severe.

Symptoms of diabetic retinopathy include:

  • Blurred vision and gradual loss of vision
  • Floaters
  • Shadows or lost vision areas
  • Decreased vision at night 

Many people with diabetic retinopathy don´t have any symptoms until they bleed into the eye. This is the reason why everyone with diabetes should be annual reviews with an ophthalmologist.

Diagnosis

The ophthalmologist can diagnose diabetic retinopathy by dilating pupil and evaluating the back of eye which allocates the retina. Also, he may use a fundus picture of the retina or fluorescein angiography.
Treatment
The following is very important to prevent diabetic retinopathy:
Strict control of sugar (glucose) in the blood, blood pressure and cholesterol - practice exercise regularly
Quit smoking 
Many patients with non-Proliferative Diabetic Retinopathy may not need treatment. However, the patients must have annual eye exam with an ophthalmologist in order to detect early signs of diabetic retinopathy and therefore have prompt treatment.
 
Treatment usually not counteracts the damage that has already happened, but you can help prevent the progression of the disease. Once the ophthalmologist notes the emergence of new vessels in the retina (neovascularization) or macular edema, treatment is advised.
Several procedures or surgeries are the main treatment for diabetic retinopathy.
Laser eye surgery creates small burns in the retina where there are abnormal blood vessels. This process is called laser photocoagulation and is used to prevent vessels to leak or to remove abnormal and fragile vessels.
Focal laser photocoagulation is used to treat macular edema. 
Panretinal photocoagulation or scattered laser is applied in a large area of the retina. Two or more sessions are often needed. 
A surgical procedure called vitrectomy is used when there is bleeding in the eye. It can also be used for repairing retinal detachment.
 
Currently have with drugs that prevent the proliferation of abnormal blood vessels and corticosteroids injected into the eye as new treatments for diabetic retinopathy with promising results.

Prognosis

Prognosis depends on good control your blood glucose and blood pressure.
Both treatments are effective in reducing the loss of vision, but not cure diabetic retinopathy or counteract changes that have already occurred.
Once proliferative retinopathy occurs there is always a risk of bleeding. You will need continuous monitoring and may require further treatment. 
 

When contact a medical professional?

Request an appointment with a doctor specializing in eyes (ophthalmologist) if you have diabetes and has not attended an eye query in the last year.
Call your doctor if any of the following symptoms are new or are worse:
  • You do not see well in the Dim light. 
  • Has blind spots. 
  • Presents vision double (you see two things when there is only one). 
  • Their vision is cloudy or blurry and you cannot focus. 
  • Experiencing pain in one eye. 
  • Having headaches. 
  • Spots that float in your eyes. 
  • Cannot see things that are on your visual field. 
  • See shadows.
 

 

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De México
664-979-2020
Toll Free
888-541-0202