Diabetic Retinopathy
Protect vision from diabetes damage
Understanding Diabetic Retinopathy
Diabetic Retinopathy: Overview
Understanding Diabetic Retinopathy
Diabetes affects the blood vessels throughout the body, particularly in the kidney and in the eye. Diabetic retinopathy is the name we give to diabetes’ adverse affects on the blood vessels in the eye. In the United States, diabetic retinopathy is the leading cause of blindness among adults. Risk of developing diabetic retinopathy increases over time. An adult who has had diabetes for 15 years or longer stands an 80 percent chance of experiencing damage to retinal blood vessels.
The retina, the multiple layers of tissue located at the back of the eye, detects visual stimuli and transmits signals to the brain. When diabetes affects the ocular blood vessels, they may develop leaks or contribute to the formation of scar tissue; these problems reduce the retina’s ability to detect and transmit images.
Stages of Diabetic Retinopathy
Diabetic retinopathy doesn’t happen all at once. It progresses through distinct stages that affect the retina in different ways. During comprehensive eye exams, our specialists track these changes closely to catch problems early and protect patient vision. Understanding these stages helps patients know what to expect and why regular monitoring is important.
1. Non-Proliferative Diabetic Retinopathy (NPDR)
This is the early stage of the disease. The blood vessels in the retina begin to weaken, leading to:
- Microaneurysms: Small bulges in the blood vessels.
- Hemorrhages: Tiny bleeds within the retina.
- Leakage: Fluid, blood, or fats leak into the retina.
At this stage, vision is often not affected, and the condition may only require careful monitoring. However, if leakage occurs in the central part of the retina (the macula), it leads to Diabetic Macular Edema (DME), which causes central vision loss.
2. Proliferative Diabetic Retinopathy (PDR)
This is the advanced stage of the disease and poses the greatest threat to vision.
- Vascular Blockage: Extensive blood vessel damage causes areas of the retina to become starved of oxygen (ischemia).
- Neovascularization: In response to the lack of oxygen, the retina signals the body to grow new, abnormal blood vessels on its surface.
- Vision Loss Risk: These new vessels are fragile and prone to bleeding (vitreous hemorrhage). They can also cause scar tissue to form, which may pull on the retina, leading to tractional retinal detachment—a condition requiring emergency surgical intervention.
Treating Diabetic Retinopathy
Diabetic Retinopathy: Treatment
Laser Treatment for Diabetic Retinopathy:
Laser treatment can help protect vision when diabetes damages the blood vessels in the retina. For proliferative diabetic retinopathy (PDR), a type of laser called scatter laser or panretinal photocoagulation is used to shrink abnormal new blood vessels and lower the risk of bleeding and further vision loss. For diabetic macular edema (DME), laser may sometimes be used to treat leaking areas in the retina, although some patients may also need medication injections depending on the type and severity of swelling. The treatment is done in the office, and while the eye is numbed, some people may still notice brief discomfort, flashes of light, or blurry vision afterward.
Vitrectomy Surgery:
This surgical procedure is reserved for advanced PDR cases where there has been a significant bleed (vitreous hemorrhage) or if scar tissue has caused a tractional retinal detachment. The surgeon clears the blood and removes the scar tissue.
Are There Symptoms? (The Importance of Monitoring)
For most people, diabetic retinopathy has no noticeable symptoms in the early NPDR stage. Vision loss only occurs when the condition progresses to advanced stages (PDR) or when Diabetic Macular Edema (DME) develops.
Do not wait for symptoms. If you have diabetes, seek regular dilated eye exams.
If you do notice any of the following, call us immediately:
- Blurred or wavy central vision.
- A sudden increase in floaters (small spots or squiggly lines).
- A dark or empty area in your vision.
- Difficulty with night vision.
