We all know ocular health is important, whether you have diabetes or not. However, if you have diabetes, you’ve probably heard more than most that it’s important to protect your eyes. Why? Because people with diabetes are significantly more inclined to develop eye complications as they age. For instance, according to the American Diabetes Association, people with diabetes are 40% more likely to suffer from glaucoma and 60% more likely to develop cataracts. Further, they’re very likely to develop some form of diabetic retinopathy within their lifetime.
However, most eye complications are preventable and treatable, and diabetic retinopathy is no different. So, we’re here to help. We want to make sure you’re well equipped to prevent future complications. How? By making sure you fully understand what diabetic retinopathy is; including the causes, potential complications, and ways you can prevent it. Let’s take a look.
What is diabetic retinopathy?
Diabetic retinopathy is the result of blood glucose fluctuations causing damage to retinal blood vessels. The retina is the light-sensitive tissue at the back of the eye and is responsible for translating light into images. In some cases, macular edema will develop as a result of retinopathy. Diabetic macular edema (DME) is the swelling of the macula, which is near the center of the retina and responsible for detailed vision.
Left untreated both of these conditions can lead to severe visual impairment and even vision loss.
What causes diabetic retinopathy?
When blood glucose levels aren’t kept in check, and remain consistently high, the small blood vessels located in the retina can be weakened, and can even begin to hemorrhage, and sometimes swell. These clusters of swelling are called microaneurysms. As it worsens, these microaneurysms can impair the blood vessels’ ability to transport blood. As this blood flow becomes increasingly scarce, the eye may attempt to improve circulation by developing new, abnormal blood vessels. These blood vessels are delicate and even more inclined to leak blood, which is accompanied by scar tissue. This scar tissue can cause the retina to pull away from its surrounding tissue, a condition known as retinal detachment.
In some cases new blood vessels might actually form at the front of the eye. When they do, the flow of fluid leaving the eye can become impaired, causing a build up of pressure in the eye, causing glaucoma. When this occurs, it’s possible to damage the optic nerve.
This most advanced stage can lead to complete vision loss.
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What are the risk factors associated with diabetic retinopathy?
- Poor glucose control
- Having diabetes for a long time
- High cholesterol
- Pregnancy (can worsen or increase speed of onset)
- High blood pressure
- Race (Hispanics, African Americans, and Native Americans are at increased risk)
What are the symptoms of diabetic retinopathy?
The early signs of retinopathy are often asymptomatic. For this reason, it’s crucial that in addition to keeping your regular appointments with your doctor you also get regular eye exams. These appointments will allow your optometrist to consistently monitor your eye health. Make sure you get a comprehensive dilated eye exam, as it will allow your doctor to check the blood vessels in your retina for any changes that may be cause for concern.
While early stages are hard to detect without a medical professional, as the condition advances symptoms include:
- Changes in vision (blurriness, loss of central vision)
- Spots or floaters in your vision
- Areas that are dark or “empty” in your vision
- Eye pain
- Difficulty seeing at night
- Double vision
- Difficulty seeing colors
If you notice any changes in your vision, you should contact your doctor immediately.
Can diabetic retinopathy be treated?
Yes. A laser therapy called photocoagulation is used to stop the blood vessels from hemorrhaging. At its later stages, a laser may be used to rid or decrease the abnormal blood vessels that have formed. Anti-VEGF injection therapy might also be utilized to treat DME. This involves the injection of a gel that blocks the growth of the protein that stimulates the growth of abnormal blood vessels.
However, if retinopathy is in its early stages, your doctor will likely encourage regular visits to monitor the advancement. He or she might also encourage you to gain better control of your blood glucose levels to stop or delay the advancement of the condition.
How can diabetic retinopathy be prevented?
While retinopathy isn’t always preventable, one of the best things you can do is to maintain regular appointments with your entire health care team, including your optometrist. You should be getting a comprehensive dilated eye exam at least once a year. Catching it early is crucial to mitigating future complications. Further, there are some things you can do to delay and, in some situations, prevent retinopathy:
- Maintain control of your diabetes– take medications as directed, implement an exercise routine, and eat a well-balanced diet that supports glucose control
- Take control of your blood pressure and cholesterol levels
- Monitor your blood sugar level– notify your doctor of fluctuations and make sure to be more diligent when you’re ill or have experienced stress or trauma
- Get regular A1C tests
- If you smoke, quit
- If you’re pregnant, get a comprehensive dilated eye exam as soon as possible
- Consume alcohol with caution