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Symptoms, Causes, Diagnosis, and Treatment

Diabetic retinopathy is a complication of diabetes caused by high blood sugar that damages the retina. If not treated properly, this disease can cause blindness. Check out an explanation of the symptoms and how to treat it in the following review.

Diabetic Retinopathy: Symptoms, Causes, Diagnosis, and Treatment

Symptoms of Diabetic Retinopathy

Diabetics need to have a comprehensive eye examination at least once a year. Diabetic retinopathy doesn’t cause any symptoms, but early detection of the disease can help protect your vision.

There are no symptoms that can be felt in the early stages of diabetic retinopathy. However, when it gets worse, you can experience:

  • Floating black dots or threads on sight (floaters).
  • Vision decreases gradually.
  • There is a black spot on the vision.
  • Shaded vision.
  • Pain in the eye, or red eye.

Causes of Diabetic Retinopathy

Diabetic retinopathy is caused by high blood sugar from diabetes. In the long term, high blood sugar can damage one part of the eye, namely the retina. This part of the eye is responsible for detecting light and sending signals to the brain via the optic nerve.

Diabetes can damage blood vessels throughout the body. Damage to the eye begins when sugar blocks the tiny blood vessels that lead to the retina, causing bleeding. The eye will make new blood vessels but this is not normal and can be damaged quickly.

Types of Diabetic Retinopathy

This condition itself has two types, namely:

  • Nonproliferative Diabetic Retinopathy (NPDR)

At this stage, the blood vessels in the retina weaken, swell, and release water and blood into the retina. NDPR can get worse when more blood vessels are blocked.

Sometimes, damage to the blood vessels can cause the center of the retina or the so-called macula to become watery (oedema). This condition needs treatment to prevent permanent blindness.

  • Proliferative Diabetic Retinopathy

This type includes the more severe or advanced stages of diabetic retinopathy. Blood vessels cannot function fully, new and abnormal blood vessels form in the retina. These blood vessels will be fragile like jelly and fill the center of the eye.

Tissue damaged by these new blood vessels can cause the retina to detach from the back of the eye. In addition, if the new blood vessels interfere with other parts of the eye, there will be pressure in the eyeball. This condition will damage the optic nerve and cause glaucoma.

Also Read: Vegetarian Diet for Diabetics, Really Beneficial?

When to See a Doctor?

Good diabetes management can prevent decreased vision. If you have diabetes, it’s best to have an eye exam once a year, even if your vision is fine.

Having gestational diabetes (diabetes during pregnancy) can increase your risk of diabetic retinopathy. If you are pregnant, your eye doctor may recommend additional tests during your pregnancy.

You should consult an ophthalmologist immediately when there are changes in the eyes, such as blurred vision or spots.

Diagnosis of Diabetic Retinopathy

The ophthalmologist will suggest several tests to make a diagnosis. Examinations that may be carried out include:

  • Sight accuracy. This test measures the ability to see at various distances.
  • Tonometry. This test will measure the pressure in the eye.
  • Pupillary dilation. This examination involves eye drops that make the pupils dilate so the doctor can see the lens and retina of the eye more clearly.
  • Ophthalmoscopy. Examination in which the doctor looks at the retina in more detail.
  • Fluorescein angiography. This examination uses an organic dye that is injected into a vein to see the blood vessels in the eye.
  • Optical coherence tomography. Examination to see images of the retina of the eye.

Risk Factors

Anyone with diabetes can develop diabetic retinopathy. The risk of this condition will increase if:

  • Have had diabetes for a long time.
  • Poor control of blood sugar.
  • High blood pressure.
  • High cholesterol.
  • Pregnant.
  • Smoke.

Diabetic Retinopathy Treatment

In the early stages, the ophthalmologist may observe the eyes. Some diabetic retinopathy patients will need a comprehensive eye exam every 2 to 4 months.

In more advanced stages, it is important to start treatment especially if you have decreased vision. This treatment will not repair the vision damage, but it can reduce the severity.

Some of the treatment measures that can be done, including:

1. Injection

Anti-VEGF drugs can slow or improve diabetic retinopathy. Other medications, such as corticosteroids may also help.

2. Laser Action

To reduce swelling in the retina, an ophthalmologist can use a laser to make your blood vessels shrink and stop leaking or bleeding.

3. Eye surgery

If your retina is bleeding heavily and there is a lot of scarring in the eye, your doctor may recommend an operation called a vitrectomy. This procedure will remove the jelly-like part of the eye and replace it with a solution saline.

Also Read: 10 Ways to Control Blood Sugar that Diabetics Must Know

Diabetic Retinopathy Complications

Diabetic retinopathy can cause complications and lead to serious vision problems, including:

1. Bleeding in the Middle Eye (Vitreous Hemorrhage)

New blood vessels can cause a jelly-like fluid to fill the center of the eye. In severe cases, this condition can cause the vitreous part of the eye to fill with blood and block vision.

This condition will not cause permanent vision loss. The blood will disappear from the eye in a few weeks or months. Vision can return clear if the retina is not damaged.

2. Retinal Ablation

The abnormal blood vessels will cause tissue to form and pull the retina away from the back of the eye. This condition will cause spots on vision, sensitivity to light, or severe vision loss.

3. Glaucoma

New blood vessels will grow in front of the eye and interfere with the flow of fluid out of the eye. This condition will cause pressure in the eye.

The pressure inside can damage the nerve that carries images from the eye to the brain (the optic nerve).

4. Blindness

If not treated properly, diabetic retinopathy, macular edema, glaucoma, and this combination can cause permanent blindness.

Prevention of Diabetic Retinopathy

You can’t always prevent this condition. However, regular eye exams, good blood sugar and blood pressure control, and treating vision problems early can help prevent vision decline.

If you have diabetes, you can reduce your risk of diabetic retinopathy by:

  • Live a healthy lifestyle.
  • Take medication or insulin injections regularly.
  • Keep an eye on blood sugar levels.
  • Periodic glycosylated blood tests
  • Keep blood pressure and cholesterol normal.
  • Quit smoking.
  • Noticing changes in vision
  1. Anonymous. 2021. Diabetic Retinopathy. (Accessed January 4, 2023)
  2. Anonymous. 2021. Overview: Diabetic Retinopathy. (Accessed January 4, 2023).
  3. Anonymous. 2022. Diabetic Retinopathy. (Accessed January 4, 2023).
  4. Sachdeva, Mira. Diabetic Retinopathy. (Accessed January 4, 2023).

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