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Diabetic Retinopathy – Eye disease

Diabetic retinopathy is a complication common in uncontrolled diabetes and a leading cause of blindness. It occurs when diabetes damages the tiny blood vessels inside the retina, the light-sensitive tissue at the back of the eye. Given that a healthy retina is necessary for good vision, damage to the blood vessels will affect your eyesight. At first you may notice no changes to your vision. But over time, diabetic retinopathy can get worse and cause vision loss. Diabetic retinopathy usually affects both eyes. All people with diabetes—both type 1 and type 2—are at risk. That’s why everyone with diabetes should get a comprehensive dilated eye exam at least once a year.

Diabetic retinopathy

Diabetic retinopathy has four stages:
1. Mild Nonproliferative Retinopathy. At this earliest stage, microaneurysms occur. They are small areas of balloon-like swelling in the retina’s tiny blood vessels.
2. Moderate Nonproliferative Retinopathy. As the disease progresses, some blood vessels that nourish the retina are blocked.
3. Severe Nonproliferative Retinopathy. Many more blood vessels are blocked, depriving several areas of the retina with their blood supply. These areas of the retina send signals to the body to grow new blood vessels for nourishment.
4. Proliferative Retinopathy. At this advanced stage, the signals sent by the retina for nourishment trigger the growth of new blood vessels. These new blood vessels are abnormal and fragile. They grow along the retina and along the surface of the clear, vitreous gel that fills the inside of the eye. By themselves, these blood vessels do not cause symptoms or vision loss. However, they have thin, fragile walls. If they leak blood, severe vision loss and even blindness can result.

Normal Vision
After Diabetic Retinopathy

Signs and Symptoms
The affect of diabetic retinopathy on vision varies widely, depending on the stage of the disease.
* Blurred vision (this is often linked to blood sugar levels
* Floaters and flashes
* Sudden loss of vision
What are the symptoms of proliferative retinopathy if bleeding occurs?
At first, you will see a few specks of blood, or spots, “floating” in your vision. If spots occur, see your eye care professional as soon as possible.

How does diabetic retinopathy cause vision loss?
1. Fragile, abnormal blood vessels can develop and leak blood into the center of the eye, blurring vision. This is proliferative retinopathy and is the fourth and most advanced stage of the disease.
2. Fluid can leak into the center of the macula, the part of the eye where sharp, straight-ahead vision occurs. The fluid makes the macula swell, blurring vision. This condition is called macular edema. It can occur at any stage of diabetic retinopathy, although it is more likely to occur as the disease progresses.

How is diabetic retinopathy treated?
During the first three stages of diabetic retinopathy, no treatment is needed, unless you have macular edema. To prevent progression of diabetic retinopathy, people with diabetes should control their levels of blood sugar, blood pressure, and blood cholesterol.
Proliferative retinopathy is treated with laser surgery. This procedure is called scatter laser treatment. Scatter laser treatment helps to shrink the abnormal blood vessels. Scatter laser treatment works better before the fragile, new blood vessels have started to bleed. That is why it is important to have regular, comprehensive dilated eye exams. The doctor places 1,000 to 2,000 laser burns in the areas of the retina away from the macula, causing the abnormal blood vessels to shrink. Because a high number of laser burns are necessary, two or more sessions usually are required to complete treatment.

How is a macular edema treated?
Macular edema is treated with laser surgery. This procedure is called focal laser treatment. Your doctor places up to several hundred small laser burns in the areas of retinal leakage surrounding the macula. These burns slow the leakage of fluid and reduce the amount of fluid in the retina. The surgery is usually completed in one session. Further treatment may be needed.

What can be done if somebody has already lost some vision from diabetic retinopathy?
An eye care professional about low vision services and devices that may help you make the most of your remaining vision.

NOTE : Visit your eye doctor frequently. Do not wait for symptoms to occur.

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