Diabetic Retinopathy

Diabetic retinopathy is a condition occurring in persons with diabetes, which causes progressive damage to the retina, the light sensitive lining at the back of the eye. It is a serious sight-threatening complication of diabetes.

Diabetes is a disease that interferes with the body's ability to use and store sugar, which can cause many health problems. Too much sugar in the blood can cause damage throughout the body, including the eyes. Over time, diabetes affects the circulatory system of the retina.

Causes diabetic retinopathy?

Diabetic retinopathy is the result of damage caused by diabetes to the small blood vessels located in the retina. Blood vessels damaged from diabetic retinopathy can cause vision loss:

  • Fluid can leak into the macula, the area of the retina which is responsible for clear central vision. Although small, the macula is the part of the retina that allows us to see colors and fine detail. The fluid causes the macula to swell, resulting in blurred vision.
  • In an attempt to improve blood circulation in the retina, new blood vessels may form on its surface. These fragile, abnormal blood vessels can leak blood into the back of the eye and block vision.

Diabetic Retinopathy Types

Non-proliferative diabetic retinopathy:
(NPDR) is the early state of the disease in which symptoms will be mild or non-existent. In NPDR, the blood vessels in the retina are weakened causing tiny bulges called microanuerysms to protrude from their walls. The microanuerysms may leak fluid into the retina, which may lead to swelling of the macula.

Proliferative diabetic retinopathy:
(PDR) is the more advanced form of the disease. At this stage, circulation problems cause the retina to become oxygen deprived. As a result new fragile blood vessels can begin to grow in the retina and into the vitreous, the gel-like fluid that fills the back of the eye. The new blood vessel may leak blood into the vitreous, clouding vision. Other complications of PDR include detachment of the retina due to scar tissue formation and the development of glaucoma. Glaucoma is an eye disease defined as progressive damage to the optic nerve. In cases of proliferative diabetic retinopathy, the cause of this nerve damage is due to extremely high pressure in the eye. If left untreated, proliferative diabetic retinopathy can cause severe vision loss and even blindness.

Risk factors for diabetic retinopathy

people with Type 1 or Type 2 diabetes are at risk for the development of diabetic retinopathy. The longer a person has diabetes, the more likely they are to develop diabetic retinopathy, particularly if the diabetes is poorly controlled.

Hispanic and African Americans are at greater risk for developing diabetic retinopathy.

Medical conditions:
persons with other medical conditions such as high blood pressure and high cholesterol are at greater risk.

pregnant women face a higher risk for developing diabetes and diabetic retinopathy. If gestational diabetes develops, the patient is at much higher risk of developing diabetes as they age

Symptoms of diabetic retinopathy

  • Seeing spots or floaters in your field of vision
  • Blurred vision
  • Having a dark or empty spot in the center of your vision
  • Difficulty seeing well at night.

Diagnosis of Diabetic Retinopathy

Diabetic retinopathy is best diagnosed with a dilated eye exam. For this exam, drops placed in your eyes widen (dilate) your pupils to allow your doctor to better view inside your eyes. The drops may cause your close vision to blur until they wear off, several hours later.

During the exam, your eye doctor will look for:

  • Abnormal blood vessels
  • Swelling, blood or fatty deposits in the retina
  • Growth of new blood vessels and scar tissue
  • Bleeding in the clear, jelly-like substance that fills the center of the eye (vitreous)
  • Retinal detachment
  • Abnormalities in your optic nerve.

Complications of Diabetic Retinopathy

Vitreous hemorrhage

The new blood vessels may bleed into the clear, jelly-like substance that fills the center of your eye. If the amount of bleeding is small, you might see only a few dark spots (floaters). In more-severe cases, blood can fill the vitreous cavity and completely block your vision

Vitreous hemorrhage by itself usually doesn't cause permanent vision loss. The blood often clears from the eye within a few weeks or months. Unless your retina is damaged, your vision may return to its previous clarity.

Retinal detachment

The abnormal blood vessels associated with diabetic retinopathy stimulate the growth of scar tissue, which can pull the retina away from the back of the eye. This may cause spots floating in your vision, flashes of light or severe vision loss.


New blood vessels may grow in the front part of your eye and interfere with the normal flow of fluid out of the eye, causing pressure in the eye to build up (glaucoma). This pressure can damage the nerve that carries images from your eye to your brain (optic nerve).


Eventually, diabetic retinopathy, glaucoma or both can lead to complete vision loss.

Prevention of Diabetic Retinopathy

If you have diabetes, reduce your risk of getting diabetic retinopathy by doing the following:

  • Manage your diabetes: Make healthy eating and physical activity part of your daily routine. Try to get at least 150 minutes of moderate aerobic activity, such as walking, each week. Take oral diabetes medications or insulin as directed.
  • Monitor your blood sugar level: You may need to check and record your blood sugar level several times a day — more-frequent measurements may be required if you're ill or under stress. Ask your doctor how often you need to test your blood sugar.
  • Ask your doctor about a glycosylated hemoglobin test: The glycosylated hemoglobin test, or hemoglobin A1C test, reflects your average blood sugar level for the two- to three-month period before the test. For most people, the A1C goal is to be under 7 percent.
  • Keep your blood pressure and cholesterol under control: Eating healthy foods, exercising regularly and losing excess weight can help. Sometimes medication is needed, too.
  • If you smoke or use other types of tobacco, ask your doctor to help you quit. Smoking increases your risk of various diabetes complications, including diabetic retinopathy.
  • Pay attention to vision changes: Contact your eye doctor right away if you experience sudden vision changes or your vision becomes blurry, spotty or hazy.

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