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Diabetic Retinopathy

In diabetic retinopathy the blood vessels of the retina become abnormal and develop tiny leaks, causing fluid or blood to seep into the retina, especially the macula. When fluid accumulates in the macula, it becomes wet and swollen and cannot work properly. This is called macular edema, which causes the central vision to become blurry.

The form of diabetic retinopathy caused by leakage of retinal blood vessels is called nonproliferative diabetic retinopathy (NPDR). Another problem with retinal blood vessels in diabetes is that they can become blocked. If the retinal tissue no longer receives nutrition from the retinal blood vessels, it will stop working properly. The areas of the retina with obstructed blood vessels will foster the growth of abnormal new blood vessels, a process called neovascularization. Neovascularization can cause bleeding and scar tissue that may result in severe loss of vision, or even blindness. The form of diabetic retinopathy in which neovascularization develops is called proliferative diabetic retinopathy (PDR). Both forms of the eye condition can occur together in an eye.

 

Symptoms

Though vision may gradually become blurred, significant loss of sight does not usually occur with non-proliferative retinopathy. Since the patient does not experience pain or external symptoms such as bloodshot eyes or discharge, changes in the retina can go unnoticed unless detected by an eye exam. When bleeding occurs in proliferative retinopathy, the patient has clouding or complete loss of sight. Connective tissue pulling on the retina causes distortion and blurring. However, if abnormalities occur in the peripheral retina, the patient may not experience any symptoms.

Nonproliferative

In diabetes, the retinal blood vessels can become damaged and develop tiny leaks. This is called nonproliferative diabetic retinopathy (NPDR). Blood and fluid seem from the tiny leaks, and fatty material (called exudates) can deposit on the retina, causing swelling of the retina. When this swelling occurs on the central part of the retina (the macula), it is called macular edema and vision will be reduced or blurred. A person with macular edema will usually experience some loss of vision. If one eye is affected, the other eye is also frequently affected. And if each macula is severely disturbed, central vision may be lost from each eye. Even if the ability to see detail has been lost from both eyes, a person with severe NPDR can usually learn to use areas just outside the macula to see some detail and perform everyday tasks. Early detection is a person’s best chance of saving their eyesight with laser surgery. Once the macula has been damaged, laser surgery is generally not helpful. For this reason, people with diabetes should test the vision of each eye, every day. One way to test vision is with the Amsler Grid.

Proliferative

In PDR, large areas of the retinal blood vessels become obstructed causing the retina to lose its source of nutrients. When this happens, peripheral vision is often reduced and the person’s ability to see at night or adjust their site to changes in lighting is often diminished. The retina will develop new, abnormal blood vessels in an attempt to compensate for its loss of nourishment. This is called neovascularization, and it is very dangerous to the eye. Neovascularization does not nourish the retina properly, and may cause other problems such as bleeding into the vitreous cavity (called vitreous hemorrhage) or the growth of scar tissue on the retina, which can pull the retina off the back wall of the eye (called traction retinal detachment). Either of these severe problems, vitreous hemorrhage or traction retinal detachment, can lead to severe loss of vision or total blindness.

Frequently Asked Questions

 

What is Diabetic Retinopathy?

Diabetic retinopathy is a serious medical condition that can lead to loss of vision. At Perich Eye Center we care for many people with this condition with some of the best, most cutting edge technology.

What causes Diabetic Retinopathy?

Diabetic retinopathy is caused by microscopic damage to the retinal blood vessels, causing them to become leaky. People with both type 1 and type 2 diabetes are both at risk for developing diabetic retinopathy. One of the main contributing factors to developing diabetic retinopathy is uncontrolled blood sugar that leads to increased damage to the retinal blood vessels.

You may be at a higher risk for diabetic retinopathy if:

-You’ve had diabetes for many years

-You are Hispanic or African-American

-You have other medical conditions

-You are pregnant

How do I recognize the symptoms of Diabetic Retinopathy?

Please let us know if you are having any of the following symptoms: vision fluctuations, blurred vision, poor to little ability to see at night, and seeing spots or floaters. These are all tell tale symptoms of diabetic retinopathy. If you have diabetes, we recommend getting a dilated eye exam at least once a year to look for signs of diabetic retinopathy or other vision problems, even if you aren’t currently experiencing any symptoms. If you are diabetic and are considering getting pregnant, please make an appointment with us to establish a baseline for your care.

How to treat Diabetic Retinopathy?

Your treatment will depend on the severity of your diabetic retinopathy. If you have only minor damage to your blood vessels, we will care for you with regular monitoring and managing of your diabetes through diet and exercise. Early detection is often the best way of protecting your eyes from serious damage.

If your diabetic retinopathy is more advanced, a laser procedure at our center may be recommended. During your surgery one of our doctors will use photocoagulation to seal leaking blood vessels and prevent further tissue damage.

Other cases may require an intraocular surgery called a vitrectomy. This procedure involves the removal of the vitreous, a gel-like fluid inside the eye. Saline liquid, or a gas or silicone oil bubble, will be used to replace this fluid and stabilize pressure in the eye.

There is currently no simple “quick fix” cure for diabetic retinopathy, but there are several ways to prevent a worsening of your symptoms and protect your vision.

Consultation Centers

 

New Port Richey

 

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Tampa

 

The Villages

 

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Zephyrhills

 

Improve your vision, contact us today.

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