What are the Four Stages of Diabetic Retinopathy?
Diabetic retinopathy is a serious eye condition that can lead to permanent vision loss. The key to keeping your vision going strong is catching this early. 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.
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 higher risk for diabetic retinopathy is you have had diabetes for many years.
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. This is why it is important to know the different stages and their symptoms so that you may be able to catch it faster. As always however, any time you notice any changes to your vision or your eyes, you should make an appointment with your eye doctor to have things checked out.
What are the Four Stages of Diabetic Retinopathy?
Diabetic retinopathy progresses in four stages: Mild Nonproliferative, to Moderate Nonproliferative, to Severe Nonproliferative, and finally Proliferative Retinopathy. Each stage can have different warning signs, although they do build on one another.
Mild Nonproliferative Retinopathy:
This is the beginning stage. This is often the hardest to recognize as its symptoms are mild in nature. When you have mild nonproliferative retinopathy, you may start to notice your vision is blurry. This is from the swelling that can begin in the retina. The blood vessels in the retina can start to leak. They are very small and are very hard to notice without a microscope, therefore this is not visible to the naked eye.
Moderate Nonproliferative Retinopathy:
When you have moved to the second stage, you are at the moderate nonproliferative retinopathy stage. At this point, the blurriness usually becomes more apparent. Additionally, your may notice a reduction in your vision. A person with macular edema will usually experience some loss of vision. Macular edema is when this swelling occurs on the central part of the retina (the macula). Blood and fluid seem from the tiny leaks, and fatty material (called exudates) can deposit on the retina, causing swelling of the retina.
You may also notice partial vision loss that fluctuates and trouble seeing at night or other low light settings.
Severe Nonproliferative Retinopathy:
You guessed it, this is the third stage of diabetic retinopathy. By now, you have gone through the first two stages the blood vessels in your retina are blocked. This means no blood is getting into the retina, which is vital. At this point, you will definitely notice problems with your vision including blurriness, loss of sight, poor to little ability to see at night, and you could be seeing spots or floaters. These are all tell tale signs of diabetic retinopathy.
If each macula is severely damaged, 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 nonproliferative retinopathy can usually learn to use areas just outside the macula to see some detail and perform everyday tasks.
Proliferative Retinopathy:
This is the final stage. In proliferative retinopathy, 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.
How do you 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.
With diabetic retinopathy we currently do not have a simple fix to cure the damage however there are several ways to prevent your symptoms from getting even worse and our top priority is to protect your vision from complete loss.
