Definition

Retinopathy is damage to the eye. It affects the thin layer of tissue in the back of the eye called the retina. Diabetic retinopathy is damage to the blood vessels in the retina caused by Type 1 or Type 2 diabetes.

There are 2 types of diabetic retinopathy:

  • Non-proliferative diabetic retinopathy—fluid from weakened blood vessels leak into the retina. It causes swelling and limits vision to area right in front of you.
  • Proliferative diabetic retinopathy—new blood vessels form in the retina and back of the eye. It can cause leaking and cloudy vision. I may also cause a detachment of the retina.
The Retina
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Causes

Diabetes causes high levels of glucose in the blood. Over time, this excess glucose can cause damage to small blood vessels throughout the body. The blood vessels in the retina are sensitive to this type of damage.

High glucose can also cause swelling and leaking in the blood vessels of the retina. Some vessels may close off. The damaged blood vessels may then be replaced with weaker blood vessels that also bleed into the eye or create scarring. The bleeding, swelling, and scarring build up and weaken or interfere with vision.

Risk Factors

Factors that may increase your risk of diabetic retinopathy include:

  • Being diagnosed with diabetes at a young age
  • Poorly-controlled diabetes
  • Elevated cholesterol levels
  • Pregnancy
  • Recent cataract surgery
  • High blood pressure

Symptoms

Early diabetic retinopathy may not cause any symptoms. Over time, diabetic retinopathy can cause:

  • Blurred or double vision
  • Reduction or loss of vision in one or both eyes
  • Dark spots or the appearance of floating objects in one or both eyes
  • Eye pressure or pain
  • Difficulty seeing in dim light
  • Seeing flashing lights or rings around lights
  • Sudden blindness (rare)

Diagnosis

You will be asked about your symptoms and past health. A physical exam will be done. You will be referred to an eye specialist. An eye exam and vision test will be done.

Images will be taken of your eye. This can be done with:

  • Fundus photography—an advanced digital photo of the retina
  • Optical coherence tomography—light waves are used to take pictures of the retina

Treatment

Early stages of the disease may not need treatment. However, it is important to manage of blood glucose, cholesterol levels, and blood pressure to slow or stop more damage. Your eye doctor will monitor your condition.

If treatment for the eye is needed, options include:

Medications

Medicine to reduce the damage to the eye may include:

  • Anti-vascular endothelial growth factor (Anti-VEGF)—injected into the eye to improve oxygen levels in the retina tissue
  • Steroid—injected into the eye to slow inflammation and damage

Surgery

Surgery may be needed to help slow or stop the progression of retinopathy. Options may include:

  • Laser treatment—to shrink abnormal blood vessels or to stop or slow leaks
  • Vitrectomy—blood vessels and/or scar tissue are removed from the middle of the eye and replaced with a clear solution

Prevention

To help reduce your chance of getting diabetic retinopathy:

  • Manage your diabetes.
  • Monitor your blood glucose levels.
  • Have regular blood glucose testing done as advised by your doctor.
  • Manage your blood pressure and cholesterol levels.
  • If you smoke, talk to your doctor about ways to quit. Smoking further damages blood vessels.
  • Have your eyes examined as advised by your eye specialist.

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