What is Diabetic Retinopathy: Causes, Symptoms, Stages, and Treatments
We all know that diabetes can be bad for heart and kidney health, but were you aware that it can affect your eyes too? Diabetic retinopathy is a common complication of both Type 1 and Type 2 Diabetes, and can cause changes in your vision.
This article helps you understand the symptoms and causes of this condition, which can be the key to stopping its progression and preserving your eyesight.
What is Diabetic Retinopathy?
Diabetic retinopathy is a common complication of Type 1 Diabetes and Type 2 Diabetes. It occurs when the small and delicate blood vessels supplying oxygen and blood to your retina become damaged due to persistent high blood sugar levels. The retina is a layer of membrane that is present at the back of your eye. It helps detect light and sends signals to your brain through the optic nerve to form images.
When the blood vessels in your eye are damaged, nourishment to the retina is cut off. This causes structural changes in the retina and your eye leading to symptoms like blurred vision, spots, floaters, etc. If left untreated or not addressed early, this can result in partial or complete blindness.
Diabetic Retinopathy: Signs and Symptoms
The following are the symptoms of Diabetic Retinopathy:
- Spotty vision
- Blurriness
- Floaters in the eye (where you see grainy or string-like particles drifting across your vision)
- Reduced or darkening field of vision
- Difficulty seeing colors
- Sudden loss of eyesight
If you experience any of these symptoms, consult a doctor immediately.
Stages of Diabetic Retinopathy
Diabetic retinopathy can be divided into 4 stages based on the progression of the condition and the presence of certain physical characteristics. They are:
- Stage 1- Mild Nonproliferative Retinopathy
- Stage 2- Moderate Nonproliferative Retinopathy
- Stage 3-Severe Nonproliferative Retinopathy
- Stage 4- Proliferative Diabetic Retinopathy (PDR)
Stages 1 to 3 together are called early or background diabetic retinopathy. Symptoms, if any, are usually very mild and often go unnoticed. However, your ophthalmologist might notice changes in your eye upon examination.
Stage 4 is called advanced diabetic retinopathy and is characterized by the formation and presence of new and fragile blood vessels in the eye. Symptoms are present and noticeable, and the risk of complications is very high.
You can read more about the stages of diabetic retinopathy here.
Causes of Diabetic Retinopathy
Diabetic retinopathy is caused by long-term high blood sugar levels, which are a result of untreated or undiagnosed diabetes. The excess sugar in your blood can damage the inner lining of the walls of your blood vessels, which become clogged and narrow over time. This can hamper the blood and oxygen supply to your retina, leading to vision problems.
Diagnosis and Testing for Diabetic Retinopathy
Diabetic retinopathy can be diagnosed by your ophthalmologist with a simple test. Your doctor will perform a comprehensive dilated eye exam to look for any structural abnormalities or changes in your eye.
Other tests include a Fluorescein Angiography, where a dye is injected into your veins in order to look for blocked or leaking blood vessels in your eyes, and Optical Coherence Tomography (OCT) which is used to take cross-sectional images of your retina to check for retinal thickness and fluid leakage.
Complications of Diabetic Retinopathy
Untreated diabetic retinopathy can lead to several complications like:
Diabetic Macular Edema (DME):
Macula is the part of your retina that is responsible for sharper vision. When the blood vessels in your eyes become damaged and weak, they start leaking fluid and blood into your macula and retina. This can obstruct the light from reaching your macula, leading to blurred and double vision.
Vitreous hemorrhage:
The vitreous humor is a clear, gel-like substance present between the lens and retina in your eye. When your blood vessels start leaking, it can fill your vitreous humor with fluid or blood which can cause floaters, blurriness, spotty vision, or temporary loss of vision.
Retinal detachment:
When your retina does not get sufficient blood or oxygen from the damaged blood vessels, it starts forming newer blood vessels that are weak and fragile. This abnormal growth can cause scarring. Contraction of the scar tissue can cause your retina to detach from the surrounding tissues and blood vessels. This could result in dark spots, bright flashes of light, or loss of vision.
Glaucoma:
The newer blood vessels formed around the retina can obstruct the draining of fluid in your eye, leading to pressure build-up. This pressure can damage the optic nerve, which can cause blindness.
Blindness:
Several of the above complications could lead to permanent loss of eyesight if left untreated.
Treatments For Diabetic Retinopathy
The treatment for diabetic retinopathy depends on the severity of your symptoms and the stage of retinopathy. Early diabetic retinopathy can be managed with regular eye exams and good blood sugar control. Later stages of diabetic retinopathy may need medical intervention.
Anti-VEGF injection therapy
Drugs that inhibit Vascular Endothelial Growth Factor (VEGF) are injected into your eyes, which prevents the formation of new blood vessels and also stops the leaking of fluid and blood.
Focal/grid macular laser surgery
Your ophthalmologist will use lasers to cauterize the blood vessels that are leaking into your macula. This prevents further leakage and allows the excess fluid in your macula to drain or get reabsorbed, which restores normal vision.
Corticosteroids
When injected into the vitreous humor, corticosteroids lower inflammation and reduce the swelling in the macula.
Scatter laser surgery
Scatter laser treatment, also known as pan-retinal photocoagulation, helps slow down or stop the growth of new blood vessels in your eye. Your ophthalmologist will use lasers to prevent fluid leakage around your retina and reduce the swelling in your eyes.
Vitrectomy
During this procedure, your surgeon removes the gel-like vitreous humor in your eye and replaces it with a saline solution. Vitrectomy helps remove the scar tissue and cloudy fluid that affect your vision.
Risk Factors for Diabetic Retinopathy
The following factors can increase your risk of developing diabetic retinopathy:
- Having Type 1, Type 2 or Gestational Diabetes
- Long-term uncontrolled high blood sugar levels
- High blood cholesterol levels
- High blood pressure or hypertension
- Smoking
Prevention of Diabetic Retinopathy
Diabetic retinopathy has no cure, but is easy to prevent. The following measures can lower your risk of developing retinopathy:
- Get regular eye check-ups (at least twice a year if you have diabetes)
- Keep your blood sugar levels in control
- Manage your blood pressure and blood cholesterol levels
- Monitor your HbA1c, cholesterol, and blood pressure levels frequently
- Quit smoking
- Limit the consumption of alcohol
- Eat a healthy, well-balanced diet
- Exercise regularly
- Make note of any changes in your vision
Don’t Have Time To Read?
- Diabetic retinopathy is a condition in which the blood vessels connected to your eye are damaged by high blood sugar levels.
- It is a common complication and affects the majority of people with Type 1 or Type 2 diabetes.
- Symptoms of diabetic retinopathy include spots in your vision, floaters, blurred or reduced field of vision, problem seeing colors, and sudden blindness.
- Diabetic retinopathy can be classified into four stages based on the progression, called Mild, Moderate, and Severe Nonproliferative Diabetic Retinopathy and Proliferative Diabetic Retinopathy.
- Diabetic retinopathy is caused by long-term damage to the lining of blood vessels in the eye, which causes them to become blocked and narrow.
- Your ophthalmologist can diagnose diabetic retinopathy by performing a comprehensive dilated eye exam, fluorescein angiography, and optical coherence tomography (OCT).
- Diabetic retinopathy can cause complications like diabetic macular edema (DME), vitreous hemorrhage, retinal detachment, glaucoma, and blindness.
- Treatment for this condition includes injections, laser treatment, and surgery.
- Risk factors of diabetic retinopathy include long-term diabetes, hypertension, high cholesterol levels, smoking, etc.
- Diabetic retinopathy can be prevented with good blood sugar, cholesterol and blood pressure control, getting regular eye exams, adopting a healthy diet and lifestyle, etc.
Also Read: Diabetic Retinopathy Stages
Friendly Asked Questions
Can diabetic retinopathy go away?
Diabetic retinopathy is a lifelong condition that cannot be cured. It can be prevented or managed with treatment and good blood sugar control.
How does diabetic retinopathy occur?
Diabetic retinopathy occurs when high blood sugar levels damage the inner linings of the blood vessels in your eye which cause them to become clogged and narrow.
Can lowering blood sugar improve vision?
Yes, lowering your blood sugar levels and maintaining good glycaemic control can prevent damage to your retina and improve your vision in the early stages of diabetic retinopathy.
Can retinopathy be cured?
No, diabetic retinopathy is a lifelong condition that cannot be cured. However, it can be managed effectively to prevent progression of eye damage.
How long does it take to go blind from diabetes?
The time taken for diabetic retinopathy to progress to complete loss of vision varies from person to person. However, most people develop symptoms of advanced retinopathy within 15 to 20 years of developing diabetes.
Can metformin affect eyesight?
Metformin does not directly affect eyesight, but in rare cases, it can cause complications like hypoglycaemia (low blood sugar levels), or Metformin-associated Lactic Acidosis (MALA, which happens when your kidneys cannot eliminate metformin, and it accumulates in your body) can cause blurred vision, dark spots in your vision, or temporary loss of eyesight.
Does metformin improve eyesight?
Use of metformin can improve blood sugar control, which can prevent or slow the progression of diabetic retinopathy and preserve your eyesight.
