Stages of Retinopathy: Understanding Diabetic Eye Disease Progression
What is Diabetic Retinopathy?
Diabetic retinopathy is a condition where the blood vessels in and around your eyes are damaged by high blood sugar levels. Over time, the blood vessels in your eyes become clogged, weak and narrow, which hampers the blood and oxygen supply to your retina. Your eye starts forming newer blood vessels to restore blood supply, but they are usually very weak. This could lead to problems in your vision. It is a common complication in both Type 1 and Type 2 Diabetes. If left untreated, diabetic retinopathy could cause partial or complete blindness.
Diabetic Retinopathy: Symptoms You Should be Aware of
- Spotty vision
- Blurriness
- Floaters in the eye (where you see grainy or string-like particles drifting across your vision)
- Reduced field of vision
- Difficulty seeing colours
- Sudden loss of eyesight
If you experience any of these symptoms, consult a doctor immediately.
Types of Diabetic Retinopathy
Diabetic retinopathy is classified into two types based on the extent of damage done to the eye.
-
Nonproliferative Diabetic Retinopathy (NPDR)
This can also be called background or early diabetic retinopathy, and usually comprises the first three stages. The term ‘nonproliferative’ means that there isn’t yet any growth of new blood vessels in the eye. Symptoms, if any, are usually very mild and often go unnoticed. However, your ophthalmologist might notice changes in your eye upon examination.
-
Proliferative Diabetic Retinopathy (PDR)
This type is also called advanced diabetic retinopathy. It is characterised by the formation of new blood vessels in the eye that supply blood and oxygen to the retina and noticeable symptoms. As this is the last stage of diabetic retinopathy, the risk of partial or complete blindness is very high.
Stages of Diabetic Retinopathy
The progression of diabetic retinopathy can be divided into four stages. They are:
-
Mild Nonproliferative Retinopathy (Stage 1)
It is the earliest stage of retinopathy, the small and delicate blood vessels in your eyes are damaged by high sugar levels in your blood. This causes the walls of your blood vessels to weaken, swell or bulge like balloons at some points, forming microaneurysms.
-
Moderate Nonproliferative Retinopathy (Stage 2)
The damaged walls of the blood vessels start to become clogged and narrow due to cholesterol build-up, which can increase the pressure in the blood vessels and cause them to leak.
-
Severe Nonproliferative Retinopathy (Stage 3)
As the blood vessels in your eyes become more clogged, the blood and oxygen supply to your retina decreases. This can cause some changes in your retina, leading to problems in your vision.
-
Proliferative Diabetic Retinopathy (Stage 4)
When the existing blood vessels in your eyes become blocked, interrupting the blood supply to your retina, your body starts forming newer blood vessels in order to restore blood flow.
These new blood vessels are generally very fragile, which makes them leak easily.
This causes bleeding in your eyes, which can cloud your vision. Also, the loss of blood supply to your retina can cause it to develop scarring.
If the scar tissue shrinks, it can end up pulling the retina away from blood vessels and supportive tissue, resulting in retinal detachment.
Diagnosing the Stage of Diabetic Retinopathy
Every stage of diabetic retinopathy has different physiological characteristics which can help identify the progression of your condition. Your ophthalmologist will perform a comprehensive dilated eye examination to get a better look at your eyes in order to make a diagnosis.
How is Diabetic Retinopathy Treated?
Diabetic retinopathy can be treated with
-
Injections:
Drugs are injected into your eye in order to reduce swelling and prevent or slow down the formation of new blood vessels.
-
Laser treatment:
A laser is used to cauterize the blood vessels that are leaking fluid.
-
Eye surgery:
Surgery is performed to remove cloudy fluid, scar tissue, or weak new blood vessels.
You can read more about the treatments available for diabetic retinopathy here.
Can Diabetic Retinopathy be Reversed?
Diabetic retinopathy cannot be reversed, but it can be stopped or slowed down with treatment. Managing your blood sugar, cholesterol, and blood pressure can prevent the worsening of retinopathy.
Don’t Have Time To Read?
- Persistently high blood sugar levels can damage the blood vessels in your eye, which can cause them to become clogged and narrow. This is called Diabetic Retinopathy.
- This narrowing of blood vessels could decrease blood and oxygen supply to your retinas, leading to retinal damage and vision problems.
- Symptoms of diabetic retinopathy include spots in your vision, floaters, blurred or reduced field of vision, problem seeing colours, and sudden blindness.
- Diabetic retinopathy can be classified into two types based on the symptoms and progression, called Nonproliferative Diabetic Retinopathy (NPDR) and Proliferative Diabetic Retinopathy (PDR).
- The progression of this condition can be divided into 4 stages based on the extent of damage in the eye, called Mild NPDR, Moderate NPDR, Severe NPDR, and PDR.
- Your ophthalmologist can diagnose the stage of diabetic retinopathy you may have by performing a comprehensive dilated eye examination.
- Diabetic retinopathy can be treated with anti-VEGF injections, focal/grid macular laser surgery, corticosteroids, scatter laser surgery, and vitrectomy.
- Diabetic retinopathy cannot be reversed, but its progression can be slowed down or stopped with treatment and better blood sugar control.
Frequently Asked Questions
Can you stop diabetic retinopathy from progressing?
If caught early, you can stop diabetic retinopathy from progressing by seeking treatment, getting regular eye checkups, and by controlling your blood sugar, cholesterol and blood pressure.
What worsens diabetic retinopathy?
Uncontrolled high blood sugar and cholesterol levels along with high blood pressure can make diabetic retinopathy worse.
How can I reverse retinopathy naturally?
Though retinopathy cannot be reversed, its progression can be stopped through treatment and controlling your blood sugar, cholesterol and blood pressure levels. You can control your blood sugar, cholesterol and blood pressure levels naturally with the following measures:
- Eat a balanced diet with more vegetables and fruits
- Cut down on added sugars, salt, and saturated fats
- Get at least 30 minutes of exercise every day
- Lose extra weight
- Quit smoking
- Limit or avoid alcohol consumption
How long does it take for diabetic retinopathy to progress?
The time taken for diabetics to develop retinopathy depends on their blood sugar control. It takes less than 5 years for untreated high blood sugar levels to start affecting your eyes. According to several studies, a majority of both Type 1 and Type 2 diabetics develop some form of retinopathy within 15 years of developing diabetes