Diabetic Retinopathy

Lama L. Jurdy, M.D.
Oculoplastic, Lacrimal and Orbital Surgeon, CMC

Diabetic retinopathy is a condition caused by changes that affect the vessels of the retina. Such changes can be severe enough to affect nerve cells and subsequently cause visual impairment. Diabetic retinopathy is the most common eye disease secondary to diabetes mellitus and is one of the leading causes of blindness.

What are the symptoms of diabetic retinopathy?

Diabetics affected by diabetic retinopathy may be asymptomatic (early on), or may present with symptoms such as blurred vision, sudden visual loss (usually in one eye), seeing rings around lights, or seeing dark spots or flashes of light.

What are the causes of diabetic retinopathy?

The longevity of the diabetes and untreated diabetes are risk factors for blindness secondary to diabetes. However, with regular eye exams and treatment by a specialist when necessary, the incidence of severe loss of vision is much reduced.

How can diabetic retinopathy cause visual loss?

Diabetic retinopathy can cause visual loss in one of two ways.

Visual loss can be caused by diabetic macular edema. This is a condition secondary to damage to retinal vessels which results in leakage from said vessels. This causes swelling in the macula, which is the central part of the retina, and leads to reduction in visual acuity.

Visual loss can also be caused by proliferative retinopathy and vitreous hemorrhage. What does this mean? With lack of good blood supply to the retina secondary to diabetes, the retina starts forming new vessels as a way to compensate. These vessels are abnormal and may cause multiple problems such as bleeding, scarring, retinal detachment and increased intraocular pressure.

What are the risk factors?

The risk of developing diabetic retinopathy increases when the diabetes is poorly controlled and/or is of long duration, as well as in the presence of sleep apnea, hypertension and elevated cholesterol levels.

How is diabetic retinopathy treated?

This depends on the findings on eye exam, and varies from simple observation, injections in the eyes, laser treatment, surgical treatment, or a combination of treatments.

What is the take home message?

Among people with diabetes, diabetic retinopathy is the most common cause of visual loss. This can be prevented by regular follow up with an endocrinologist and an ophthalmologist. Since diabetic retinopathy may be present and still go unnoticed by the patient until visual loss occurs, diabetics should make sure to have a comprehensive eye exam at least once a year. Appropriate follow-up, detection and early treatment can protect against loss of vision.

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