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Diabetic Retinopathy

© Alexandria Powell

What is diabetic retinopathy?
Diabetic retinopathy is a potentially blinding complication of diabetes that occurs when tiny blood vessels in the retina are damaged. It can occur in both type I and type II diabetes, and is actually more common in type I. However, because you can have type II diabetes for many years without knowing it, retinopathy is often present in type II patients at the time their diabetes is discovered.

The retina is a light-sensitive tissue found at the back of your eye. It translates light entering the eye into nerve signals, and then sends these signals on to your brain for interpretation. Without a properly functioning retina, your eye cannot communicate with your brain, and vision becomes impossible.

In the early stages of diabetic retinopathy, damaged blood vessels leak fluids and lipids, causing the retina to swell. Most of the eye damage during this stage is due to fluid and blood accumulating in the central part of the retina, and area known as the macula. The macula helps us to see detail, so when macular edema occurs, it blurs vision.

The advanced stage of the disease is called proliferative diabetic retinopathy. After many small vessels are destroyed and retinal tissue can no longer gain the nutrition it needs to function properly. New, abnormal blood vessels grow in the damaged tissue. This neovasculariztion, if not stopped in time, can lead to bleeding, scarring, retinal detachments, or glaucoma - all of which can cause decreased vision or blindness.

How do you know if you are developing retinopathy?
There are often no symptoms even when the disease is advanced enough to be vision threatening. The longer you have had diabetes, the more likely it is that you'll develop retinopathy. Your eye doctor can diagnose retinopathy by a dilated retinal examination. This should be performed at least once a year for all people with diabetes, and may be performed more often if there is some degree of retinopathy already present. The good news is, by getting treatment in time, 90% of people with advanced retinopathy can be saved from going blind.

Can diabetic retinopathy be avoided?
There are strategies that can help prevent diabetic retinopathy from developing. The most important is the careful control of blood glucose levels. Achieving tight control through diet, exercise, and sometimes medication can prevent a number of the complications of type II diabetes. Control of blood pressure is important too. Have your blood pressure checked frequently. Avoid smoking. Finally, have a dilated retinal examination at least once every 12 months.