Diabetic Retinopathy - FAQs

What is retina?
Retina is the sensitive part of the eye which sees and conveys images to brain for analysis. The eye can be compared with a camera. The cornea and lens together act as focusing mechanism to focus just as there is lens for the camera. The retina is akin to film of camera which records the images.
 
What is diabetic retinopathy and how it happens?
Diabetic retinopathy is the complication of diabetes that affects the retina. Diabetes primarily affects the blood vessels all over body and same happens in the retina as well. Retina has tiny blood vessels that are easy to damage. Having high blood glucose for a long time can damage these tiny blood vessels. It causes blood vessels to weaken, bulge and leak fluid into surrounding tissue, causing swelling - a condition called macular edema. Some blood vessels then become clogged and do not let enough blood through.Because the blood vessels are no longer delivering the proper amount of nutrients to the retina, more vessels grow on the retina in an attempt to restore blood flow. This is akin to new twigs growing out from a tree when a branch of the tree is cut. These new blood vessels are also weak and inadequate, making them prone to leakage and breaking.They can bleed into the eye and block vision.After some time, these vessels may contract and pull the retina along with them causing a so called tractional retinal detachment.
 
Who's at the most risk for diabetic retinopathy?
All diabetics are at risk for developing diabetic retinopathy.Fluctuating and uncontrolled blood sugar levels lead to an increased risk of this disease.Long duration of the diabetes also increase risk. Most people don't develop diabetic retinopathy until they've had diabetes for at least 10 years. High blood pressure, high cholesterol, and pregnancy can all place a patient at greater risk of suffering from the eye disease. Diabetics can minimize their risk by controlling their blood sugar and by having their eyes examined by a qualified ophthalmologist at least once a year.
 
Is there any way to prevent diabetic retinopathy?
There is no absolute way to prevent it. However, keeping your blood sugar at an even level can help prevent or minimize diabetic retinopathy. If you have high blood pressure, keeping that under control is helpful as well. Even controlled diabetes can lead to diabetic retinopathy, so you should have your eyes examined once a year; that way, your doctor can begin treating any retinal damage as soon as possible. You can prevent vision threatening complications if treated early enough.
 
What are the symptoms of diabetic retinopathy?
In the early stages,there may not be any symptoms of diabetic retinopathy.That is why it is imperative that diabetics have their eyes examined by an ophthalmologist annually.
Later symptoms of diabetic retinopathy include cloudy vision and blurred vision.You may develop blind spots or floaters as well.
 
Why there is reduction in vision in diabetic retinopathy?
Reduction in vision occurs due to either a macular edema/ischemia or due to complications of proliferative retinopathy i.e. vitreous hemorrhage & tractional retinal detachment.
 
How is diabetic retinopathy diagnosed?
Early signs of diabetic retinopathy can be detected with a routine eye exam. Getting an early diabetic retinopathy diagnosis will help delay progression of the disease and allow you to seek effective treatment sooner. Examination requires pupil dilation which is done by placing special eye drops into the patient’s eye. These drops dilate the pupil and make it wide; allowing the ophthalmologist to check the retina.
 
Why a fluorescein angiography is required?
Fluorescein angiography is an examination in which a dye is injected intravenously and as the dye travels through the blood-stream & passes into the blood vessels of the retina,photographs of the retina are taken rapidly.It reveals the status of blood flow in the retina. It shows the leaking vessels so that they can be treated and closed. It helps to see the clogged vessels and extent of the clogging which is not seen by naked eye. It also show formation of abnormal new vessels on retina. It can also shows the blood supply to center of retina called macula, to determine if that is causing visual loss. All this information is required for further treatment.
 
What are the different types of diabetic retinopathy?
Diabetic retinopathy is classified as either nonproliferative (background) or proliferative. Nonproliferative retinopathy is the early stage, where small retinal blood vessels break and leak. In proliferative retinopathy, new blood vessels grow abnormally within the retina. This new growth later on contract causing tractional retinal detachment, which can lead to vision loss. The new blood vessels may also grow or bleed into the vitreous humor, the transparent gel filling the eyeball in front of the retina. After some time, these vessels may contract and pull the retina along with them causing a tractional retinal detachment leading to loss of vision. Proliferative retinopathy is much more serious than the nonproliferative form and can lead to total blindness.
 
What is the treatment?
The treatment depends on what type of retinopathy one is having and whether macular edema is present or not. There are 3 types of treatment Laser Photocoagulation, Diabetic Macular Edema and Vitrectomy Surgery.
Laser Photocoagulation Diabetic Macular Edema Vitrectomy Surgery