Diabetic Retinopathy

Although diabetes is a systemic disease, this disorder can cause eye problems in the natural lens, eye muscles, iris, retina, and other structures of the eye.  Diabetes causes progressive retinal changes due to the deterioration or damage of the small blood vessels which supply the eyes with oxygen and nourishment.

Signs and symptoms of diabetes include: increased thirst, frequent urination, weight loss, and lack of energy.  These typical symptoms of diabetes are often ignored or thought to be associated with other ailments.  As a result it may be years before the condition is diagnosed.  The longer a person is diabetic, the greater the risk of damage to the eyes.  If undetected, diabetes can lead to blindness.  Most patients with diabetes will experience some eye complication, but only a small percentage will develop severe vision loss when the disease is well-managed.

Damage to the small blood vessels is classified into two general categories: nonproliferative diabetic retinopathy and proliferative diabetic retinopathy.

In nonproliferative diabetic retinopathy, the retinal changes are ranked according to their severity and include microaneurysms (tiny outpouching of blood vessels), dot hemorrhages (pinpoint areas of bleeding in the retina), cotton-wool spots (areas of infarction or loss of blood flow to areas of the retina), venous beading (causing the normally smooth wall of the retinal blood vessels to look bumpy), and macular edema (swelling of the macula).  Macular edema is the most common cause of visual impairment in patients with diabetic retinopathy. Only a small part of the retina, the macula is responsible for our fine, central vision. If left untreated, many of these changes can cause irreversible damage to the eyes.  Close monitoring for changes is important.  Laser procedures can be performed to help keep vision from getting worse.

In proliferative diabetic retinopathy, new vessel begin to form in the retina.  This neovascularization is believed to be in response to the lack of oxygen.  The eye, in its own way, tries to reroute the blood flow.  These new vessels however are not “normal.” The vessels tend to be tiny and can grow in a haphazard pattern or break causing further problems from bleeding.  Laser treatment on the retina may help prevent further outbreak of new vessels, but the laser treatment for this type of retinopathy can be much more extensive and require several treatments.

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