Diabetes has always been known to cause quite a few complications if not managed in time. An unmanaged and uncontrolled diabetes tends to affect the eye, liver, kidney and more in the long run. As such, we will be looking into one such complication arising out of diabetes for our today’s entry as part of our informative series on diabetes. We’ll be having a keen look into the Diabetic Retinopathy and shall deal with its causes, symptoms and the treatment module for it.
Diabetic eye problems are closely related as unmanaged diabetes will give way to a host of eye disorders. Diabetic is known to cause different eye related issues often known by as the diabetic eye disease. An untreated instance of such diabetic eye disease can cause complication, in the long run, even pertaining to blindness on some cases.
The most common of the eye problem as a result of diabetes is the diabetic retinopathy which affects the retina of the eye. Diabetic retinopathy when untreated for long can cause diabetic macular edema further on.
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How Does Diabetes Affect the Eye and the Vision?
Diabetes causes a rise in the blood glucose levels and in the blood pressure levels. Such elevated levels of blood glucose cause the nerves of the retina to get affected. As when the nerves of the retina are affected along, blood vessels may cause leaks with floating spots around. This, in turn, leads to affecting the vision of the eye.
Furthermore, such effect of the blood glucose levels causes the optic nerve, the nerve which transports the light to the brain of which it creates an image for us gets damaged. That in itself affects the vision of the eye and may lead to impairment or hemorrhage.
What is Diabetic Eye Disease?
Diabetic Eye Disease refers to a group of eye-related issues seen by in people suffering from diabetes. There are four sub-types of the diabetic eye disease which we’ll discuss briefly on down below.
The most popular diabetic eye diseases are:
Diabetic Retinopathy: The first and foremost of diabetic eye disease around, Diabetic Retinopathy revolves around the blood vessels of retina being affected. This one is the most common of diabetic eye disease around. It can lead to vision impairment or blindness in the long run.
Diabetic Macular Edema (DME): This one is rather a consequence of diabetic retinopathy as almost more than half of diabetic retinopathy cases develop DME later on. DME is a case where the macula area of the retina swells. Here the fluid builds up in the macula and causes it to swell. Such instance will affect a person’s reading, driving, and more activities.
Cataract: Although cataract is something which is seen in people regardless of the diabetes factor, a diabetic patient is more prone to developing cataract earlier than others. Cataract causes the clouding of the eye’s lens in a person. As for the stats, diabetic patients are around 2-5 times at risk than the normal ones.
Glaucoma: This one refers to the case where the eye’s optic nerve is damaged. Glaucoma is actually a group of diseases and sees the bundle of nerves connecting the eye to the brain damaged. Glaucoma cases are twice as likely to develop in diabetic patients than the rest.
What is Diabetic Retinopathy?
Diabetic Retinopathy as aforementioned above is the most common of the diabetic eye disease. It is caused as a result of unmanaged blood sugar levels and blood pressure levels in the long run. Diabetic Retinopathy can further cause a loss of vision or even blindness in some instance.
During diabetic retinopathy, the blood vessels of the retina region are damaged and leak blood and further causing the growth of fragile new vessels. These blood vessels when damaged for can cause vision impairment in a person.
It is further divided into three sub-divisions as:
- Background Retinopathy
- Diabetic Maculopathy
- Proliferative Retinopathy
What are Diabetic Retinopathy Stages?
The eye disease actually progresses through four different stages. The following is the list of the stages:
Mild Non-Proliferative Retinopathy: This is caused as there are small swellings which develop around the blood vessels of the retina. These are also known as microaneurysms and they are responsible for releasing fluid into the retina.
Moderate Non-Proliferative Retinopathy: The second stage is caused when the blood vessels which are responsible for carrying blood into the retina of the eyes get damaged. the condition takes place when there is an interruption in the smooth transportation and flow of blood.
Severe Non-Proliferative Retinopathy: This is the stage where the majority of blood vessels that are responsible for carrying blood into the retina are completely destroyed. As such, there is a need of newblood vessels.
Proliferative Diabetic Retinopathy: This is the most progressive stage in diabetic retinopathy. In this stage, there are new blood vessels which grow inside the surface of the retina and also along the fluid that fills our eye. These new blood vessels are not as strong and they break really easily. Now, in this case, there can be retinal detachment which ultimately leads to blindness.
What are the Causes of Diabetic Retinopathy?
As in the case of a diabetic patient, high blood sugar levels are a common theme around. These high blood sugar levels cause the tiny blood vessels of the retina to damage which leads to vision impairment. The retina is what helps detect the light and send the message to the brain so that we see the image ahead of us.
It starts off with the leaking of fluid or hemorrhage which further develops into abnormal blood vessel proliferation. In the end, this affects the cells of the retina and causes obstruction in vision. Diabetic retinopathy starts off from the mild stage and continues along to the moderate and severe stage. In the end, the proliferative stage occurs, which is the most advanced stage of the diabetic retinopathy.
What are the Symptoms of Diabetic Retinopathy?
Diabetic retinopathy doesn’t show any symptoms in the initial stage and often goes unnoticed for long until the vision is affected. With the progress in the diabetic retinopathy, small floating spots may appear as a result of bleeding from the abnormal retina blood vessels.
Diabetic Macular Edema (DME), a consequence of diabetic retinopathy generally shows swelling in the macular region and prompt bleeding. A block in the vision is also a symptom of the case.
Here’s what the major symptoms of diabetic retinopathy look like:
- Blurred vision or changes in vision.
- Floating spots in the eye
- Double vision
- Pain in the eye region
Risk Factors for Diabetic Retinopathy
There are quite a few risk factors involving the diabetic eye disease which we’ll mention with a list down below.
- A poor control of diabetes.
- High blood sugar levels
- High blood pressure levels
- Persistent diabetes for a long haul.
- Sleep apnea.
- High blood cholesterol levels.
Diagnosis Procedure for Diabetic Retinopathy
Diabetic Retinopathy is generally diagnosed by a medical advisor with comprehensive dilated eye test where the doctor shall check for:
- Change in blood vessels of the eye region.
- Leaks or fatty deposits in the blood vessels of the eyes.
- Macula swelling for DME
- Any damage to the nerve tissue.
The dilated eye test includes different examinations related to the eye like
- Visual Acuity Testing (Eye chart test)
- Tonometry (Pressure inside the eye)
- Pupil Dilation (To examine the retina and optic nerve)
- Optical Coherence Tomography (OCT)
Furthermore, in cases of severe diabetic retinopathy or emergence of DME, Fluoresce in Angiogram is done to check the damage in the blood vessels.
How Does Diabetes Cause Blindness?
Diabetes starts off by elevating the blood glucose levels which affects the nerves of the retina. It causes the blood vessels of the retina region to cause leaks and bleeding. Such leaks affect the retina and the optic nerve which in turn leads to vision impairment like blurriness, or hemorrhage. In the long run, it leads to blindness.
In fact, diabetes gives rise to many diabetic eye diseases like diabetic retinopathy, diabetic macular edema and more. These eye diseases are known to cause blindness and vision impairment in the patients.
Treatment Procedure for Diabetic Eye Diseases:
There are a number of treatment procedures available for diabetic retinopathy and DME. We’ll look to deal with these treatment procedures in brief down below. Read along
Anti-VEGF Injection: This involves the injection of Anti-VEGF drugs into the vitreous gel to help block the vascular endothelial growth factor also known by as VEGF. VEGF is what stimulates the growth of the abnormal blood vessels in the retina region.
Such injection helps to reverse the abnormal growth of blood vessels in the eye and helps treat the condition. As of the norm, such injections are generally required at regular interval for the first six months of the treatment after which such injections are less required.
Surgery for Diabetic Retinopathy:
Following are a few surgical procedures which are performed in order to treat the problem of diabetic retinopathy in diabetic patients:
Focal/Grid Macular Laser Surgery or Scatter Laser Surgery: In this treatment method, small laser burns are made in the blood vessels to help slow the leak of fluid in the macular region. That helps keep the swelling in the retina down. Normally the treatment is completed within one session, but in some cases, one may require an additional session of it.
Vitrectomy: Vitrectomy involves surgical removal of the vitreous gel present in the center region of the eye. It is used to treat the severe bleeding in the vitreous and requires anesthesia to help curb the pain during the procedure. It is often done in the advanced proliferative diabetic retinopathy cases.
Corticosteroids: This one is generally used to treat the DME cases and requires either injection or implant of the corticosteroids into the eye. The implants are biodegradable and help suppress the DME symptoms.
Is Diabetic Retinopathy Reversible?
A curb on the diabetic symptoms and signs may help a long way in preventing and even reversing oneself from getting affected with the diabetic eye disease. We’ll mention a few preventive steps for it in a list down below. Go on.
- Management of blood glucose levels.
- Regular blood checkups.
- Regular cholesterol checkups.
- A dilated eye examination at a timely interval of a year.
- Testing the urine for ketone levels at regular intervals.
- Avoiding indulgence on alcohol and tobacco.
- You should go and see the ophthalmologist on a regular basis for eye exams and check-up.
Diabetic eye diseases are a cause of uncontrolled diabetes. It’s safe to say that a proper management of diabetic signs will lead to a better life ahead. If not, such complications like the diabetic eye disease can result in.Diabetic eye diseases are not something to be messed around with. It is known to cause vision impairment and more even leading to blindness in many cases. We advise you to seek the services of a medical doctor to help you around if you’re suffering from it. Don’t let the disease get by to you. Treat it in time and you’d be good for a long time.
That’s all from us on this one. We’ll be back with another one the next time. Till then, stay safe and stay healthy.