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Diabetic Retinopathy

What is diabetic retinopathy?

Diabetic retinopathy is a leading cause of blindness in American adults. It’s caused by changes in the blood vessels of the retina, the light sensitive layer of tissue at the back of the inner eye. In some people, retinal blood vessels may swell and leak fluid. In others, abnormal new blood vessels grow on the surface of the retina. These changes may result in vision loss or blindness.

While you can’t completely avoid diabetic retinopathy, you can reduce your risk of developing it. Better control of blood sugar slows the onset and progression of retinopathy and lessens the need for laser surgery for severe retinopathy.

Diabetic eye disease refers to a group of eye problems that people with diabetes may face. All can cause severe vision loss or even blindness. Fortunately, diabetic eye disease often can be treated before vision loss occurs. All people with diabetes should have a dilated eye exam at least once a year.

Diabetic eye diseases include:

  • Diabetic retinopathy
  • Cataracts
  • Glaucoma

Diabetic retinopathy is the most common eye disease in people with diabetes.

What causes diabetic retinopathy?

Diabetic retinopathy is caused by changes in the blood vessels of the retina. In some people with diabetic retinopathy, retinal blood vessels may swell and leak fluid have. In others, abnormal new blood vessels grow on the surface of the retina. These changes may result in vision loss or blindness.

What are the risk factors for diabetic retinopathy?

Anyone with diabetes is at risk for diabetic retinopathy. The longer you have diabetes, the more likely you are to develop diabetic retinopathy.

What are the symptoms of diabetic retinopathy?

In the early stages of diabetic retinopathy, you may have no symptoms. Vision may not change until the disease progresses.

A condition called macular edema may occur with diabetic retinopathy. It happens when the macula, a part of the retina, swells from the leaking fluid and causes blurred vision. When new vessels grow on the surface of the retina, they can bleed (hemorrhage) into the eye, which may decrease vision.

How is diabetic retinopathy diagnosed?

In addition to a complete medical history and eye exam, your eye care professional may perform the following tests to diagnose diabetic retinopathy:

  • Visual acuity test. This is the common eye chart test. It measures vision ability at various distances.
  • Tonometry. This standard test is done to determine the pressure (intraocular pressure, or IOP) inside the eye.
  • Pupil dilation. For a close up exam of the eye’s lens and retina, the pupil is widened with eye drops. 
  • Ophthalmoscopy. This is a test in which a doctor looks very closely at the retina using a special magnifying glass.

How is diabetic retinopathy treated?

Specific treatment w will be determined by your doctor(s) based on:

  • Your age, overall health, and medical history
  • Extent of the disease
  • Your tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the disease
  • Your opinion or preference

Even people with advanced retinopathy have a good chance of keeping their vision if they seek treatment before the retina becomes severely damaged. Treatment for diabetic retinopathy may include:

  • Laser surgery. This is often used to treat macular edema and proliferative retinopathy. It involves shrinking the abnormal blood vessels, or sealing the leaking ones.
  • Vitrectomy. Vitrectomy is a procedure that involves removing the cloudy vitreous (the clear, jelly-like substance that fills the center of the eye) and replacing it with a salt solution.

Can diabetic retinopathy be prevented?

Although diabetic retinopathy can’t be prevented, the risk of developing it can be reduced by:

  • Having a dilated eye exam once a year. An eye exam does not prevent retinopathy, but it can help diagnose eye problems that can then be treated. An eye exam can also alert you and your health care provider if the diabetes needs to be better controlled.  

Following your diabetes management plan by:

  • Taking medications as directed
  • Using insulin as directed, if indicated
  • Eating to manage blood sugar level
  • Exercising to lower and help the body use blood sugar
  • Testing blood-sugar levels regularly
  • Testing urine for ketone levels regularly
  • Regular health care follow-up to evaluate diabetes control and rule out or treat other risk factors, such as high blood pressure 

Better control of blood sugar slows the onset and progression of retinopathy and lessens the need for laser surgery for severe retinopathy.

Key points

Diabetic retinopathy is caused by changes in the blood vessels of the retina. Retinal blood vessels may swell and leak fluid or new blood vessels may grow on the surface of the retina. These changes may result in vision loss or blindness.

Anyone with diabetes is at risk for diabetic retinopathy. The longer you have diabetes, the more likely you are to develop diabetic retinopathy. Although you can’t prevent diabetic retinopathy, you can reduce the risk of developing it by having a dilated eye exam once a year. An eye exam does not prevent retinopathy, but it can help diagnose eye problems that can then be treated.

Even people with advanced retinopathy have a good chance of keeping their vision if they seek treatment before the retina becomes severely damaged.

Treatment for diabetic retinopathy may include laser surgery and vitrectomy (removing the jelly-like substance from the center of the eye and replacing it with saline).

Better control of blood sugar slows the onset and progression of retinopathy and lessens the need for laser surgery for severe retinopathy.

Next steps

Tips to help you get the most from a visit to your health care provider:

  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.
Online Medical Reviewer: Fetterman, Anne, RN, BSN
Online Medical Reviewer: Fincannon, Joy, RN, MN
Date Last Reviewed: 2/26/2014
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