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Diabetic retinopathy

Diabetic retinopathy is a complication of diabetes and a leading cause of blindness. It occurs
when diabetes damages the tiny blood vessels inside the retina, the light-sensitive tissue at
the back of the eye. A healthy retina is necessary for good vision.

If you have diabetic retinopathy, at first you may notice no changes to your vision. But over
time, diabetic retinopathy can get worse and cause vision loss. Diabetic retinopathy usually
affects both eyes.

Who is at risk for diabetic retinopathy?

All people with diabetes--both type 1 and type 2--are at risk. That's why everyone with
diabetes should get a comprehensive dilated eye exam at least once a year.

During pregnancy, diabetic retinopathy may be a problem for women with diabetes. To
protect vision, every pregnant woman with diabetes should have a comprehensive dilated
eye exam as soon as possible. Your doctor may recommend additional exams during your
pregnancy.

How diabetic retinopathy causes vision loss

Blood vessels damaged from diabetic retinopathy can cause vision loss in two ways:

1. Fragile, abnormal blood vessels can develop and leak blood into the centre of the
   eye, blurring vision. This is proliferative retinopathy and is the fourth and most advanced
   stage of the disease.
    
2. Fluid can leak into the centre of the macula, the part of the eye where sharp,
   straight-ahead vision occurs. The fluid makes the macula swell, blurring vision. This
   condition is called macular edema . It can occur at any stage of diabetic retinopathy,
   although it is more likely to occur as the disease progresses. About half of the people
   with proliferative retinopathy also have macular edema.

Normal vision

Same scene viewed by a person with diabetic retinopathy

Symptoms of Diabetic retinopathy

Diabetic retinopathy often has no early warning signs. Don't wait for symptoms . Be sure to
have a comprehensive dilated eye exam at least once a year.

Diagnoses

Diabetic retinopathy are detected during a comprehensive eye exam that includes:

• Visual acuity test. This eye chart test measures how well you see at various distances.
• Dilated eye test. Drops are placed in your eyes to widen, or dilate, the pupils. Your
  eye care professional uses a special magnifying lens to examine your retina and optic
  nerve for signs of damage and other eye problems. After the exam, your close-up
  vision may remain blurred for several hours.
• Tonometry. An instrument measures the pressure inside the eye. Numbing drops may
  be applied to your eye for this test.

Your eye care professional checks your retina for early signs of the disease, including:

• Leaking blood vessels.
• Retinal swelling (macular edema).
• Pale, fatty deposits on the retina--signs of leaking blood vessels.
• Damaged nerve tissue.
• Any changes to the blood vessels.

Diabetic Retinopathy treatment

During the early stages of diabetic retinopathy, no treatment is needed, unless you have
macular oedema. To prevent progression of diabetic retinopathy, people with diabetes
should control their levels of blood sugar, blood pressure, and blood cholesterol.

Proliferative retinopathy is treated with laser surgery.

What happens during laser treatment?

Both focal and scatter laser treatment are performed in your doctor's office or eye clinic.
Before the surgery, your doctor will dilate your pupil and apply drops to numb the eye. The
area behind your eye also may be numbed to prevent discomfort.

The lights in the office will be dim. As you sit facing the laser machine, your doctor will hold
a special lens to your eye. During the procedure, you may see flashes of light. These flashes
eventually may create a stinging sensation that can be uncomfortable.

You will need someone to drive you home after surgery. Because your pupil will remain
dilated for a few hours, you should bring a pair of sunglasses.

For the rest of the day, your vision will probably be a little blurry. If your eye hurts, your
doctor can suggest treatment.