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The retina, located in the back of the eye, detects visual images and transmits them to the brain. Major blood vessels lie on the front portion of the retina. If damaged, they may leak fluid or blood and also grow scar tissue. This leakage affects the retina's ability to detect and transmit images to the brain.
Vision is typically not affected during the early stages of diabetic retinopathy, however during its advanced stages, new blood vessels grow in the retina. These new vessels are the body's attempt to overcome and replace the damaged vessels. The new vessels are weak and may bleed. The bleeding may cause vision to become hazy, occasionally resulting in a complete loss of vision.
Other serious eye conditions can occur as a result of diabetic retinopathy. The new vessels can form scar tissue that may damage the retina and cause the retina to pull away from the eye wall. This condition is called retinal detachment and if left untreated can lead to blindness. The growth of abnormal blood vessels on the iris of the eye can also lead to glaucoma. Diabetic retinopathy can also cause your body to form cataracts which will require surgery to remove.
There are typically no symptoms in the early stages of diabetic retinopathy. As the disease progresses patients may report seeing floating debris (floaters) in their eyes that can be bothersome at times. It can also make reading difficult and cause double vision.
Having diabetes does not mean that you will develop diabetic retinopathy, but all diabetics are at risk as changes in blood sugar levels affect the blood vessels in the eye. Risk increases for patients who have had diabetes for 10 years or more.
You can help control your risk of developing diabetic retinopathy by controlling your blood sugar levels, eating a healthy diet, exercising regularly, monitoring your blood pressure and coming back to our office for your annual eye exam.
Regular examinations are extremely important as there are typically no symptoms in the early stages of diabetic retinopathy. Vision may not change until the disease becomes severe. An exam is often the only way to diagnose changes in the vessels of your eyes.
A test called fluorescein angiography is typically used to examine the vessels in the eye. During the test, fluorescein, a harmless orange-red dye, will be injected into a vein in your arm. The dye travels through your body to the blood vessels in your retina. Next, a special camera with a green filter will flash a blue light into your eye and will be used to take multiple photographs. The pictures will be analyzed to identify any damage to the lining of the retina or atypical blood vessel development.
Diabetic retinopathy does not usually impair sight until the condition has reached an advanced stage called proliferative retinopathy (when abnormal new blood vessels bleed into the eye). Pan-retinal photocoagulation may be performed to treat proliferative retinopathy by using a laser to destroy the dead areas of retina where blood vessels have been closed. The retina stops manufacturing new blood vessels when these areas are treated with the laser, and those that are already present tend to decrease or disappear.