Retinopathy associated with diabetes
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Diabetic retinopathy is the most common among a group of diabetic eye diseases, which sometimes lead to partial or total blindness. In the United States, it is the most common cause of blindness among adults.

Diabetic retinopathy

If you are a diabetic, then the sugar in your body is not being stored or used properly. Your blood sugar then gets too high. In diabetic retinopathy, it is this sugar, which damages the blood vessels in the retina, which is the light sensitive tissue at the back of the eye. It is the retina which gives you vision.

In some cases, blood vessels swell and leak fluid and in other cases, new blood vessels are formed. The disease may not be noticed by you until loss of vision sets in. Diabetic retinopathy normally affects both your eyes.

Diabetic retinopathy can also cause retinal thickening. It may also involve the peripheral retina, the macula or both.

Stages of diabetic retinopathy

In the early stage of the disease, called non-proliferative retinopathy, the walls of the blood vessels become weak and cause dot-like hemorrhage. When this happens small balloon like swellings are formed in these tiny blood vessels. This may also cause edema in the retina leading to loss of vision.

As the disease progresses, the blood vessels which nourish the retina are blocked. As more blood vessels are blocked, the blood-deprived retina sends signals to the body for more blood.

At this final and advanced stage of the disease, called proliferative retinopathy, signals sent by the retina trigger the growth of new blood vessels. The new blood vessels formed in the retina are abnormal and have weak walls, and by themselves do not cause any damage. The damage is caused by the weak walls of these new arteries, which leak blood to the eye leading to vision impairment.

Signs and Symptoms

In the early stages, you may not see any symptom nor feel any pain. Later you may have macular edema, which is the condition where the macula – the light sensitive part of the retina - swells due to leaking fluid. If new blood vessels grow in your retina then blood from these vessels may leak into your eyes and block vision.

Often you can have macular edema or proliferative retinopathy and still have normal vision. But you run a high risk of becoming at least partially blind. In such cases, only the eye care professionals can tell whether you have any of these conditions. Remember, timely treatment is important to avoid blindness.

Clinicians often rely on early signs rather than symptoms to detect diabetic retinopathy. These are leaking blood vessels, macular edema, pale fatty deposits on the retina, which are signs of leaking blood vessels, damaged nerve tissues and any changes in the blood vessels.

On your part, if you are a diabetic watch out for spots of blood or specks, caused by hemorrhage, floating in your vision. If they occur, see the doctor immediately. Sometimes these specks vanish by themselves. Even so, see your doctor. You cannot get complacent as hemorrhage can recur.

Treatment

If you are a diabetic, then prevention must be your watchword. All diabetics risk developing retinopathy. Therefore, as a diabetic, be sure to have a thorough eye examination done every year.

Maintain a healthy diet to keep your blood sugar, blood pressure and blood cholestrol under control. Visit your doctor regularly for eye examination, particularly if you notice any of the signs mentioned above. Early detection is vital to prevent blindness.

In the early stages, no treatment is needed unless you have macular edema. Macular edema is treated with laser surgery. The procedure is called focal laser treatment. Laser treatment slows down the leakage of blood and reduces the amount of fluid in the retina. Complete treatment may require more than one session. Focal laser treatment cannot only reduce the risk of vision loss by 50%, but in a small number of cases of vision loss, it can be improved.

Proliferative retinopathy can be treated by laser photocoagulation, which seals off the blood vessels and destroys new growth. This treatment is almost painless since the retina has no nerve endings. However, you may suffer partial blindness. The main aim of the procedure is to arrest further growth of the disease.

If blood has leaked into the vitreous humor, contained in the eye chamber, then a procedure called vitrectomy is performed. Vitrectomy removes the blood. The body gradually replaces the lost vitreous humor, usually improving the vision.

 
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