HOW DIABETIC RETINOPATHY OCCURS, SYMPTOMS
The diabetic retinopathy is one of the complication of the diabetes which affects the eyes. This is caused due to the damage in the blood vessels in the tissue at back of eye that is retina. One of the major risk factor is poorly controlled blood sugar.
EPIDEMIOLOGY OF DIABETIC RETINOPATHY:
Nearly 5.4 percent of people in U.S aged over 40 years have diabetes
Worldwide one-third of estimated 285 million people with the diabetes show signs of diabetic retinopathy.
STAGES IN DIABETIC EYE DISEASE:
There are mainly 2 main stages of this diabetic eye disease. they are:
* NPDR( Non- proliferative diabetic retinopathy)
* PDR ( Proliferatve diabetic retinopathy)
NPDR: This is the early stage of diabetic eye disease. The people with diabetes usually have this. With this NPDR, tiny blood vessels leak which lead to swelling of retina. When, the macula swells, it is macular edema. This is the reason why the diabetic people lose their vision.
Even the blood vessels in the retina can close off which is called as macular ischemia. Here the blood cannot reach the macula sometimes even some small particles called as exudates form in the retina which can affect the vision.
PDR: This is the more advanced stage. Here in this case the retina starts growing new blood vessels which is called to be as Neo-vascularization. These new vessels bleed when they bleed little we might observe dark floaters, if bleeding is more than it might block all vision.
These new vessels form scar tissue. This PDR is very serious and can affect both central and peripheral vision.
SYMPTOMS OF DIABETIC RETINOPARHY:
The diabetic retinopathy usually show no symptoms during early stages.
Symptoms may include:
- Blurred vision
- Impairment of color vision
- Floaters, or transparent and colorless spots and dark strings that float in the patient’s field of vision.
- Patches or streaks that block the person’s vision.
- Poor night vision
- sudden and total loss of vision
The possible complications along with this include:
* Vitreous hemorrhage: A newly formed blood vessel leaks into vitreous gel fills the eye, stopping light from reaching retina. The symptoms in this include loss of vision and sensitivity to light .
* Detached retina: The scar tissue pulls the retina away from back of eye. This thereby cause floating spots in individual field of vision and severe vision loss.
*Glaucoma: The normal fluid flow in eye become blocked as new blood vessels form. The blockage cause increase in the ocular pressure which increase risk of damage of optic nerve and vision loss.
CAUSES AND RISK FACTORS of diabetic retinopathy :
- Not controlling blood and sugar levels
- High cholesterol levels
- Diabetes for longer time
* DILATED EYE EXAM: Doctor administers a drop into the eye of the patient which dilates the pupil so that the doctor can view the eye in more detailed way. During the examination following are been observed:
- Any abnormalities in blood vessels, optic nerve, retina
- Changes in eye pressure or overall vision
- New blood vessels
- Retinal detachment
- Scar tissue
This drops sting and the bright lights of photographs startle the person receiving the test.
* FLUORESEIN ANGIOGRAPHY:
Drops are used to dilate pupils, and a special dye called fluorescein is injected into the vein in arm of patient. Pictures are taken as dye circulates through eye. This test determines which blood vessels are been blocked. If any laser treatment can be done or not.
* OPTICAL COHERENCE TOMOGRAPHY:
This noninvasive imaging scan provides high-resolution cross-sectional images of retina, revealing its thickness. After any treatments, scans are used to check the effectiveness of treatment.
This is OCT is similar to ultrasound testing but uses light rather than sound to produce images. This scan also detects disease in the optic nerve.
TREATMENT OF DIABETIC RETINOPATHY:
The medications are been used to reduce the swelling of macula, slowing vision loss and to improve vision.
Some steroids are also been used to reduce the swelling these are injected into the eye.
LASER SURGERY: This is been used to seal off the leaking blood vessels which reduces the swelling of the retina .This laser surgery also helps in shrinking blood vessels and prevent them from growing again.
VITRECTOMY: If the patient having advanced PDR, then this surgery is recommended. In this condition the ophthalmologist removes vitreous gel and blood from leaking vessels in back of eye. This allows light rays to focus properly on retina and the scar tissue also might be removed from retina.
- Control the blood pressure and sugar levels
- Have regular visits to ophthalmologist for dilated eye exams.
- If any vision changes observed immediately consult doctor.
- Eating healthy and balanced diet
- Regular exercise
- Maintenance of healthy body weight
- Smoking cessation
- Strictly controlling alcohol intake
- Taking any anti-hypertensive measures according to doctors instructions.
M KEERTHI KUMARI