Diabetic Retinopathy

It is the disease of in the back of the eye (retina) due to diabetes. It can result in severe loss of vision and blindness.
However if it is detected early and treated the vision can be preserved.

Who are affected by diabetic retinopathy?

Those who are having diabetes and

• Having it for long time
• Diabetes is not controlled well
• High blood pressure
• High lipid levels
• Diabetic women who are pregnant
• Excess body weight

What are the symptoms due to diabetic retinopathy?

• There may not be complaints even in severe stages in some patients
• Reduced or blurred vision in one or both eyes-swelling of center of retina or retina being pulled by proliferative membranes
• Sudden decrease in vision-due to bleeding in one or both eyes
• Distorted images- center of retina being pulled by proliferative membranes

How does diabetes affect the back of the eye-retina?

Due to increased sugar levels in the blood the blood vessels and cells of retina become affected. Blood flow in small blood vessels become closed and cause chemical changes which lead to two important changes in the retina.

• The small blood vessels become leaky and fluid and blood from blood vessels escapes in to retina causing swelling and accumulation of fat in the center-macular edema which leads to blurred vision in the affected eye

• If too many small blood vessels are closed then there is less oxygen in retina. So as a reaction new blood vessels form on the surface of retina. However these vessels are fragile and break and cause bleeding causing reduced vision.

Sometimes if the new blood vessels exuberant they undergo scarring and pull the retina to which they are attached-causing tractional retinal detachment. This leads to severe loss of vision when it involves center of the eye.

How can you prevent problems due to diabetic retinopathy?

• As soon as you are found to be diabetic(type 2 diabetic patients) you should have checkup for diabetic retinopathy with an eye doctor
• After this first eye checkup you should see eye doctors regularly –they will put drops in your eyes to see the back of the eye
• Control blood sugar and blood pressure well
• Maintain healthy diet and do regular exercises

How can we treat the diabetic retinopathy?

• If the vision is reduced due to swelling of center of retina(macular edema) then injections in the eye or laser treatment can help. Sometimes the treatment is needed for long time.
• If there are new blood vessels and bleeding then laser treatment or injections in the eye can help
• If there is very dense hemorrhage or the retina is pulled then surgery is needed to correct. However this surgery is a major surgery and it is always better to prevent the diabetic retinopathy going in to this stage.

Dr Vivek B Wani MS, FRCSED
Vitreoretina surgeon
KLES Dr. Prabhakar Kore Hospital