What are the risks of diabetic retinopathy?

Uncontrolled diabetes can result in decreased vision and even irreversible blindness, due to a complication called diabetic retinopathy. Early diagnosis of diabetic retinopathy through regular eye examinations by an Eye Specialist in Lahore can help to preserve vision. Read on to know more about diabetic retinopathy, its symptoms, stages and risks:

What is diabetic retinopathy?

Diabetic retinopathy is a leading cause of blindness, throughout the world, and affects both type I and II diabetics. This type of retinopathy often occurs after years of vascular changes secondary to diabetes. This risk increases with age, as well as, poor control of blood glucose levels (BSL) and blood pressure.

Diabetic retinopathy is the result of microvascular changes in the light sensitive—retinal layer of the eye. The leaky changes in the retinal blood vessels cause edema and neovascularization in the retinal layer, and if they progress uncontrollably, they can lead to retinal damage and blindness.

There are two main types of diabetic retinopathy:

  • Non-proliferative retinopathy: this is the early form of diabetic retinopathy 
  • Proliferative retinopathy: this is the more advanced form of diabetic retinopathy

To minimize the risk of diabetic retinopathy, diabetics should maintain good control of their BSL, serum cholesterol and blood pressure. Additionally, all diabetics should get annual eye examinations, including the fundoscopy with dilated pupil, and early intervention in case of disease. 

What are the stages of diabetic retinopathy?

The stages of diabetic retinopathy progress as:

  • Stage I: mild non-proliferative diabetic retinopathy

In this early form of disease, there are tiny areas of swelling in the retinal blood vessels, called micro-aneurysms, which cause only small amount of fluid leakage in the retina. Although only small amount of fluid leaks, this can still trigger swelling in the macular region of the retina.

  • Stage II: moderate non-proliferative diabetic retinopathy

With progression to the second stage, the area of swelling and leakage increases. At this stage, the micro-aneurysms are severe enough to interfere with the nourishment of the retina.

  • Stage III: severe non-proliferative diabetic retinopathy

At this stage, the blood supply to the retina is significantly impeded. Consequently, the hypoxia triggers vascular growth factors to make new blood vessels.

  • Stage IV: proliferative diabetic retinopathy

The newly formed blood vessels are fragile and leaky. As a result, there is excessive fluid buildup in the retina, causing vision problems like reduced visual field, blurred vision and even blindness.

What are the symptoms of diabetic retinopathy?

Diabetic retinopathy can take years to progress to stage IV. In the early stages, there are hardly any symptoms, and diagnosis is made only coincidentally or on routine examination. Later on, with progression of disease, there are symptoms like:

  • Increased blurriness
  • Distorted vision
  • Poor night vision
  • Pain or pressure in the eyes
  • Floaters or blank spots
  • Flashing lights or rings in vision
  • Change in color perception
  • Decrease in the visual field

What are the risks of diabetic retinopathy?

The risks of diabetic retinopathy include:

  • Vitreous hemorrhage: symptomatic changes are seen if the newly formed, fragile blood vessels bleed into the vitreous body.If the bleeding area is small, only floaters or dark spots are seen. With more severe bleeding, there is complete visual loss as blood fills the vitreous cavity.
  • Glaucoma: if these new, fragile blood vessels form on the iris of the eye, it can interfere with the outflow of aqueous fluid, thereby causing rise in the intraocular pressure. This condition of high pressure, referred to as glaucoma, can cause irreversible damage to the optic nerve if left untreated. Acute glaucoma is a medical emergency.   
  • Retinal detachment: the retinal layer can detach from the back of the eye if the newly formed blood vessels trigger scarring. With the growth of scar tissue, the retina pulls away causing flashes or floaters to appear, and even complete visual loss.
  • Blindness: advanced stage diabetic retinopathy can lead to complete blindness, especially without proper management by professionals like Dr. Aurangzeb Shaikh.

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