Diabetic Retinopathy – A Leading Cause of Blindness Worldwide

Diabetic retinopathy is the disease that diabetes (more commonly known as diabetes mellitus) causes in the eye. Symptoms range from mild blurriness to complete blindness. The disease is not curable, but severe vision loss can usually be preceded with early diagnosis and treatment.

The retina is the light sensitive tissue that lines the inside of the eye. It captures light and transmits images to our brain, thus creating "vision." The retina can be damaged by a variety of diseases, for instance, macular degeneration, retinal detachments and diabetic retinopathy.

Diabetic retinopathy affects the retina is a couple of ways. Most commonly, retina blood vessels become incompetent and leak fluid and blood into the surrounding tissue. If the fluid accumulates in the macula, causing macular edema, vision becomes blurred. Macular edema does not cause blindness.

Fewer patients develop the more aggressive and severe form of retinopathy, namely, proliferative diabetic retinopathy. The hallmark of this stage of the disease is the presence of neovascularization. Abnormal blood vessels grow on the surface of the eye and other internal eye structures. This abnormal tissue can lead to diabetic retinal detachments, causing blindness. A very rare, painful, type of glaucoma may develop as well.

Retinal treatment for macular edema traditionally involves the use of laser treatment. Intravitalreal steroids and anti-VEGF (vascular endothelial growth factor), delivered via intraocular injection, are becoming more of the mainstay of treatment.

Treatment of proliferative retinopathy starts with pan-retinal photocoagulation, another type of laser treatment. Proliferative diabetics can also develop retinal detachments or bleeding in the vitreous. In these cases, vitrectomy eye surgery may be helpful.

Most people believe, incorrectly, that good sugar control prevails the eye disease from developing. The largest risk factor to developing the disease is the number of years a patient has been diabetic. Period.

Diabetic retinopathy can be a devastating disease. Early detection and treatment is essential to maintaining excellent useful vision. All patients with diabetes, regardless of vision, should have a dilated eye exam at least annually. Waiting until there is noticeable vision loss may be too late.