Diabetic Retinopathy Symptoms
Diabetes can damage blood vessels throughout the body. Because of this, diabetes can cause multi-organ diseases and problems, including kidney damage (nephropathy), nerve damage (neuropathy), heart disease, and stroke. With diabetes, one may also develop retina damage (retinopathy). Blood vessels can be damaged within the retina, the light-sensitive tissue at the back of the eye. At first, this damage causes minor changes resulting in blurry vision, but over time, it could ultimately lead to blindness.
Common Signs of Diabetic Retinopathy
In the early stages of diabetic retinopathy, patients show little to no symptoms. In fact, many patients we see don't have any symptoms when they visit us. However, symptoms do grow over time and are flags to be aware of. Below are the common signs and symptoms of diabetic retinopathy:
Vision Fluctuation
Vision will fluctuate and may lose focus with rising and falling blood sugar. Vision may become blurry, colors may look different, or dark strings may float when trying to see. Patients may notice their vision fluctuate at various times during the day.
Seeing Blood Spots
If you have a greater blood leak, you may see spots of blood in your field of vision within a few days or weeks. In extreme cases, a person will only be able to see light from dark. It may take months or even years for the blood to clear from the inside of the eye. In some cases, the blood will not clear and may need surgical removal. Large hemorrhages often happen more than once, usually during sleep.
Swelling and Scarring
The retina in the back of the vitreous cavity may hemorrhage, swell, and scar. Because diabetes affects the blood vessels, the circulating blood may leak out into the retina tissue. As the disease progresses, the body tries to grow new blood vessels to supply blood carrying nutrition and oxygen to the damaged retina. These new vessels are more diseased and weaker than the original vessels. Eventually, the retina loses functionality. This happens because of a lack of nutrients and oxygen, and from any resulting scar tissue. These affect your eyes' light-sensitive nerve tissues, and vision deteriorates.
Types of Diabetic Eye Disease
Diabetes causes damage to the blood vessels throughout the body. High blood sugars damage the walls of blood vessels, making them leaky. This results in leaking of fluid and bleeding in tissue adjacent to the blood vessels. The surrounding tissue can swell and accumulate lipid deposits. This also affects the nourishment of the tissue. If the tissue isn’t properly nourished, the body responds by growing new blood vessels to feed the tissue. These new blood vessels are more frail than normal blood vessels. They bleed easier and this blood can accumulate within the vitreous, the jelly that fills the back two-thirds of the eyeball.
Diabetic eye disease can be broken down into 2 main categories:
Non-Proliferative Diabetic Retinopathy (NPDR)
This is the early stage of the disease process. At this stage, the blood vessel walls begin to leak. This results in lipid deposits accumulating and microaneurysms, a small out-pouching of the retinal blood vessels.
In these early stages, there are often no symptoms of these changes occurring. This is why yearly dilated eye exams are so important.
Diabetic macular edema results when this bleeding and leaking of fluid accumulates in the central part of the back of the eye, called the macula. This area is responsible for our central vision. When swelling occurs here, you will often notice blurry or distorted vision.
Proliferative Diabetic Retinopathy (PDR)
At this stage, the retinal tissue isn’t getting nourishment that it requires. This results in the development of new, abnormal blood vessels (neovascularization). These new blood vessels can form near the optic nerve or elsewhere in the back of the eye. They can also develop on the iris, the colored part of the eye. These new blood vessels are frail compared to normal blood vessels. Bleeding in the vitreous can cause a sudden loss of vision. These changes within the eye can also lead to a tractional retinal detachment or neovascular glaucoma.
Diabetic Retinopathy Treatment Options
The best treatment for diabetic retinopathy is early detection and prevention. This comes from careful attention to diet and lifestyle as well as management with your doctor. Yearly dilated eye exams are important to detect the earliest changes within the eye associated with diabetes.
There are three main types of treatment for patients who have diabetic retinopathy.
Medicine
Laser Surgery
Vitrectomy
Who is at Risk for Diabetic Retinopathy?
Having diabetes puts you at risk of developing diabetic retinopathy at some point in your lifetime. How well your blood sugar is controlled is the major factor determining your risk of developing retinopathy. How long you have had diabetes is also a risk factor. Uncontrolled high blood pressure in someone with diabetes also increases the risk of developing retinopathy. Ethnicity also plays a role, as African-American, Hispanic, and Native American people have a higher risk of developing diabetic retinopathy.
If you are at risk for the disease and the potential onset of diabetic retinopathy or if you would like to learn more about treatment options to avoid blurry vision or even vision loss, please contact our ophthalmologists today.
Content reviewed by Kelsey J. Kleinsasser, O.D.
