Top 5 Threats to your eyes – Diabetic Retinopathy

DIABETIC RETINOPATHY

  • Diabetes is a condition where the body doesn’t have enough insulin, or doesn’t use insulin effectively.
  • Type 1 diabetes
    • Usually in people under 40
    • Body produces no insulin
    • Must use insulin injections to compensate

 

  • Type 2 diabetes
    • Usually people over 45
    • Body doesn’t produce enough insulin, or can’t use the insulin properly
    • Can sometimes be controlled by exercise and diet, or may also need medication
    • More common in obese people

 

Diabetic Retinopathy

  • Occurs when the blood sugars are badly controlled over a period of time.
  • Initially has no symptoms
  • As it progresses, leads to partial, and eventually total blindness
  • Leading cause of blindness in people under 65
  • Usually affects both eyes
  • Eye health checks are recommended annually in order to detect any changes

 

Symptoms

  • Initially, there are no symptoms
  • Fluctuations in vision from blurry to clear with changes in blood sugar
  • Floaters in your vision
  • Sudden, painless loss of vision
  • Poor vision at night
  • Colours appear different
  • Dark areas in your field of vision

 

Stages

1. Non Proliferative

  • Early changes at the back of the eye
  • Blood vessels get damaged, causing small haemorrhages
  • Blood vessels develop bulges
  • Can get blurry vision, as small vessels supplying the macula (the part of the eye responsible for central vision and fine detail) close, and the macula doesn’t receive enough blood

 2.    Proliferative

  • Neovascularisation

    • The original blood vessels close over, and the eye responds by growing new blood vessels, that are of inferior quality to the original ones, and are more prone to leakage.
    • These new blood vessels are often accompanied by scar tissue

 

  • Vitreous Haemorrhage

    • The new vessels can bleed into the gel that fills the eye
    • This may appear like floaters in your vision, or if there is sufficient bleeding, it can obscure all vision in that eye
    • Vision loss caused by vitreous haemorrhage is usually temporary, and as the blood recedes, the vision may return to normal if there is no further damage at the back of the eye

 

  • Retinal Detachment

    • The scar tissue at the back of the eye can shrink, causing the retina to pull away from where it’s attached to the back of the eye.
    • This is a serious condition, and must be treated very quickly to stop the retina detaching further.
    • If the retina detaches completely, there will be permanent, complete loss of vision in the eye.

 

  • Neovascular Glaucoma

    • If enough blood vessels close, new blood vessels can grow on the iris (the coloured part of your eye), and block the drainage system of the eye
    • This means that the fluid produced in the eye can’t drain away efficiently, and builds up in the eye, causing extra pressure
    • This extra pressure can damage the nerves in the eye, causing loss of vision from the outside in, and if left untreated can cause complete blindness.

Normal Retina

normal-retina1

 

Retina with Diabetic Retinopathy

abnormal-retina

Treatment

  • There is no cure, but treatment can help maintain vision or slow progression of vision loss.
  • Treatment is much more effective if administered before there is extensive damage to the retina, in order to prevent serious vision loss
  • In the early stages, it can be managed by better control of blood sugar by diet and exercise
  • Laser is often used as a treatment
  • Injections are sometimes used to attempt to shrink the new blood vessels

 

Reduce the Risk

  • Control blood sugars
  • Stop smoking
  • Control blood pressure
  • Have regular eye tests to monitor for change
  • Good diet, and regular exercise

 

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