Diabetic retinopathy occurs when diabetes damages the tiny blood vessels in the retina. At this point, most people do not notice any changes in their vision. As November is Diabetes Eye Disease Awareness Month, let us take this opportunity to gain knowledge about Diabetic Retinopathy.
Initially patient can experience black Spots or strings seen floating in the field of vision (floaters), Blurring of vision which is not improving with spectacle use, difficulty in reading, Frequent change in glasses, and Impaired color vision
Eventually, as the disease progresses there could be a sudden severe loss of vision.
Formation of microaneurysms (balloon-like dilatation of the small blood vessels), maybe the earliest sign of diabetic retinopathy. They look like, tiny red dots on the retina. These are the earliest changes seen in the eye.
Small patches of bleeding (hemorrhage) can be seen on the retina.
Small yellow dots can be seen on the macula (the area of maximum vision). This can lead to a significant drop in vision.
Sometimes fluid can collect in the retina causing swelling of the retina.
Eventually, due to uncontrolled sugar levels, these changes can progress and worsen resulting in an advanced form of diabetic retinopathy. In this form of Diabetic Retinopathy, new blood vessels grow over the retina and into the vitreous. Bursting of these new blood vessels may cause bleeding into the eye, a condition known as vitreous hemorrhage. The patient experiences a sudden severe loss of vision and the presence of a black curtain falling in front of the eye.
In some cases, the retina is separated (detached), causing total blindness. Such cases often require surgery and outcomes of the surgery are generally very poor.
How to diagnose diabetic retinopathy?
Regular check-ups using a slit lamp and special lenses at the eye doctor’s clinic can help diagnose diabetic retinopathy.
Certain tests can also be done in cases of severe diabetic retinopathy. Angiography of the eye known as fundus fluorescence angiography (FFA) is done, wherein a dye is injected into the vein of your arm. This dye reaches the eye and magnified photos of the eye are captured with the use of a specialized camera. This test helps to confirm the diagnosis of severe stage of diabetic retinopathy.
- Lasers – Lasers are widely used in the treatment of diabetic retinopathy and is performed as an outpatient procedure under topical anesthesia. In this, a beam of light is applied to the affected area on the retina thus preventing bleeding. This procedure takes around 10-20 minutes and is done in 2-3 sittings giving a gap of 1 week in between each sitting. Additional procedures may be required depending on the severity of the disease.
- Intravitreal injections – Injections are given inside the eye to reduce the swelling and bleeding in the retina. A minimum of 2-3 injections is given monthly, depending on the patient’s improvement. They are given inside the operating theatre under sterile conditions. The procedure takes about 5-10 minutes.
- Surgery– Some severe cases of bleeding or separated retina may need to undergo a surgical procedure called a vitrectomy.
Early diagnosis and treatment is the key to avoid irreversible damage to the retina and severe loss of vision. For this, patients suffering from diabetes are recommended to have a regular check-up every 3-6 months depending on the severity of the disease affecting the eye.