Diabetic Retinology

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Diabetic Retinopathy - Keep an Eye on your sight

Causes

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If you have diabetes, your body doesn't use sugar (glucose) properly. Sugar in your blood is vital to your health because it's a main source of energy for your body's cells. But too much sugar in your blood can cause damage throughout your body, including your kidneys, nerves, heart and eyes. Damage to the capillaries in your eyes occurs in Diabetic Retinopathy.

Diabetic Retinopathy occurs in two types, usually affecting both eyes similarly:


Nonproliferative diabetic retinopathy (NPDR) This type, also called background diabetic retinopathy, is an early stage of the disease. It's the most common type of retinopathy, and symptoms are often mild or nonexistent.
In NPDR the walls of blood vessels in the retina weaken. Tiny bulges called microaneurysms (mi-kro-an-u-riz-umz) protrude from the walls of the small vessels in the retina. Another term for these microaneurysms is "outpouchings." The microaneurysms may begin to leak, oozing fluid and blood into the retina. As NPDR progresses, other signs of damage appear. These include swelling or beading of some of the larger retinal veins and patches of swollen nerve fibers, which are called cotton-wool spots because they look like fluffy wisps of cotton.	Click for details
Mild NPDR may not affect your ability to see clearly. Vision problems from more severe NPDR are usually the result of swelling (edema) of the central part of the retina (macula) — a condition called Diabetic Macular Edema (DME) — or the closing of capillaries, which reduces blood flow to the macula (macular ischemia). When the macula can't function properly, your central vision decreases.

Proliferative diabetic retinopathy (PDR) This is the more advanced form of the disease. Retinopathy becomes proliferative when abnormal new blood vessels grow (proliferate) in the retina or the optic disc. The blood vessels also can grow into the vitreous, the clear, jelly-like substance that fills the center of your eyes.

This abnormal growth generally follows the widespread closing of capillaries in the retina. The condition can cause vision loss affecting both your central and peripheral vision. The new blood vessels may leak blood into the vitreous, which clouds or even blocks your vision.

Other complications include detachment of the retina due to scar tissue formation (traction retinal detachment) and a form of glaucoma associated with the growth of abnormal blood vessels on the iris, the colored portion of the eye surrounding the pupil (neovascular glaucoma).

Blurred vision in diabetes

Blurred vision can be brought on by rapid fluctuations in blood sugar. Prolonged periods of elevated blood sugar cause sugar and its breakdown products to accumulate in the lens. This accumulation sucks up water and makes the lens swell, resulting in nearsightedness — meaning distant objects appear blurry. The nearsightedness subsides once your blood sugar is brought under steady control.

Blurred vision can also be caused by macular swelling (edema), regardless of your blood sugar level. This is cause for greater concern because macular edema often develops in people with diabetic retinopathy. The swelling may fluctuate during the day, making your vision get better or worse. If blood vessels in your eye are hemorrhaging, you might notice spots floating in your field of vision. These small spots are often followed within a few days or weeks by larger spots or clouds, which are caused by more marked hemorrhaging.

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