Diabetic Retinopathy


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Diabetes is the most common cause of blindness in the over 65 year olds. This incidence is falling, however still over 5% of diabetics in the UK will become blind after 30 years of the condition.

The eye is a very delicate organ that enables us to see what is in our environment. Light that enters the front of your eye travels through the cornea (the front of the eye) and the lens into the middle of the eye, which contains a clear colourless fluid. Once it has passed through the central part of the eye, it hits the part of the eye that is responsible for detecting light, called the retina.

If you suffer from diabetes and your blood glucose control isn’t as good as it should be, the high concentrations of sugar and fat within your blood can cause tiny blood vessels within your eye to become blocked. This then causes other blood vessels to enlarge and grow which then begins to prevent light that enters your eye from being detected, causing your vision to become blurry.

Types of Retinopathy

There are thre main types of retinopathy in diabetic patients. The first type is known as background retinopathy and can be detected using an ophthalmoscope. It occurs when the small blood vessels within the eye burst and leek blood into the retina. This initial type of retinopathy does not cause vision loss, but can increase your risk of developing the second more serious type of retinopathy called pre-proliferative retinopathy.

Pre-proliferative retinopathy is a precursor to developing the most serious type of eye condition known as proliferative retinopathy. This intermediate stage occurs when the retina begins to swell from not having enough oxygen supplied to it. This is seen through an ophthalmoscope as looking like spots of cotton wool. The more spots you have, the greater the risk of progression to proliferative retinopathy.

The progression to proliferative retinopathy can be rapid or slow and is very serious. It occurs when the eye becomes starved of oxygen for so long that it starts to grow new blood vessels to try and compensate. These new vessels are very unstable and branch repeatedly, often bursting in the process. This causes the clear fluid within the eye to fill with blood, preventing you from seeing through the affected eye. This problem eventually resolves when the blood is re-absorbed into the vessels within the eye, however repeated bursting is common.

Preventing Diabetic Retinopathy

To help prevent you from developing retinopathy, it is vital that you control your blood glucose levels within a normal range as much as possible. You should also try and stop smoking and keep your blood pressure down, as these can both increase progression to proliferative retinopathy. It is vital that you attend all your screening appointments with an ophthalmologist, when you should have these will be outlined in the screening section.

Treating Diabetic Retinopathy

With regards to treating diabetic retinopathy, about 50% of vision loss can be prevented by early laser photocoagulation. The aim of this treatment is to prevent the growth of any new blood vessels. Your ophthalmologist will be able to advise you as to whether you will require this treatment.


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