What is Diabetic Retinopathy?

Diabetic retinopathy is a complication of diabetes. It is caused when high blood sugar levels, and high blood pressure damage the retina. If it is left undiagnosed, and is not treated it can cause blindness.

Diabetic Retinopathy is a progressive condition , so usually it would take several years to be serious enough to threaten your sight.

In the early stages there will not normally be any obvious symptoms, but it can be detected by taking photographs of the eyes during diabetic eye screening.

The retina is a thin layer of nerve tissue lining the inside of the back of the eye. Light that enters your eye through the pupil is focused by the lens onto the retina. This causes signals to be sent along the optic nerve to the brain where they are interpreted into the images you see.

The retina has to have a constant blood supply in order to function properly, and it receives this through a network of very small blood vessels.

If your blood sugar levels are persistently high, the blood vessels supplying the retina can be damaged over time, and in three main stages…

Three Main Stages of Diabetic Retinopathy.

The blood vessels supplying the retina develop tiny bulges. These may bleed slightly but although this normally will not affect your sight, you must prevent it from worsening. This is sometimes called ‘R1’.

The blood vessels supplying the retina develop more severe and more widespread changes which lead to more significant bleeding into the eye. This is more serious than background retinopathy, and calls for more frequent screening to check for any changes. This is also known as non-proliferative retinopathy or R2.

Scar tissue is being formed on the retina in this final stage, as are new, weak blood vessels, which bleed very easily. This can result in loss of vision, and is sometimes called ‘R3’

If you notice that your vision is worsening or becoming cloudy, or you see floaters or have eye pain or redness then you should get a check up straight away.

How is Diabetic Retinopathy Treated?

If you have diabetic retinopathy that is threatening or affecting your sight,you may be offered the following treatments

This treatment acts on the new weak blood vessels at the back of the eye, and can help to stabilise the changes that are taking place. It can stop your vision from getting worse, but it won’t improve it.

When treating a diabetic retinopathy with laser therapy we will give you eye drops to dilate your pupil, and drops to numb your eye. We will place a special contact lens in your eye to help focus the laser precisely, and the procedure will normally take twenty to forty minutes.

Diabetic retinopathy can be treated with ‘Anti-VEGF’ injections into the eye.

VEGF stands for ‘vascular endothelial growth factor’ which is protein that stimulates formation of new blood vessels. Anti-VEGF works by blocking this protein in the eye which in turn inhibits the growth of abnormal new blood vessels in your eye. If there are fewer abnormal blood vessels growing it follows that there will be less bleeding and leakage from them.

Steroid injections may be used instead of anti-VEGF in some cases.

You will be given eye drops to numb your eye, the skin around your eye will be cleaned, and some small clips will be used to keep your eye from closing while a very fine needle is used to give the injection. Most people have minimal discomfort with this procedure, which will be given once a month to begin with, and stopped or given less frequently once your vision stabilises.

Diabetic retinopathy can be treated with eye surgery if a lot of blood has collected inside your eye, or if scar tissue has formed which may have already caused or may go on to cause retinal detachment. 

During the surgery some of the jelly-like vitreous in the eye is removed through a small incision, scar tissue may be removed, and a laser may be used to stop your vision from deteriorating any further.

The surgery is normally carried out with a local anaesthetic and sedation, which means you won’t be aware of the procedure, and there will be no pain.

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