What is Diabetic Retinopathy?

Dr.Prashaant Chaudhry, Dr.Vidya Chaudhry, 3 mins read

Diabetic retinopathy, as the name suggests, is a condition that occurs in the retina of diabetics and can develop in both type 1 or 2 diabetes and in those who have a long history of poorly controlled blood sugar levels. While most people will start out with really mild retinal damage and almost manageable problems, a lot of them eventually lose their sight. If you’re considering diabetic retinopathy treatment in Delhi or anywhere, understand that you must not delay treatment or leave it untreated altogether. Diabetic retinopathy is one of the most common causes of blindness and eye disease for diabetics in India, and the number of people with diabetes is rising staggeringly in the last few decades.

The Centre’s Union Health Ministry held the first National Diabetes and Diabetic Retinopathy Survey (2015-19) which revealed the prevalence of Diabetic Retinopathy (DR) at 16.9 per cent and sight-threatening DR at 3.6 per cent. This was over a small sample size and it should be noted that diabetes followed by diabetic retinopathy are becoming significant non-communicable disease leading to blindness. The International Diabetes Federation estimates there will be 629 million diabetics by 2045, and a huge portion of this will Indians.

Understanding diabetic retinopathy is the first step anyone can take if they are concerned about this condition, recognising the signs early can prove as significant as getting treatment from the best eye specialists in Delhi or visiting the best eye care hospitals for treatment in Delhi retrospectively.

Types of diabetic retinopathy:

Diabetic retinopathy stages determine the type of Retinopathy, they are:-

Non-proliferative diabetic retinopathy (NPDR)

NPDR, also known as background retinopathy is “nonproliferative” as the eye doesn’t make new blood vessels during the very early stages of diabetic retinopathy. During this time, damaged blood vessels often leak out lipids and fluid into the eye while in other cases, the centre of the retina starts to swell up; causing a condition called macular edema. The four stages - mild, moderate, severe and very severe, can also progress to the other types, or to the fourth stage, called proliferative diabetic retinopathy.

Proliferative diabetic retinopathy (PDR)

Also known as advanced retinopathy, PDR is the stage wherein new blood vessels start growing inside the retina itself. The new blood vessel formations are mostly abnormal and bleed easily.

Diabetic retinopathy symptoms:

Diabetic retinopathy symptoms are quite uncommon during the early stages of the condition which makes it even harder to detect early on. The symptoms will not appear until some major damage occurs inside the eye. You can avoid the unseen diabetic retinopathy damage by keeping your blood sugar levels and blood pressure well under control, along with ensuring you get regular eye examinations to monitor your eye health.

You can set yourself up with safe and transparent eye testing at Aakash Healthcare itself and leave your eye care program to our eye specialists.

When diabetic retinopathy symptoms do appear, they usually appear in both eyes and may include difficulty seeing at night, seeing floaters or dark spots, vision loss, inability to distinguish colours, and blurred vision.

Diabetic Retinopathy- Causes:

As the name suggests, it’s related to diabetes which is linked to high levels of sugar in the blood over long periods of time. The excess sugar damages blood vessels, including those that supply the retina with blood. High blood pressure also factors in as a risk for retinopathy.

The retina is a layer of tissue, responsible for changing images that the eye sees into nerve signals that the brain can understand, it’s like a theatre projector that accumulates images and processes them together. When blood vessels of the retina get damaged, they get blocked, which cuts off the retina’s blood supply partially. The lack of blood flow can cause other; weaker blood vessels to grow in the retina and these new albeit weak blood vessels may leak or bleed and make scar tissue that causes vision loss.

The longer a person has diabetes, the greater the chances of developing diabetic retinopathy. Did you know that almost every individual who has had diabetes for over 30 years and over half of over 20 years will surely exhibit and experience some signs and symptoms of retinopathy. Keeping diabetes under control is the best protection you can get yourself in slowing the progression of diabetic retinopathy.

Diabetic Retinopathy - Diagnosis:

Dilated eye exams which involve the use of eye drops that widen the pupil are enough to diagnose the condition. In addition; a fluorescein angiography test may be performed as well along with an Optical Coherence Tomography (OCT) exam to produce clearer images of the retina.

Diabetic Retinopathy- Treatment:

Treatment options are limited for early diabetic Retinopathy so regular eye exams for monitoring eye health will be needed first.

For advanced diabetic retinopathy, treatment depends on the type and severity of retinopathy.

Photocoagulation surgery is laser treatment for diabetic retinopathy and can help prevent vision loss. There is Scatter Photocoagulation to reduce the risk of blindness and Focal Photocoagulation to keep macular edema from worsening. These proliferative diabetic retinopathy options may be followed by Vitrectomy that entails removing scar tissue and cloudy fluids from the eye.

Injections may also be required in the eye of Anti VEGF (Accentrix or Pagenax) or steroid implants (Ozurdex) to quickly reduce the retinal swelling which will prevent permanent loss of vision. These injections may be required more than once depending on the condition of the eye.

In advanced diabetic retinopathy stages, there is tractional retinal detachment or non resolving vitreous hemorhhage (blood in eye). This may require 25 gauge retinal surgery or vitrectomy by our retinal specialist.

Diabetic retinopathy is not to be taken lightly as it can lead to diminished eyesight or even blindness and if you have been diagnosed with diabetes, it’s important you keep track.

Also Read: Diabetes Retinopathy: Is it Reversible?