Retina
What is diabetic retinopathy?
Diabetic retinopathy is damage to the small blood vessels of the retina caused by long term raised blood sugar. Weakened vessels leak fluid and blood, and in later stages fragile new vessels grow and can bleed. Early stages cause no symptoms, so regular screening is the only reliable way to find it before vision is affected.
How diabetes affects the retina
Raised blood sugar over years weakens the walls of the tiny vessels supplying the retina. Some vessels bulge and leak, producing small haemorrhages and deposits. Others close off, leaving areas of retina short of oxygen.
Retina starved of oxygen releases chemical signals that encourage new blood vessels to grow. These new vessels are fragile, bleed easily into the jelly of the eye and can pull on the retina as they contract.
The stages
- Background or mild retinopathy, with small leaks and dots that do not affect vision
- Moderate to severe non proliferative retinopathy, with more extensive leakage and closed vessels
- Proliferative retinopathy, where new fragile vessels grow and bleeding or retinal traction can occur
- Diabetic macular oedema, where fluid collects at the centre of vision. This can happen at any stage and is the commonest reason vision drops
What raises the risk
- How long you have had diabetes
- Persistently high blood sugar, shown by a high HbA1c
- High blood pressure and raised cholesterol
- Kidney disease, pregnancy and smoking
Treatment
Controlling blood sugar, blood pressure and cholesterol is the foundation, and it slows progression at every stage. Where the retina is already affected, treatment options include intravitreal injections to reduce macular swelling and abnormal vessels, retinal laser to treat areas starved of oxygen, and surgery where there is persistent bleeding or traction on the retina.
Standard Eye Specialist Hospital provides diabetic eye assessment, optical coherence tomography of the macula and intravitreal injection treatment. Where an eye needs vitreoretinal surgery this is arranged with an appropriate surgical service.
When to seek urgent assessment
- A sudden shower of new floaters or a dark curtain, which may mean bleeding inside the eye or a detached retina
- A sudden painless loss of vision in one eye
- Rapidly worsening blurring or distortion of central vision
Frequently asked questions
- Can I have retinopathy with perfect vision?
- Yes, and this is common. Significant retinopathy often exists before vision changes, which is exactly why annual screening is recommended for everyone with diabetes.
- Will good sugar control reverse it?
- Good control strongly slows progression and helps treatment work better, but it does not undo changes that have already happened.
Concerned about these symptoms?
Arrange an eye examination with our consultant ophthalmologist in Garki, Abuja.
Care at Standard Eye
Related answers
- What happens at a diabetic eye screening?
- What is diabetic macular oedema?
- What happens during an intravitreal injection?
- What is an OCT scan of the retina?
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