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Diabetic Retinopathy: What Happens When Diabetes Affects Your Eyesight?

retina of a diabetic

Story at-a-glance -

  • In a study conducted by the U.S. Centers for Disease Control and Prevention (CDC), it was found that diabetic retinopathy prevalence is high, as it affects one-third of diabetic American adults over age 40 years, and over one-third of African-Americans and Mexican-Americans
  • Losing your vision because of diabetic retinopathy can be irreversible, but if you’ve detected and addressed diabetes as early as possible, your risk of blindness goes down by as much as 95 percent

If not appropriately managed or reversed, diabetes can have profoundly damaging repercussions on various aspects of your health, including your eyesight. One of the most commonly experienced side effects of this illness is diabetic retinopathy.

As mentioned in previous pages, diabetes can damage the tiny blood vessels in your different body organs, such as your eyes. This is due to the excessively high levels of sugar in your bloodstream. When there's excessive damage to the blood vessels in your retina,1 the light-sensitive tissue found at the back of your eyes,2 you'll have what's called diabetic retinopathy.

Defining Diabetic Retinopathy

There can be many ways by which diabetes can damage the blood vessels in your retina. For one, the high sugar levels can cause the vessels to swell and leak blood and other fluids. They can also close up and keep blood from passing through. In some cases, new blood vessels may abnormally grow on the retina. As a result, the person's vision becomes blurred or cloudy, affecting both eyes.3

Regardless of how diabetic retinopathy manifests, it can be quite alarming because you may experience no apparent symptoms initially. But as the condition progresses, it can lead to mild vision problems and eventually blindness.4 There are four stages of this condition, which are classified as follows:5

1. Mild non-proliferative retinopathy — This is when balloon-like swelling occurs in small areas of the retina's tiny blood vessels. These are called microaneurysms, and manifest at the earliest stage of the disease. This  can cause fluid to leak in the retina.

2. Moderate non-proliferative retinopathy — In this stage, the blood vessels that nourish the retina become distorted and swollen, causing them to lose their ability to transport blood. Characteristic changes may occur in the retina and may contribute to diabetic macular edema (DME), or the buildup of fluid in the macula.

3. Severe non-proliferative retinopathy — When this stage  occurs, it means that more blood vessels have become blocked, preventing sufficient blood supply from traveling  to areas of the retina. As a result, these areas secrete growth factors that prompt the retina to grow new vessels.

4. Proliferative diabetic retinopathy (PDR) — This is the advanced stage that happens when new blood vessels have grown along the retina's inside surface and into the vitreous gel, which is the fluid that fills your eyes.

Since these new blood vessels are fragile, they are more prone to leaking and bleeding. Scar tissue may also cause the retina to detach from its underlying tissue, which can then prompt permanent vision loss.

How Prevalent Is This Condition and Who Is at Risk?

In a study conducted by the U.S. Centers for Disease Control and Prevention (CDC), it was found that diabetic retinopathy is fairly common, as it affects one-third of diabetic American adults over age 40 years, and over one-third of African-Americans and Mexican Americans.6

Diabetic retinopathy can affect anyone who has diabetes, regardless of type. It may occur in both Type 1 and Type 2 diabetics. An increased risk is seen in adults and the elderly, as well as in people who do not properly control and manage their blood sugar and blood pressure levels.7

The longer you have diabetes and the less controlled your blood glucose level is, the higher your chances of developing this eye complication.8 Other risk factors of diabetic retinopathy include:9

  • Having high cholesterol levels
  • Being pregnant
  • Smoking cigarettes or tobacco
  • Being African, Hispanic or Native American
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Symptoms of Diabetic Retinopathy

It can take years, or even decades, for diabetic retinopathy symptoms to appear. In some cases, the early signs of this condition are only detected after a retinopathy screening check. Some of the hallmark symptoms of this disease include:10,11

  • Sudden vision changes

  • Distorted, fluctuating and/or blurred vision

  • Dark strings or spots floating in your vision (called floaters)

  • Dark or empty parts in your field of vision

  • Impaired color vision

  • Seeing dark patches or spots

  • Poor night vision

  • Loss of vision

In the later stages of diabetic retinopathy, blindness or retinal detachment can occur.

Protect Your Vision by Managing Your Diabetes Early

Losing your vision to diabetic retinopathy can be irreversible, but if you've taken the steps to detect and address diabetes as early as possible, your risk of blindness goes down by as much as 95 percent. It's best to get a dilated eye exam every year to check for this condition; however, if you've been diagnosed with diabetic retinopathy already, then you may need more frequent eye exams. The same applies to pregnant women.

According to studies such as the Diabetes Control and Complications Trial (DCCT), proper management of diabetes can slow the onset of diabetic retinopathy, as well as prevent it from worsening. The study found that participants who kept their blood glucose level as normal as possible were less likely to develop this condition, compared to those who did not control their glucose levels.12

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