Diabetic Retinopathy: What are the Risks?

Diabetic retinopathy is a complication of diabetes that causes damage to the retina, in the back of the eye. The retina is responsible for the transmission of light into the eye, and damage to it can eventually lead to blindness. In this article we'll aim to explain what this condition is, what its symptoms are and how you can reduce the risks of developing it if you have diabetes.

What are the causes of Diabetic Retinopathy?

To understand what causes this condition, we have to understand diabetes first. Diabetes is a chronic condition that makes a person's blood sugar levels become too high, as the body cannot properly use or produce insulin. Insulin is a hormone that helps us regulate our sugar levels and allows us to transform that sugar into energy. There are two types of diabetes:

  • Type 1: The body's immune system attacks the cells that produce insulin. 
  • Type 2: The body does not produce enough insulin or doesn't react to insulin.

Diabetes doesn't inherently cause a loss of vision, but people with diabetes, regardless of which type, are at risk of developing diabetic retinopathy. High blood sugar levels can damage the blood vessels in the retina, which needs a constant supply of blood. This normally occurs in three main phases:

  1. Background retinopathy: Tiny bulges develop in the blood vessels in your retina. The vessels may leak a small amount of blood and fluid into your retina, but your vision is normally not affected at this stage.
  2. Pre-proliferative retinopathy: There might be a more significant bleeding into the eye, and blood vessels get swollen and start becoming blocked, being unable to carry blood as usual. Besides causing changes in the retina, it could also damage the macula, responsible for our central vision, and develop into diabetic macular oedema. More than 50% of people who suffer from diabetic retinopathy will develop this condition. Reaching this second stage means that you're at a greater risk of your vision being affected, and your doctor might recommend more regular eye tests, perhaps every 3 to 6 months.
  3. Proliferative retinopathy: At this stage, there is a lack of blood reaching your retina due to the blocking of damaged blood vessels. This triggers the creation of new blood vessels, which are usually weaker and prone to tearing and bleeding. Their bleeding can cause scar tissue which can pull the retina away from the back of your eye (retinal detachment). In this stage you are at severe risk of losing your vision. Treatment might help you to stop it from deteriorating further, but you most likely won't be able to recover any lost vision.

Symptoms of Diabetic Retinopathy

As we mentioned, people who suffer from this condition usually don't notice any changes in their vision at first. Nevertheless, it can still be detected during eye examinations. In more advanced stages, you might experience the following symptoms:

  • Eye pain or redness
  • Gradually worsening vision
  • Blurred vision
  • Floaters: shapes that appear to be floating in your field of vision. They might look like squiggly lines or dark spots

(Normal Vision)

(Vision with diabetic retinopathy)

    Having these symptoms doesn't have to mean that you have diabetic retinopathy, but it's still important to have them checked by your doctor or ophthalmologist.

    Risk Factors 

    As we saw, anyone with diabetes could be at risk of developing diabetic retinopathy. However, there are some factors that increase this possibility:

    • Having had diabetes for a long time, the longer you've had diabetes for, the higher the risk of developing diabetic retinopathy.
    • Constantly high blood sugar levels which have not been properly controlled.
    • High blood pressure.
    • High cholesterol.
    • Pregnancy. If a woman suffers from diabetic retinopathy, the condition might progress more rapidly during pregnancy due to an increase in sugar (glucose) levels.
    • Ethnicity. People of African, Caribbean or Asian origin are at a higher risk.
    • Smoking, which can also increase the risk of developing other complications related to diabetes.

    Prevention and Treatment

    The best way to reduce the risk of developing diabetic retinopathy is by keeping your diabetes in check. Make sure you take your diabetes medication and control your blood sugar, blood pressure and cholesterol levels. Of course, exercise and a healthy diet can also help.

    In relation to treatment, it will only be needed if there is a threat to your vision. Your doctor will monitor your condition and prescribe a treatment if needed. The possible treatments are:

    • Injections of steroid medicine, injected directly into your eyes they can help prevent the progression of the condition by stopping swollen blood vessels from growing.
    • Laser surgery, to shrink swollen blood vessels that are affecting your vision.
    • An eye operation, to remove blood and scar tissue

       

      Low Vision Aids, Lighting and Technology

      A number of tools and devices can help people with diabetic retinopathy carry out daily activities and maintain their independence. Low Vision Aids can be helpful for many daily tasks.