Diabetic Retinopathy Video
Causes of diabetic retinopathy
Chronic high blood sugar as a result of uncontrolled diabetes is the main cause of diabetic retinopathy. Diabetes affects the blood vessels of the body, including the tiny blood vessels in the retina. Blockages may be caused in the tiny blood vessels that nourish the retina, cutting off its blood supply. Early diabetic retinopathy, otherwise known as nonproliferative diabetic retinopathy (NPDR), is diagnosed when the nerve fibres in the retina or the macula begin to swell. This can result in blurring of vision which comes and goes over the day, depending on your blood sugar levels.
Over time these damaged and blocked vessels may close off and lead to the development of new blood vessels on the surface of the retina. These abnormal blood vessels can leak or bleed in the vitreous and lead to pressure in the eyeball resulting in glaucoma. This is then categorised as advanced diabetic retinopathy.
Symptoms
While many may only experience mild visual distortions, in advanced stages, symptoms of diabetic retinopathy may include:
- Spots or floaters in your vision
- Vision that fluctuates during the day
- Vision that sometimes changes from blurry to clear
- Poor night vision
- Dark or empty areas in your vision
- Colours that appear faded
The extent of these changes on what type of diabetes you have. Roughly 40% of people with type 1 diabetes and 20% of those with type 2 diabetes will develop some sort of diabetic retinopathy. While this condition is sight-threatening, early blindness is usually preventable with routine checks and effective management of underlying diabetes.
Treatment of diabetic retinopathy
All type 1 and Type 2 Diabetics should have a thorough eye examination including dilated retinal examination at least once per year. Dr York will perform a thorough eye examination and dilated retinal examination including photos and a 3 D scan of your retina. Diabetes is a PMB condition and all medical aid funds in South Africa cover an annual Diabetic Retinopathy consultation with an Ophthalmologist. This screening examination and any treatment required will be covered by the chronic benefit on your medical aid, regardless of whether your plan has a medical savings benefit or not.
Treatment of Diabetic Eye Disease is based on the visual symptoms you are experiencing and the stage of diabetic retinopathy diagnosed. In most cases controlling blood sugar and blood pressure is the first priority for treatment as proper blood sugar control can bring some of the vision back and prevent any further damage.
- Medications
In addition to this, anti-VEGF medications may be prescribed by your eye specialist to reduce swelling of the macula and slow the vision loss by preventing the growth of abnormal new blood vessels. In some cases, this medication can improve vision. This medication is generally administered through injections in the eye that may be given as often as monthly. - Laser surgery
In particular, cases where new vessel growth (neovascularisation) has been detected, Dr York may suggest laser surgery to shrink blood vessels, help seal off any leaking blood vessels, or prevent them from growing preventing them from causing serious complications for your vision. If the treatment is successful, the new vessels shrink and disappear over a few months.
While laser treatment aims to prevent your vision from getting worse, it cannot restore lost vision or make your vision better. - Vitrectomy
For advanced diabetic retinopathy where the gel inside the eye has become cloudy, or if scar tissue has formed, leading to retinal detachment, it may be necessary to have an eye surgery known as a vitrectomy. During this surgery, your ophthalmologist removes vitreous gel and blood from leaking vessels in the back of your eye and replaces it with a clear solution that light can pass more easily through. This allows light rays to focus properly on the retina again.