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CataractWhat is Cataract?Read more...
Corneal TransplantWhat is Corneal Transplant?Read more...
Dry Eye SyndromeWhat is Dry Eye Syndrome?Read more...
Diabetic RetinopathyWhat is Diabetic Retinopathy?Read more...
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GlaucomaWhat is Glaucoma?Read more...
Retinal DetachmentWhat is Retinal Detachment?Read more...
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UveitisWhat is Uveitis?Read more...
VitrectomyWhat is Vitrectomy?Read more...
What is Retinopathy?
The term retinopathy covers various disorders of the retina, which can affect vision. Retinopathy is usually due to damage to the tiny blood vessels in the retina. Retinopathy is commonly caused by diabetes, but is sometimes caused by other diseases such as very high blood pressure. If you have diabetes, it is vital that you have your eyes checked regularly. Damage to the retina at the back of the eye (retinopathy) is a common complication of diabetes. If left untreated, it can get worse and cause some loss of vision, or blindness in severe cases. Good control of blood sugar (glucose) and blood pressure slows down the progression of retinopathy. Treatment with a laser, before the retinopathy gets severe, can often prevent loss of vision.
Diabetes mellitus (just called diabetes from now on) occurs when the level of sugar (glucose) in the blood becomes higher than normal. There are two main types of diabetes - type 1 and type 2.
What is Diabetic Retinopathy ?
The condition of diabetic retinopathy happens with those who have diabetes that results in progressive damage to the retina. The condition is due to the damaged caused to the small blood vessels responsible for nourishing the retina. Clouding of the vision and swelling of the retinal tissue is due to leaking of the blood and other fluids from these small blood vessels. Both eyes can get affected by this condition. There are more chances of diabetic retinopathy in those people who have been suffering from diabetes for a very long time. Diabetic retinopathy has been regarded as a serious sight-threatening condition. Diabetic retinopathy has four stages -
Retinopathy can also cause swelling of the macula of the eye. This is called macular edema. The macula is the middle of the retina, which lets you see details. When it swells, it can make your vision much worse.
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Causes and Symptoms of Diabetic Retinopathy
Most of the time, there are no symptoms of diabetic retinopathy until it starts to change your vision. When this happens, diabetic retinopathy is already severe. Having your eyes checked regularly can find diabetic retinopathy early enough to treat it and help prevent vision loss. Changes in vision can be a sign of severe damage to your eye. These changes can include floaters, pain in the eye, blurry vision, or new vision loss.
If you are not able to keep your blood sugar levels in a target range, it can cause damage to your blood vessels. Diabetic retinopathy happens when high blood sugar damages the tiny blood vessels of the retina. When you have diabetic retinopathy, high blood pressure can make it worse. High blood pressure can cause more damage to the weakened vessels in your eye, clouding more of your vision. This may result into swelling and hemorrhage of the retina.
Stages of Diabetic Retinopathy
Non-proliferative diabetic retinopathy (NPDR) - NPDR is the early state of the disease in which symptoms will be mild or non-existent. In NPDR, the blood vessels in the retina are weakened causing tiny bulges called microanuerysms to protrude from their walls. The microanuerysms may leak fluid into the retina, which may lead to swelling of the macula.
Proliferative diabetic retinopathy (PDR) - PDR is the more advanced form of the disease. At this stage, circulation problems cause the retina to become oxygen deprived. As a result new fragile blood vessels can begin to grow in the retina and into the vitreous, the gel-like fluid that fills the back of the eye. The new blood vessel may leak blood into the vitreous, clouding vision. Other complications of PDR include detachment of the retina due to scar tissue formation and the development of glaucoma. Glaucoma is an eye disease defined as progressive damage to the optic nerve. In cases of proliferative diabetic retinopathy, the cause of this nerve damage is due to extremely high pressure in the eye. If left untreated, proliferative diabetic retinopathy can cause severe vision loss and even blindness.
Diagnosis of Diabetic Retinopathy
Diabetic retinopathy can be diagnosed through a comprehensive eye examination. Testing, with special emphasis on evaluation of the retina and macula, may include -
Supplemental testing may include -
Treatments for Diabetic Retinopathy
Glucose control - the Diabetes Control and Complications Trial found that intensive glucose control in patients with insulin-dependent diabetes mellitus (IDDM) decreased the incidence and progression of diabetic retinopathy. It may be logical to assume that the same principles apply in non-insulin-dependent diabetes mellitus (NIDDM).
Laser photocoagulation - this involves directing a high-focused beam of light energy to create a coagulative response in the target tissue. In nonproliferative diabetic retinopathy (NPDR), laser photocoagulation is indicated in the treatment of clinically significant macular edema.
Panretinal photocoagulation (PRP) is used in the treatment of PDR. It involves applying laser burns over the entire retina, sparing the central macular area.
Vitrectomy - this procedure can be used in PDR in cases of long-standing vitreous hemorrhage (where visualization of the status of the posterior pole is too difficult), tractional retinal detachment, and combined tractional and rhegmatogenous retinal detachment.
Cryotherapy - when laser photocoagulation in PDR is precluded in the presence of an opaque media, such as in cases of cataracts or vitreous hemorrhage, cryotherapy may be applied instead.
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