The retina needs a constant supply of blood, which it receives through a network of tiny blood vessels. Over time, a persistently high blood sugar level can damage these blood vessels in 3 main stages:
- background retinopathy – tiny bulges develop in the blood vessels, which may bleed slightly but don’t usually affect your vision
- pre-proliferative retinopathy – more severe and widespread changes affect the blood vessels, including more significant bleeding into the eye
- proliferative retinopathy – scar tissue and new blood vessels, which are weak and bleed easily, develop on the retina, this can result in some loss of vision
However, if a problem with your eyes is picked up early, lifestyle changes and/or treatment can stop it getting worse.
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Symptoms Of Diabetic Retinopathy
In the early stages of diabetic retinopathy, you will have very little obvious symptoms. The only way you will be aware of early diabetic retinopathy signs will be at your annual eye exam.
But please contact your GP or eye clinic immediately if you experience any of the following:
- gradually worsening vision
- black spots floating in your field of vision
- blurred vision (like looking thru a glass of water)
- eye pain or redness
- sudden vision loss
These symptoms don’t necessarily mean you have diabetic retinopathy, but it’s important to get them checked out. Don’t wait until your next screening appointment.
Over time, too much sugar in your blood can lead to the blockage of the tiny blood vessels that nourish the retina, cutting off its blood supply. As a result, the eye attempts to grow new blood vessels. But these new blood vessels don’t develop properly and can leak easily. This causes blood to build up in your vitreous humor which causes vision problems.
Diabetic Retinopathy Screening
Once a year you will be advised to have an annual eye test if you are over 12 years old and a diabetic. When you go to your eye screening appointment bring your glasses or contact lenses with you if you wear any. I would also advise you to bring a pair of sunglasses because your eyes will be very sensitive to light after the eye drops. Also, bring somebody with you as you won’t be able to drive after the eye drops. It takes a few hours for the eye drops to wear off.
What happens during a diabetic eye screening
You go for diabetic eye screening in your GP practice, at a hospital or at a clinic. They use a camera to take photographs of your eyes.
The test takes about 15 minutes. When you first arrive you will have your sight measured by doing the standard eye chart test. After this you will be given eye drops to dilate your pupils, this gives a better quality picture.
Your eyes must be fully open for a good photograph to be achieved. Be aware that it may take a few attempts to get the photograph just right. The photographs need to be examined in detail to be able to advise on the condition of your retina.
Some opticians may give you a rough idea on the day but you should not expect them to. You will receive the results of your screening by letter. Allow a few weeks for the letter to arrive. If you do not receive the letter within one month, let your GP or health center know.
What They Are Looking For
During the exam, your eye doctor will look for:
- Abnormal blood vessels
- Swelling, blood or fatty deposits in the retina
- The growth of new blood vessels and scar tissue
- Bleeding in the clear, jelly-like substance that fills the center of the eye (vitreous)
- Retinal detachment
- Abnormalities in your optic nerve
In addition, your eye doctor may:
- Test your vision
- Measure your eye pressure to test for glaucoma
- Look for evidence of cataracts
Treatments For Diabetic Retinopathy
The main treatments for more advanced diabetic retinopathy are:
This is the most common treatment for retinopathy. If you have this treatment and manage your blood sugar levels well, it can prevent eye damage from getting worse. But it won’t usually improve your sight.
Focal laser treatment
You may need a focal laser treatment if you have advanced diabetic retinopathy. This treatment can stop or slow blood leakage from your blood vessels by burning the abnormal blood vessels. This treatment should stop symptoms and can reverse them.
Scatter laser treatment
This type of laser treatment can shrink abnormal blood vessels and scar them so they’re less likely to grow or bulge in the future.
Injections of medication into your eyes
In some cases of diabetic maculopathy, injections of a medicine called anti-VEGF may be given directly into your eyes to prevent new blood vessels forming at the back of the eyes. The main medicines used are called ranibizumab(Lucentis) and aflibercept (Eylea).
An operation to remove blood or scar tissue from your eyes
Vitrectomy is a surgical procedure where the vitreous humor gel that fills the eye cavity is removed to provide better access to the retina. This allows for a variety of repairs, including the removal of scar tissue, laser repair of retinal detachments and treatment of macular holes
I had a few sessions of laser treatment, it is not a nice experience and even after eye drops to numb the eye, I could still feel pain in some parts of the eye while having the laser treatment. I then had a vitrectomy a few months after laser to remove the vitreous humor gel in both eyes about a month apart from each other. Although the thought of needles and drills in my eyes really scared me this procedure was painless and gave me back some eyesight after being virtually blind for 12 months due to the leaked blood from my eye vessels not draining from the eye and staying within the vitreous humor gel.
Surgery often slows or stops the progression of diabetic retinopathy, but it’s not a cure. Because diabetes is a lifelong condition, future retinal damage and vision loss are still possible.
Even after treatment for diabetic retinopathy, you’ll need regular eye exams. And you may need further treatment in the future.
Coping And Support
The thought that you might lose your sight can be frightening, and you may benefit from talking to a therapist or finding a support group. Ask your doctor for referrals.
If you’ve already lost some vision, you will be put in touch with a low vision clinic, they will be able to help you with things such as magnifiers etc. I was given a great device you put over the top of your cup when making a cup of tea, it vibrated to tell you there was enough water in the cup. I also had some magnifying glasses, like the ones to the right, I looked so silly in them but they were a godsend for reading things. To purchase Low Vision Products that can help you please visit this page
Treatments for diabetic retinopathy are often very successful, but they’re not a cure. Diabetes is a chronic condition, which means you’ll likely experience complications of the condition for the rest of your life. This includes vision problems. There is plenty of support out there if you are partially sighted/severely sighted or blind, services that can make daily living easier and plenty of products specifically for visual problems