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Diabetic Retinopathy |
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Diabetes is a vascular disease and can cause retinopathy.
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What is retinopathy?
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Retinopathy is the condition of the retina, blindness from retinopathy can thoeritically be prevented. In Iceland it has been prevented by doing regular eye checks and tight control of diabetes.
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Types of Retinopathy
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Diabetes can cause damage to vital organs including retina. Unfortunately the condition may progress from no or mild retinopathy to a much more severe type.
- No retinopathy: many people have a basically healthy retina. If you can control your diabetes and blood pressure at this stage it will help prevent or slow down any harmful changes.
- Background retinopathy: is an early form of retinopathy.
- Maculopathy: this is more serious. Eventually your sight may become reduced. Laser and blood pressure control help.
- Pre-proliferative or non proliferative: stage before the new blood vessels start growing.
- Proliferative retinopathy: when the new vessels grow. These blood vessels are very delicate and can bleed easily. Laser is very effective in stopping the new vessels grow.
There are other conditions that may be present:
- Retinal scarring: scars develop on the surface of the retina
- A vitreous haemorrhage: this occurs when the new vessels bleed
- A retinal detachment: the retina can peel off the back of the eye
Controlling your diabetes and blood pressure also helps to prevent other problems such as neuropathy and kidney damage
Preventive measures:
- keep to a healthy diet
- have regular exercise
- have regular checks of your eyes (with dilated pupils)
- have regular checks or your glucose, HbA1C, & blood pressure,
- attend your annual diabetic review where your urine protein, feet, and other checks are carried out
- keep your blood sugar, blood pressure, and fat levels as normal as possible as below keep a diary of glucose readings
- Record your lipids and blood pressure in the comments section of your glucose diary or in your shared care card
- Remember if you have (but are not yet diabetic) impaired glucose tolerance (pre-diabetes in the US) you may progress to diabetes. A healthy diet, not being overweight, having lots of exercise, can delay or prevent this progression.
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Treatment:
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Laser treatment is the main treatment of retinopathy. It is usually carried out in a darkened room in clinic. Anaesthetic drops are dropped into your eye, a contact lens is placed on your eye, and you have to sit at a laser slit lamp. This is virtually the same machine as that used for the regular examination, but a laser has been added on.
Each treatment is slightly different, depending on the condition of the eye. Laser is simply a highly focused and powerful light, where the light rays are all of the same type. Therefore it can be pointed at one spot on the retina very accurately. Each bright flash lasts 0.1seconds The commonest laser is Argon Green, wavelength 530nm, but other wavelengths can be used and most are equally effective. Other types of light were used before laser was introduced.
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Surgery:
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Surgery is also required in very severe cases of proliferative type of diabetic retinopathy where there is a scarring and detachment of the retina.
Cataract can happen on its own or as a result of diabetes, it requires surgery for two reasons, one for vision improvement if it has caused decreased vision and secondly for monitoring of the diabetic retinopathy, when it obstructs the view of the retina. |
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