Diabetic retinopathy(DR) is an eye disease associated with diabetes. It happens due to the increased blood sugar level damage to the retinal blood vessels. The retina is the light-sensitive tissue present at the back of the eye. An individual who has been dealing with diabetes for a long time is more prone to the risk of this disease. The recognition of diabetic retinopathy at its initial stage is important for early detection and immediate treatment. Here in this blog, we will explore the 7 common diabetic retinopathy symptoms you should be aware of:

What are the Main Diabetic Retinopathy Stages?

There are two main stages:

• Nonproliferative Retinopathy- This is the early stage of diabetic retinopathy in which the blood vessels leak and swell, in some cases this can cause swelling of the retina or macular edema. This may result in mild vision loss but it can be treated.

• Proliferative Retinopathy- This is the advanced stage of diabetic retinopathy in which new abnormal blood vessels are grown on the surface of the retina. These blood vessels bleed into the vitreous (the clear gel that fills the eyes). At this stage of diabetic retinopathy, urgent treatment is required as it can cause severe vision loss.

Common Diabetic Retinopathy Symptoms You Should be Aware of:

• Blurry Vision – This is the early sign of diabetic retinopathy. This occurs due to the increased blood sugar level that causes fluid to leak into the eye and affects the ability of the retina to focus properly. At the initial stage, you notice difficulty reading and seeing distant objects.

• Floaters– Floaters are specks or spots that appear to drift across your field of vision. They are often caused by small amounts of blood leaking into the vitreous, the gel-like substance that fills the center of the eye. Floaters can appear as dark strings or spots and may increase in number as diabetic retinopathy progresses.

• Sudden Vision Loss– In some cases, diabetic retinopathy can cause sudden vision loss. This occurs when there is significant bleeding into the eye, leading to a sudden vision blockage. Immediate medical attention is necessary if you experience sudden vision changes.

• Empty or Dark Areas in Vision– As diabetic retinopathy progresses, it can lead to the development of dark or empty areas in your vision. These spots may grow larger over time, impairing your ability to see clearly.

• Difficulty seeing at night – A person who has diabetic retinopathy experiences difficulty seeing in low-light conditions or at night. This symptom can be attributed to damage to the retina, which affects its ability to adjust to changes in light levels.

• Impaired Color Vision – Another symptom of diabetic retinopathy is impaired color vision. You may notice difficulty distinguishing between colors or perceiving subtle differences in shades. This can affect your ability to perform tasks that require color recognition, such as driving or reading.

• Vision Changes in Both Eyes – Diabetic retinopathy typically affects both eyes, although one eye may be more severely affected than the other. It’s important to pay attention to changes in vision in both eyes, as early detection and treatment can prevent further damage.

Diabetic Retinopathy Causes:

• Poorly controlled or long-duration diabetes
• Chronic inflammation associated with diabetic retinopathy
• Increased blood pressure and cholesterol
• Obesity
• Smoking
• Genetic factors
• Changes in the flow of blood
• Damage or rupture of blood vessels

Diabetic Retinopathy Diagnosis

At the time of the diabetic retinopathy eye test, your eye doctor will do a visual acuity test to measure how well you can see at various distances. Then, your doctor dilates (widen) your pupil with drops to see more clearly inside the eye and examine the signs of damage.

An ophthalmologist uses a special instrument called an ophthalmoscope to examine any abnormalities in the retina such as blood vessel changes (microaneurysms and hemorrhages), swelling, and fluid deposits. This process is known as fundoscopy.

In some cases, a fluorescein angiography may be performed to provide more detailed information about the blood flow in the retina. A special dye is injected into a vein in your arm, and photographs are taken as the dye circulates through the blood vessels in your retina. This test helps to identify areas of leakage and abnormal blood vessel growth.

Optical Coherence Tomography (OCT) is a technique used to measure or detect the thickening or swelling of the macular edema (retina). This technique uses light waves for the detailed cross-sectional image of the retina.

Tonometry measures the intraocular pressure (pressure inside the eyes) which can indicate any other eye conditions that may coexist with diabetic retinopathy.

Diabetic Retinopathy Treatment

The diabetic retinopathy treatment depends on the type and severity of disease. At the initial stage of DR, if you have mild or moderate non-proliferative DR:

Follow regular diabetic eye tests to monitor the progression of the disease, and manage blood pressure, blood sugar level, and cholesterol. Maintain a healthy diet, quit smoking, and lifestyle modification.

For Advanced Diabetic Retinopathy:

• Laser therapy– Photocoagulation to seal leaking blood vessels or scatter laser treatment (pan-retinal photocoagulation) to shrink abnormal blood vessels.
• Injections– Anti-VEGF medications (e.g., ranibizumab, aflibercept) to reduce swelling and leakage in the retina.
• Vitrectomy Surgery– to remove scar tissue or blood from the eye in severe cases.
• Steroid Injections– to reduce swelling and inflammation in cases of diabetic macular edema.
• Anti-VEGE therapy- to block abnormal blood vessel growth and reduce swelling.

Diabetic Retinopathy Eye Care Plan

• Schedule regular eye tests
• Maintain blood sugar level
• Adopt a healthy lifestyle
• Adhere to medications
• Understand the signs and symptoms of diabetic retinopathy
• Monitor the progression of diabetic retinopathy

The bottom Line

Diabetic retinopathy is a serious eye condition that affects people with diabetes. If you do not get proper medical attention or leave it without treatment, it can cause severe complications that include permanent vision loss. Having a complete dilated eye test at least once a year can help you catch the diabetic retinopathy symptoms early and prevent complications.

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Written and Verified by:

DR. SHILPI GANG

MBBS (GOLD MEDALIST), MD (AIIMS, NEW DELHI)

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