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Persistently elevated blood sugar levels may occur concurrently with high blood pressures, leading to various blood vessels' damage. Damage to the blood vessels, including the retinal blood vessels, may result in random growth, blockage, or leakage. It implies that the retina will not get adequate blood to function correctly, leading to poor vision.
A diabetic patient should maintain the glucose levels to prevent complications such as diabetic retinopathy. Early diagnosis allows for early treatment of the eye condition without any severe long-term impacts.
Elevated blood glucose for extended periods leads to diabetic retinopathy. Excess blood sugar destroys blood vessels supplying your retina. The retina converts images into signals that the brain can detect. Damage to retinal blood vessels cuts off blood supply to the area leading to less perfusion.
Angiogenesis is responsible for the compensatory mechanism. However, the new blood vessels are weaker and are prone to leakage. The resulting scar tissue may lead to vision loss. Having diabetes for an extended period increases your chances of having diabetic retinopathy.
It is common to observe retinopathy symptoms in patients who have had diabetes for more than 30 years. Pregnant diabetic patients should consider comprehensive eye examinations for early detection of retinopathy.
The development of diabetic retinopathy occurs in stages. After eye screening, your result will contain a number and a letter that denote your type of retinopathy. The numeral denotes the extent of damage present if any.
Some of the common retinopathies include:
In background retinopathy, your eyesight is not affected yet. However, it would help if you embraced preventive mechanisms to prevent the worsening of the condition. In the results you obtain after eye screening, R1 may represent background retinopathy. Background retinopathy is also known as non-proliferative diabetic retinopathy. In this stage, the eye does not embrace angiogenesis in the initial stages of retinopathy.
In the initial stages, the destroyed retinal blood vessels will leak fluid and blood into your eye. In some instances, the retinal center will begin to swell, leading to edema of the macula. The stages of non-proliferative diabetic retinopathy include mild, moderate, and severe. It can progress to the fourth stage, which is proliferative retinopathy.
Diabetic maculopathy affects the center of your eye, interfering with your ability to drive or read. In the presence of fluid building up in the eye and affecting your vision, the ophthalmologist will represent it as M1.
It is also known as advanced retinopathy. In this stage, angiogenesis begins within the patient's retina. The new vessels are abnormal, and they are at the center of your eye.
Note that symptoms are rare in the initial stages of diabetic retinopathy. The symptoms will not appear till severe damages occur in the eye. The best way of preventing the complications is by having your blood glucose levels under control and embracing regular eye examinations. When symptoms appear, they affect both eyes.
Your physician may employ dilated eye examination in diagnosing diabetic retinopathy. It involves using eye drops to dilate the pupils to allow the physician to examine your eye. The physician may check for retinal detachment, nerve tissue damage, variation in the lens, scarring, blockage of the vessels, and swelling. Blood vessel leakage and an abnormal blood vessel are also symptoms associated with retinopathy.
Besides the above eye examinations, the physician may carry out fluorescein angiography. In the procedure, the physician will inject some dye into the patient's arm. The aim is to track blood flow within the patient's eye. The physician will take pictures as the dye circulates to determine any leakage or blockage in the retinal vessels.
Eye examination by use of optical coherence tomography applies light waves to get retinal images. Through the pictures, the physician will determine retinal thickness. Besides, OCT reveals the amount of fluid accumulating in your retina.
Patients in the early stages of diabetic retinopathy have limited treatment options. The physician may recommend regular eye examinations. Background retinopathy lacks treatment. However, patients with background retinopathy require routine eye examination. It is vital for the monitoring of eye health when there is a need to undergo treatment.
An endocrinologist's input is critical as they help slow the condition's progression through proper blood sugar control. In advanced retinopathy, treatment relies on the severity and type of retinopathy. An ophthalmologist may recommend photocoagulation surgery to prevent loss of vision.
Photocoagulation surgery incorporates the use of a laser beam to minimize or stop the leakage. In proliferative retinopathy, lasers focus on problematic areas to ensure improved blood circulation. It allows nutrients and oxygen to reach the retina. Also, it prevents the formation of weaker vessels and minimizes leaking. Below are the forms of photocoagulation:
Vitrectomy entails the removal of cloudy fluid and scar tissue from the vitreous fluid. Ophthalmologists will replace the vitreous humor with a transparent substance such as silicone fluid or saline. The procedure is necessary when hemorrhage is obscuring vision because it has not healed. Vitrectomy is also crucial when there is a risk of retina detaching.
The gas or liquid that ophthalmologists use in replacing the vitreous gel will be absorbed.
During laser treatment, the ophthalmologist may apply a local anesthetic on the patient's eye and eye drops to dilate the pupils. A contact lens is also necessary to keep the patient's eyelids open and focus on the laser beam. For effective treatment, it would be best if you kept your eyes still. After the procedure, your eyes may be sensitive to light, and the vision could be blurred temporarily.
Laser treatment effectively manages maculopathy as it restores oxygen and nutrient supply to your retina. The procedure is painless with no adverse effects. However, it influences peripheral vision and night driving. Laser treatment may not improve your sight, but it prevents the worsening of the complications.
It is an intra-ocular injection, where a physician injects a drug into your eyes to minimize fluid leakage on the macula. Besides, it helps in the stimulation of newer blood vessels to enhance retinal nutrient and oxygen supply. Note that an anti-VEGF injection may be associated with a temporary rise in pressure within the eyes and blurred vision. Physicians may recommend multiple sessions at a month interval.
Loss of vision among diabetic patients is gradual. The blindness does not set in suddenly. Hence, the need to control or avoid risk factors that may exacerbate diabetic retinopathy.
You can maintain healthy eyes by considering the following:
Regular screening will help in the early identification of problems before significant alteration in your vision occurs. Diabetic patients above 12 years should consider eye screening at least once annually. Symptoms associated with diabetic retinopathy may differ from one patient to another. However, there are common symptoms such as struggling with night vision, dimmer vision, and seeing floaters.
If you notice the above symptoms, promptly reach out to your vision. Ensure your blood glucose levels are within the normal range because a spike in blood sugar may also cause blurriness. Keep in touch with an endocrinologist to help you manage diabetes. They should regularly check your glycated hemoglobin to ensure it does not exceed 6.5%.
Persistently elevated blood pressures and excess cholesterol in plasma are among the significant risk factors for retinopathy. Ensure your blood pressure is below 130/80 mmHg. It would be best if your plasma cholesterol is below four mmol/l and triglycerides less than 1.7 mmol/l.
Regular physical activities and a healthy diet are vital in preventing diabetic retinopathy. Smoking is a risk factor for elevated plasma cholesterol that may worsen diabetic retinopathy. Smoking cessation is necessary for better eye health.
Retinopathy may cause blindness. Fortunately, it is treatable when detected early enough. Patients who have had diabetes for several years are probably at an early stage of retinopathy. Hence, the need for regular retinopathy screening every year.
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