Diabetic retinopathy | Symptoms|Risk factors|Classification|Complication|Treatment.

What is Diabetic Retinopathy?

Diabetic retinopathy is a complication of diabetes that is caused by high blood sugar that damage the back part of the eye called the retina. It can be dangerous when it is not diagnosed and untreated, which may lead to loss of vision.

Diabetic retinopathy refers to retinal changes seen in patients with diabetes mellitus with an increase in the life expectancy of diabetes, the incidence of diabetic retinopathy has increased. Diabetic retinopathy is a leading cause of blindness.

To minimize the risk of this happening, person with diabetes should:

1. They should control their blood sugar level, blood pressure, and cholesterol.
2. The patient should check sugar levels regularly.
3. Diabetic patient should also check their eye regularly.

causes 

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.

The damages to your eyes start when sugar blocks the tiny blood vessels that go to your retina, causing them to leak fluid or bleed.

How diabetes can affect the eyes

Part of the eye retina is the light-sensitive lear of the cell, which is at the back part of the eye that converts light into an electrical signal. Those signals are sent to your brain which turns them into the image you see.

The retina needs a constant supply of blood so, if your blood sugar level is high it may damage your blood vessels in 3 main stages:

1. Background retinopathy: The tiny bulges deployed in the blood vessels, that may bleed slightly but they usually don't affect your vision.
2. Pre- proliferative retinopathy: This can be more severe and widespread which can affect the blood vessels.
3. Proliferative retinopathy: This can scar tissue and new blood vessels, that make them weak and can bleed easily. It can cause loss of vision.
   
   

Risk factors

• Duration of diabetes
• Age of onset of diabetes also acts as a risk factor.
• Poor metabolic control.
• Sex incidence is more in females than males.
• Heredity
• Pregnancy
• Hypertension- When associated, may also accentuate the change of diabetic retinopathy.
• Other risk factors include Smoking, Obesity, Anaemia, and Hyperlipidemia.

Symptoms

The early stage of diabetic retinopathy usually doesn't have any symptoms. Some people notice changes in their vision like trouble in reading or seeing faraway's objects. The condition which progresses diabetic retinopathy symptoms is included.

1. Spots or dark string floating in your vision.
2. Fluctuating vision 
3. Impaired color vision
4. Dark or empty areas in your vision.
5. Vision Loss

Diabetic retinopathy usually affects both eyes.

Classification of diabetic retinopathy

• Non-proliferative diabetic retinopathy

1. Mild nonproliferative diabetic retinopathy
2. Moderate non-proliferative diabetic retinopathy 
3. Severe non-proliferative diabetic retinopathy 
4. Very severe non-proliferative diabetic retinopathy

• Proliferative diabetic retinopathy  
• Diabetic maculopathy
•  Advance diabetic eye disease

Complications

Diabetic retinopathy involves the abnormal growth of blood vessels in the retina. Complications can lead to serious vision loss.

1. Vitreous hemorrhage 
2. Retinal detachment
3. Glaucoma 
4. Cataract

Blindness eventually, diabetic retinopathy, glaucoma or both can lead to complete vision loss.

Prevention

Diabetic retinopathy can be prevented by controlling your blood sugar levels. Doing regular check-ups of your sugar and your eyes should be examined every 6 months. So, that you can know your eye condition which helps you to prevent severe vision loss.

1. Manage your diabetes- Take a healthy diet and physical activity should be in your daily routine.
2. Monitor your blood sugar level- you have to check and record your blood sugar level every day.
3. Keep your blood pressure and cholesterol under control- Maintaining your balanced diet, regular exercise, and losing weight can help. Medication is important.
4. If you smoke or use other types of tobacco, you have to quit- smoking increases your risk of various diabetes complications, including diabetic retinopathy.
5. Pay attention to vision changes. Contact your eye doctor if you notice any changes in your vision or becomes blurry, spotty, or hazy.

Treatment

Treatment of diabetic retinopathy are as follows;

1. Laser treatment - To reduce swelling in your retina, eye doctors can use lasers to make the blood vessels shrink and stop leaking.
2. Eye injections - Medicines called anti-VEGF drugs can slow down or reverse diabetic retinopathy. Other medicines, called corticosteroids, can help.
3. Eye surgery - If your retina is bleeding a lot or you have a lot of scars in your eye, your eye doctor may recommend the type of surgery called a vitrectomy.

Written by Barsha Panth