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Diabetic retinopathy is an eye problem that affects the retina of the eye and causes total and irreparable blindness. It usually occurs after 15 to 20 years of diabetes. Poorer the control earlier is the onset. Association of hypertension and increased blood cholesterol make the condition more serious.
In initial stages, there may not be any visual symptoms. Some patients may get macular edema marked with a decrease in the vision without exhibiting diabetic retinopathy.
Here is some important aspect of the disease that you should know:
Symptoms as the condition progress: you might experience blurred or fluctuating vision, impaired color vision, spots or dark strings floating in your vision, dark or empty areas in your vision and an even significant decrease in vision which is not corrected with glasses. Diabetes can cause early cataract formation (diabetic cataract) in the eye.
Causes: In an uncontrolled diabetic patient, the blood supply to the retina is decreased due to vascular constriction, in due course of time. This causes anoxia which promotes new vessel formation which may leak causing macular edema and or exudates. The newly formed vessels are fragile, can cause small projections (aneurysms) or may bleed. This all happens in the most sensitive central part of the retina (macula) thereby affecting vision to varying degree.
Advanced diabetic retinopathy: more edema, exudates, and hemorrhages occur. The newly formed vessels may profusely bleed in the cavity of the eye, seriously affecting vision. In due course of time, retinal fibrosis occurs which may cause retinal detachment and total blindness. Few eyes may develop an increase in intraocular pressure (glaucoma) at any stage of the disease, causing blindness even without advanced diabetic retinopathy.
When does the risk increase: longer the duration, higher the incidence. If you have an uncontrolled blood sugar ideally evaluated by hb1ac (glycosylated HB) test, hypertension and increased cholesterol. Pregnancy too increases the risk. Ethnicity plays an important role. More prevalent in native Americans, Hispanics and Africans and now some studies highlight incidence in southeast Asia, including Indians.
When should you consult ophthalmologist: once you are declared diabetic, you must consult an ophthalmologist. Thereafter as per his advice every one or two years or even early if your control is poor or if your parents suffered from advanced diabetic retinopathy. If you are pregnant, eye examination may be needed frequently. Remember, proper control of risk factors and timely examination and intervention can prevent you from becoming blind. A Recent introduction of oct evaluation & intravitreal therapy has significantly helped patients with diabetic retinopathy.