Diabetic retinopathy is an eye disease caused by diabetes. Diabetes can affect your eye. Hence, if you’re someone suffering from diabetes, you should get a regular eye exam. Damaged blood vessels and abnormal new ones can cause vision loss.
To have come so far, you’re either suffering from diabetes or have already experienced some effects of diabetes on your eyes. Therefore, without much further delay, we’ll get into a small explanation about diabetes and diabetic retinopathy, and dive into its different types like proliferative diabetic retinopathy and so on.
Diabetes VS Diabetic Retinopathy
Diabetes is a chronic health condition that affects how your body turns food into energy. Whatever we eat is broken down into sugar and released into our bloodstreams. When our blood sugar goes up, the pancreas is signaled to release insulin. Insulin holds the key responsibility to let the blood sugar into the body’s cells and use it as energy.
Now, for someone suffering from diabetes, our body either doesn’t make enough insulin or can’t use it as well as it should.
Hence, if our body doesn’t have enough insulin or stops responding to it, too much blood sugar stays in the bloodstream, which leads to some serious health problems like heart disease, kidney disease, and vision loss.
Our focus is on vision loss, so let’s talk about that.
People with diabetes are likely to encounter an eye disease called diabetic retinopathy. As the name suggests, it’s an eye disease caused by diabetes and affects the retina. This happens when high blood sugar levels cause damage to the blood vessels in the retina, which may swell and leak. In some cases, the blood vessels may close up, stopping the blood from passing through. In another scenario, abnormal new blood vessels may grow on the retina. All these changes can cause vision loss or low vision.
Two Stages of Diabetic Eye Disease
Diabetic eye disease is categorized into two different stages. We’ll be giving you in-depth details of both these stages and how they affect a person’s vision.
Non-proliferative Diabetic Retinopathy
Non-proliferative diabetic retinopathy (NPDR) is the early stage of diabetic eye disease. This stage may be experienced by many people who have diabetes. During this stage, the symptoms are either mild or non-existent.
In non-proliferative diabetic retinopathy, the blood vessels in the retina are weakened. There are tiny bulges, called microaneurysms, in the blood vessel that may leak and cause the retina to swell. A swelled macula is called macular edema, which is the most common reason for people with diabetes to experience vision loss.
In some cases, with NPDR, the blood vessels in the retina may be closed off, which is known as macular ischemia. This condition disrupts the flow of blood, which ultimately does not reach the macula. Sometimes, tiny particles, known as exudates, are formed in the retina, which affects the vision as well.
My Vision Seems Fine… Am I Still Prone to Have Diabetic Retinopathy?
Yes.
There are often no visual symptoms in the early stages of non-proliferative diabetic retinopathy. Vision is affected during the progressive damage to the vessels in the macula (the central part of the retina). Diabetic injury to the macula causes swelling or ischemia – nerve damage due to lack of blood flow. Hence, it’s important to get your eyes examined for diabetic damage before any symptoms occur. Your vision can be successfully preserved if the disease is consistently monitored and treated in the early stages.
Proliferative Diabetic Retinopathy
Proliferative diabetic retinopathy is an advanced stage of diabetic eye disease. During this stage, circulation problems deprive the retina of oxygen, which leads to a fragile retina that also grows new blood vessels, known as neovascularization. These new vessels often bleed into the vitreous (the gel-like fluid that fills the eye), clouding the vision. If they bleed a lot, all vision might be blocked.
Moreover, these new blood vessels can form scar tissue, which causes a detached retina as well as the development of glaucoma. Glaucoma is an eye disease where progressive damage to the optic nerve happens. In proliferative diabetic retinopathy, the new blood vessels grow into the area of the eye that drains the eye fluid, raising the eye pressure and damaging the optic nerve.
PDR is a very serious stage and can steal both your central and peripheral vision, even leading to blindness.
How do the Abnormal, New Blood Vessels Cause Eye Damage?
The new blood vessels (neovascular vessels), grown in proliferative diabetic retinopathy, can abruptly bleed into the middle of the eye, leading to vitreous hemorrhage. Moreover, neovascularization causes scar tissues to appear, which pulls the retina off the interior eye wall, creating a situation of retinal detachment. Some of the new blood vessels may also grow on the iris, or the colored part of the eye, which causes a painful and blinding rise in eye pressure, called neovascular glaucoma.
How to Treat Proliferative Diabetic Retinopathy?
Other than optimizing blood glucose with a balanced diet and blood pressure control, there are a few treatment options that can help stop further vision loss and restore the lost retinal function, where possible.
Medication injections, like anti-vascular endothelial growth factor (anti-VEGF), into the eye, are highly effective in reversing the growth of the abnormal retinal blood vessels in PDR. These injections must be taken repeatedly to prevent recurrent growth of the blood vessels.
The most common treatment for proliferative diabetic retinopathy is laser photocoagulation which has been in use for decades. In this procedure, brief spots of bright light are scattered through the sides of the retina, which helps reduce the growth of the new blood vessels and seals the retina to the back of the eye.
In cases where you have advanced proliferative diabetic retinopathy, a vitreous hemorrhage that cannot be cleared, or retinal detachment, a surgery called a vitrectomy may be suggested. During this surgery, the blood-filled vitreous is removed and replaced by saline, clearing the way for additional laser treatment. In severe cases, more than one vitrectomy surgery may be required.
Though these treatment options are available and help prevent further vision loss, as long as you have diabetes, the chances of diabetic eye disease worsening are still there. Therefore, one must take special care in controlling blood sugar and blood pressure.
Managing Vision with Diabetic Eye Disease
The damage caused to the eyes by diabetes is somewhat irreversible, even with the treatment options available. Yet, there is a way to overcome the visual limitation one might face after undergoing surgery or treatment.
Over the years, several low-vision solutions have emerged and have helped people with low vision and legal blindness, caused by severe eye conditions, to live independent life.
Here are a few technological advancements that provide visual aid:
Screen Reader
Reading is quite important for everyone. We need to be able to read to get somewhere or acquire anything. We usually read things off our smartphones or computers. Screen readers are put in place for such devices that help the visually impaired identify general graphics, and information in files, folders, menus, dialog boxes, etc.
Smart Canes
To feel more independent, you must be able to navigate through your surroundings. But with low vision, one may face too many obstacles. Smart canes are designed in conjunction with a regular cane. It allows the user to detect obstacles through the sonic waves and vibration of the handle.
Visual Aid Glasses
Low vision glasses are among the most advanced technology for the visually impaired and legally blind. These devices help restore vision by stimulating the remaining sight of a user.
IrisVision Inspire eyewear is a low vision solution that targets the functional area of the eye and enhances the leftover vision to improve the overall sight.
As discussed, both central and peripheral vision may be affected by diabetic retinopathy. IrisVision Inspire can reduce the visual field loss by its 70-degree FOV and 14X magnification. This is achieved through the Scene Mode of the headset.
That’s just one example!
You can do a lot more. Just give it a go and have a look at what others have to say about IrisVision.
