HealthyCanada.com

Retinopathy is a term used to describe the damage to the blood vessels in the back of the eye a common complication in people with diabetes and the leading cause of new cases of blindness among Canadian adults. Diabetes affects the body where there are small blood vessels and these are in your kidneys nerve endings and your eyes. Retinopathy usually affects both eyes. Between 40 to 45 percent of people diagnosed with diabetes have some stage of diabetic retinopathy. The good news is that it is treatable and in many cases preventable.

Diabetic retinopathy occurs when diabetes damages the tiny blood vessels inside the retina the light-sensitive tissue at the back of the eye. A healthy retina is necessary for good vision. Whether you have type 1 or type 2-diabetes if you do not adequately control your blood glucose levels and your blood pressure your chances of developing diabetic retinopathy will increase with every year you live with the condition.

Diabetic retinopathy has four stages:

1. Mild Nonproliferative Retinopathy. At this earliest stage microaneurysms occur. They are small areas of balloon-like swelling in the retina's tiny blood vessels.
2. Moderate Nonproliferative Retinopathy. As the disease progresses some blood vessels that nourish the retina are blocked.
3. Severe Nonproliferative Retinopathy. Many more blood vessels are blocked depriving several areas of the retina with their blood supply. These areas of the retina send signals to the body to grow new blood vessels for nourishment.

4. Proliferative Retinopathy. At this advanced stage the signals sent by the retina for nourishment trigger the growth of new blood vessels. This condition is called proliferative retinopathy. These new blood vessels are abnormal and fragile. They grow along the retina and along the surface of the clear gel that fills the inside of the eye.

By themselves these blood vessels do not cause symptoms or vision loss. However they have thin fragile walls. If they leak blood severe vision loss and even blindness can result.

At first you may notice no changes to your vision. However if bleeding occurs you will at first see a few specks of blood or spots "floating" in your vision. If spots occur see your eye care professional as soon as possible. You may need treatment before more serious bleeding occurs. Hemorrhages tend to happen more than once often during sleep.

Sometimes without treatment the spots clear and your eyesight will improve. However bleeding can reoccur and cause severely blurred vision. You need to be examined by your eye care professional at the first sign of blurred vision before more bleeding occurs.

If left untreated proliferative retinopathy can cause severe vision loss and even blindness. Also the earlier you receive treatment the more likely treatment will be effective.

Proliferative retinopathy is treated with laser surgery. Although you may notice some loss of your peripheral vision this can save the rest of your sight. The procedure may slightly reduce your color vision and night vision.

Laser treatment works better before the fragile new blood vessels have started to bleed. That is why it is important to have regular comprehensive dilated eye exams. Even if bleeding has started laser treatment may still be possible depending on the amount of bleeding.

If the bleeding is severe you may need a surgical procedure called a vitrectomy. During a vitrectomy blood is removed from the center of your eye.

Early detection and treatment can prevent or delay blindness due to diabetic retinopathy in 90 percent of people with diabetes. Good glycemic control through lifestyle and medications has been shown to reduce or delay by 76 percent the development of retinopathy in people with diabetes. Intensive therapy reduces the first appearance of any retinopathy by 27 percent. Laser surgery can reduce the risk of severe vision loss from to 4 percent or less.

If you have lost some sight from diabetic retinopathy ask your eye care professional about low vision services and devices that may help you make the most of your remaining vision. Ask for a referral to a specialist in low vision. Many community organizations and agencies offer information about low vision counseling training and other special services for people with visual impairments.