WHAT WE TREAT
Diabetic Retinopathy
Diabetic retinopathy happens when high blood sugar damages the retina’s tiny blood vessels.
About Diabetic Retinopathy
Overview
Diabetic retinopathy is an eye condition caused by damage to the small blood vessels of the retina due to chronically high blood sugar levels from diabetes mellitus. Over time, these changes can lead to vision loss. There are two main forms:
- Nonproliferative Diabetic Retinopathy (NPDR)—the early stage of the disease.
- Proliferative Diabetic Retinopathy (PDR)—the more advanced and potentially more sight-threatening stage.
Causes
Nonproliferative Diabetic Retinopathy (NPDR)
In NPDR, small retinal blood vessels become weakened, leading to:
- Microaneurysms
- Retinal hemorrhages
- Exudates and cotton-wool spots
- Retinal swelling (diabetic macular edema)
At this stage, there is no growth of new blood vessels, but vision can be affected by macular swelling.
Proliferative Diabetic Retinopathy (PDR)
In PDR, the retina responds to poor blood flow by producing abnormal new blood vessels (neovascularization) on its surface and sometimes in the front of the eye. These vessels are fragile and prone to:
- Vitreous hemorrhage (bleeding into the gel inside the eye)
- Scar formation and retinal detachment
- Neovascular glaucoma, a serious condition caused by new vessel growth on the iris that blocks fluid drainage
Without prompt treatment, these complications can cause severe and permanent vision loss, and in rare cases, loss of the eye.
Treatment Options From LRR
Treatments
In early NPDR, management focuses on systemic control of diabetes and vascular risk factors in coordination with your primary care provider.
If the disease progresses, retinal treatments include:
- Intravitreal injections: Anti-VEGF or corticosteroid medications to reduce swelling and leakage.
- Laser therapy: To seal leaking blood vessels or reduce abnormal vessel growth.
- Surgery (vitrectomy): For advanced cases with vitreous hemorrhage, retinal detachment, or neovascular glaucoma.
More To Know
Symptoms
- Early NPDR: Often no symptoms; vision may remain normal. Regular dilated eye exams are essential for early detection.
- More Advanced NPDR: Blurred or fluctuating vision, decreased clarity, or difficulty focusing.
- PDR: Hazy or distorted vision, new floaters, difficulty with night vision, or slow adaptation to light changes.
- Neovascular glaucoma or retinal detachment: Eye pain, redness, flashes of light, or sudden loss of vision.
Prevention
While diabetic retinopathy cannot always be prevented, its progression can be slowed by:
- Controlling blood sugar, blood pressure, and cholesterol
- Having regular dilated eye exams
- Getting regular A1C testing (goal <7%)
- Not smoking
- Reporting vision changes promptly to your eye doctor
Possible Complications
- Vitreous hemorrhage: Bleeding inside the eye causing floaters or vision loss.
- Retinal detachment: Scar tissue pulls the retina away from the back of the eye.
- Glaucoma: Elevated eye pressure from new vessel growth at the drainage angle.
- Blindness: From retinal or optic nerve damage if untreated.
Who Is at Risk?
Anyone with diabetes can develop diabetic retinopathy. Risk increases with:
- Long duration of diabetes
- Poor blood sugar control
- High blood pressure or cholesterol
- Pregnancy
- Tobacco use
- African American, Hispanic, or Native American heritage
Managing Advanced Disease
Proliferative diabetic retinopathy often requires a combination of injections and laser treatment to prevent further bleeding and scar formation. If severe complications develop, retinal surgery may be needed to restore or preserve remaining vision.
Prepare For Your Visit
If you already have an appointment made, we look forward to providing your care! If you need an appointment or have questions, please reach out to the Lakes Region Retina care team.
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