What you need to know about diabetic retinopathy

Keep your blood sugar levels under control to lower the risk of diabetes-related vision loss

Diabetic retinopathy is a disease that attacks people having diabetes. It usually happens when blood sugar levels are high, leading to blood vessel damage in the retina and vision loss or damage.

Diabetic retinopathy can occur in type 1 & 2 diabetes patients. Despite controlling diabetes, the risk of blindness remains high. Hence, a retina check-up is a must.

The early symptoms include floaters, blurriness, inability to perceive colour, poor night vision and dark or empty spots in the centre of vision.

There are four stages of Diabetic Retinopathy:

Mild Nonproliferative Retinopathy

This is the first stage where the small blood vessels in the retina develop tiny bulges that protrude from walls, sometimes leaking fluid and blood into the retina. At the initial stage, one is likely to have no vision loss. The chances of entering the third stage are high if this stage has affected both the eyes and has been left undiagnosed. Hence, it is ideal to go for an annual screening.

Moderate Nonproliferative Retinopathy

This is the second stage where the blood vessels inside the retina start swelling. Due to the inability to carry blood, they cause physical alterations, which lead to diabetic macular oedema. The macula is a part of the retina, which is responsible for the vision straight ahead (aids when you are driving). In the second stage, vision is at risk. The doctors recommend going for a regular eye test to lessen further damage.

Severe Nonproliferative Retinopathy

This is the third stage where the blood vessels get blocked. Due to this, the retina receives less blood, and the scar tissue begins forming. The low blood supply can block the vessels completely. This will lead to dark spots and blurry vision, further resulting in macular ischemia. At this stage, one is most likely to lose vision.

Proliferative Diabetic Retinopathy (PDR)

This is the most advanced stage where new, thin, and weak blood vessels grow in the retina. These bleed into the vitreous and cause scar tissue. As the scar tissue grows smaller, retinal detachment takes place. This leads to the loss of vision. A doctor can manage the treatment to stop further vision loss, but it cannot be restored if vision is completely lost.

Here are a few points to keep in mind if one is suffering from diabetic retinopathy:

-If you have diabetes, educate yourself about the early stage of diabetic retinopathy, which is asymptomatic; hence, screening is essential.
-Get an annual screening performed by telemedicine or onsite fundus photography.
-Women with pre-existing diabetes who are pregnant or planning a pregnancy should be counselled to avoid further complications.
-Everybody above the age of 35 should test for diabetes; if you test positive for diabetes, a routine retina screen is recommended.
-Good control over blood sugar levels can significantly lower the risk of diabetic retinopathy.

(Dr S Natarajan is Chief, Clinical Services, Aditya Jyot Eye Hospital, A unit of Dr. Agarwal's Eye Hospital)