Diabetes retinopathy means that the vessels in the retina of the eye are damaged by diabetes. It can lead to vision changes or poorer visual acuity. Therefore, it is important that you who have diabetes go for regular eye examinations.
It is quite common to have some kind of changes in the retina if you have diabetes. The changes usually do not lead to any problems with vision.
What is Diabetic Retinopathy?
The eye is largely filled with a transparent jelly-like mass called the glass body. On the inside of the eye is the retina that the glass body is stuck in. The retina contains the visual cells that are important for the eyesight. In the middle of the retina are the yellow spots that are needed to be able to look sharp and detailed.
The retina can swell
High blood sugar and high blood pressure affect blood vessels throughout the body. There are small blood vessels in the retina that are particularly sensitive to high blood sugar. In diabetic retinopathy, small bleeding and sometimes swelling of the retina can occur in the eye. If the swelling affects the yellow stain, you will have visual acuity.
Vision can be affected in different ways
The damage to the blood vessels causes the retina to not get enough oxygen. If it goes on for a long time, the retina tries to compensate for the lack of oxygen by forming new blood vessels. It is called proliferative diabetes retinopathy. The new blood vessels leak blood and burst easily. If such a blood vessel bursts, the blood enters the vitreous, which becomes cloudy. This means that you get visual disturbances with cloudiness, soot flakes in the field of vision and blurred vision.
Symptoms of diabetes retinopathy
Diabetes retinopathy initially gives no symptoms. Therefore, it is important for those with diabetes type 1 or diabetes type 2 to have regular eye exams. Then changes in the retina can be detected in time and treated before they have caused any damage to the eyesight.
You get symptoms of diabetic retinopathy first if you get a bleeding in the eye or a swelling of yellow spots.
A bleeding can be experienced as smoke or soot flakes in the eye
Bleeding from newly formed blood vessels causes a sudden visual impairment with moving cloudiness. You will then experience a marked change with blurred vision, smoke or moving black soot flakes that interfere with vision.
Retinal detachment can be experienced as flashes, dots or shadows
Newly formed vessels in the eye can increase the risk of retinal detachment . You can notice this in several ways:
- You see lightning on the edge of the field of view.
- You see small moving points, dashes or rings. They are called clouds.
- You will see a grayish or opaque shadow on the edge of the field of view that increases in distribution towards the central vision.
A swelling of the yellow stain can give blurred vision
Swelling in the yellow spot results in impaired visual acuity. You will find it difficult to read and recognize faces. It can also affect how you look from a distance, so that you are not allowed to drive. It often happens gradually and over a longer period of time, unlike the visual impact you may experience from a bleeding that comes suddenly. It can be difficult to tell the difference between this type of vision impairment and other common causes of vision impairment, such as cataracts.
When should I seek care?
If you see lightning or large moving spots, contact a health care center or an on-call reception . You can also contact an eye reception directly. If closed, you can wait for the on-call reception or the health center opens.
If it’s in a hurry
If you see a grayish or dark shadow on the edge of the field of vision, contact a health care center, eye reception or emergency room reception. If closed, seek care at an emergency room.
Diabetes Retinopathy Study
You who have diabetes will receive a referral to eye photography by your diabetes doctor. The regular checks allow changes to be detected and treated even before they cause any symptoms of diabetic retinopathy. You usually get a call to the bottom shot, but it’s good if you find out when it’s time for the next shot.
The eye is photographed with a special camera
Eyepiece photography means that the back of the eye where the retina sits is photographed with a special eye-camera.
Before shooting, you get eye drops that dilate the pupils, which takes about 10-30 minutes. You get that in order for the photographs to get the best quality possible.
By comparing images taken during previous checks, the doctor or eye nurse can see if the retina has changed.
The investigation goes fast and does not hurt
The examination takes five to ten minutes, but you can expect a little longer to allow the pupils to enlarge before shooting. The investigation does not hurt and is completely harmless. The pupil enlargement drops make you look worse for a few hours. Therefore, avoid driving after the examination. It can also be good to protect your eyes with sunglasses as you may be dazzled by sunlight. For some, vision may be affected for a few days
How often you should be examined depends on how big the changes are
You may regain control after two to three years if you have no retina changes.
You may be checked every year if you have small to moderate changes in the retina.
You will be called an ophthalmologist if you have more widespread changes. The ophthalmologist will then decide how often you should go for the checks and what treatment you should receive.
Treatment of diabetes retinopathy
Diabetes retinopathy can be treated in three different ways:
- injection Treatment of diabetic retinopathy
- Laser treatment of diabetic retinopathy
If you have a yellow spot swelling, your doctor will treat it with injections of medicine into your eye. The treatment is done in an operating room and the injection goes very quickly. The eye is anesthetized with eye drops and the treatment usually does not hurt.
The injection treatment of diabetic retinopathy reduces the swelling of the yellow spot. The treatment does not cure the diabetes complications in the eye but effectively slows down the changes. This means that you often need to receive injection treatment several times.
The risk that your vision will continue to deteriorate is reduced if you receive injection therapy and in many cases the vision improves.
You get laser treatment when new blood vessels have formed in the retina. The laser causes the growth of the newly formed vessels to cease and the vessels gradually shrink and disappear.
Then the laser treatment goes on
When you receive laser treatment, the eye is first anesthetized with eye drops. The anesthetic is given to put a treatment lens on the eye. Then you have to sit still with your head in a support of the eye microscope while the doctor gives the laser treatments via the treatment lens into the eye. The treatment usually does not hurt and takes about 15 to 30 minutes.
The treatment of diabetic retinopathy usually needs to be repeated two to three times before the entire eye is finished.
Your eyes may become more sensitive afterwards
The laser treatment can make your eyes more sensitive to light. Sometimes even your field of vision becomes smaller. Your night vision can often be impaired. It also takes longer for the eye to adjust as you move from light to dark. These complications are usually permanent. The changes may also be due to the disease itself.
You may need surgery if it does not help with laser treatment of diabetic retinopathy or injection therapy. This is especially true if any of this has happened:
- You have had a bleeding eye that the eye cannot take care of.
- The doctor notes that there are many newly formed vessels and scar tissue in the retina that can put you at risk of retinal detachment.
The surgery can be done either with local anesthesia or under anesthesia. The operation hinders the course of the disease for the vast majority. But it is not always the vision becomes as good as it was before the changes began to affect it.
Diabetes retinopathy and pregnancy
Tell your diabetes doctor if you are or are planning to become pregnant so that they can inform the eye clinic. Pregnancy can impair the changes in the eye quickly. Therefore, you may need to go on checks more often when you are pregnant.
What can I do for myself?
You can reduce the risk of diabetes retinopathy by not smoking and by having good metabolic control.
Metabolic control means that you regularly check this:
- your blood sugar
- your blood pressure
- your blood fats.
Your values should be within normal levels.
Changes in the eye caused by diabetes retinopathy can go back by having a good metabolic control. Talk to your diabetes doctor for help with this.
Important to check the controls
Make sure to go for regular checks. Then changes can be detected early and treated before they cause visual impairment. Even if you are usually called for examination, it may be good to keep track of when it is time for the next check.
Smoking causes oxygen deficiency in all tissues of the body. Therefore, you who have diabetes should avoid smoking. If you need help to quit smoking, your doctor can tell you what support is available.