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Diabetic Retinopathy continued...

Types of Retinopathy in Diabetes:

  • Background retinopathy. Sometimes the blood vessel damage exists, but there is no vision problem. This is called background retinopathy. It's important to carefully manage your diabetes at this stage to prevent background retinopathy from progressing to more serious eye disease.
  • Maculopathy. In maculopathy, the person has developed damage in a critical area called the macula. Because this occurs in an area that is critical to vision, this type of eye problem can significantly reduce vision.
  • Proliferative retinopathy. New blood vessels start to grow in the back of the eye. Because retinopathy is a microvascular complication of diabetes, a disease of small vessels, this type of retinopathy develops because of an increasing lack of oxygen to the eye from vascular disease. Vessels in the eye are thinned and occluded and they start to remodel.

Here, it is important to address the risks factors that can worsen the occluded vessels. Smoking cessation, high blood pressure control, cholesterol management, and blood sugar control must take place in order to stop the progression of new vessels from forming into the orbit of the eye. These are fragile vessels that can bleed and eventually cause a clot to form in the orbit, which scars and causes detachment of the retina. This eventually leads to irreversible vision loss.

Treatment of diabetic retinopathy may involve laser procedures or surgery. In a study of people with diabetes with early retinopathy, laser therapy to burn the fragile vessel resulted in a 50% reduction of blindness.

To prevent retinopathy with diabetes, have your eye doctor screen your eyes annually. Women with diabetes who later become pregnant should have a comprehensive eye exam during the first trimester and close follow-up with an eye doctor during the rest of their pregnancy to avoid serious eye problems with diabetes. (This recommendation does not apply to women who develop gestational diabetes, since they are not at risk for retinopathy.)

Preventing Eye Problems With Diabetes

Everyone should have regular eye exams, but annual eye exams are particularly important if you have diabetes. A thorough eye exam can help identify a problem early on when it is more easily treated. This can also help prevent further vision loss. 

If you are considering pregnancy and have a history of diabetes, you should have an eye exam prior to and possibly during pregnancy. Ask your eye doctor what is right for you.

Also, controlling your blood sugar and blood pressure will help prevent eye problems if you have diabetes.

When to Contact Your Doctor About Eye Problems in Diabetes

If you have diabetes, contact your doctor about any eye problems in if any of the following occur:

  • Black spots in your vision.
  • Flashes of light.
  • "Holes" in your vision.
  • Blurred vision.