Diabetes and Retinopathy, this is worth reading

Let us start with some basic anatomy….. no there is no tests at the end and I am not going to ask any questions. I just feel that for you to understand the effect of Diabetes on the eye, you need to know what the eye looks like and how it functions.

The eye consist mainly of a ball of jellylike substance (vitreous humour), which is securely fit in the eye case in the skull. Most part of the body of the eye is hidden with only a small percentage of the eye that is visible.

In the front, there is a lens, which can change shape and length in order for the eye to focus, and behind the lens is an opening where the light is allowed to pass through. This opening is called the pupil.

Inside the eye, at the back of the eye, there is a network of capillaries and light sensitive tissue, pretty much the same idea as an old camera….. the life before we went digital.

At the centre of the retina, we find the Macula. This is a very small area, almost like the size of a pinhead, and is the most specialized part of the eye. In order for us to see, we need to have the light focus perfectly on the macula which also enables us to see very small and fine detail. The rest of the retina gives us peripheral vision, enabling us to see on the side.

Diabetes is a very non sympathetic condition and does not spare anything, including your most valuable asset….. sight!!

Diabetic eye diseases may include:

Cataract
Cataracts develops early in the life of diabetes sufferers which causes clouding of the lens of the eye.

Glaucoma
Glaucoma is an increase in fluid pressure in the eye that leads to damage of the optic nerve and eventually loss of vision. A sufferer of diabetes, is nearly twice as likely to get glaucoma as other adults.

Diabetic Retinopathy
One of the worst visual impairment conditions that can occur from Diabetes is most probably Diabetic Retinopathy. This is damage to the blood vessels in the retina which supply the eye with blood, nutrients and oxygen.

Diabetic Retinopathy causes changes in the blood vessels in the retina and is the most common eye disease in adult diabetics. It is also the major cause of blindness in American adults.

Diabetic retinopathy can have different effects on different sufferers as everyone is unique and does not respond to the disease the same way. In some people, the capillaries may swell and leak fluid, while in other people abnormal new blood vessels will grow on the surface of the retina.

This will either cover the retina and the macula or allow parts of the eye to die, thus permanent irreparable damage. To have perfect vision, we need a healthy retina.

In the first stage of diabetic retinopathy, the sufferer may not notice any changes in vision, but after a while it can get worse and cause complete loss of vision and this always affects both eyes.
Stages of Diabetic Retinopathy

We discern four stages in diabetic retinopathy:
Stage 1: Mild nonproliferative retinopathy
Small balloon-like swellings appear in the blood vessels in the retina. This is known as microaneurysms.

Stage 2: Moderate nonproliferative retinopathy
During this stage some of the blood vessels that supplies the retina with blood, nutrients and oxygen gets blocked off completely, causing ischemia (lack of oxygen) to certain parts of the retina. As we all know, oxygen is much needed to sustain life and keep organs functioning.

Stage 3: Severe nonproliferative retinopathy
As the disease progress, many more blood vessels gets blocked off which is now depriving the retina of a great deal of nutrients and oxygen. The body in response will send a signal to the brain that it is in need of more oxygen, which the body will then grow more blood vessels on the retina to rectify the ischemia.

Stage 4: Proliferative retinopathy
At this stage the new blood vessels are growing on the retina in order to restore blood supply to the affected areas of the retina. This is a very advanced stage of the disease and the blood vessels are abnormal and fragile.

These blood vessels grow along the retina and the clear gel inside the eye. These bloods vessels are very thin and do not cause any visual impairment, but if they leak blood, severe vision loss and blindness will be the result.

When bleeding in the eye occurs, it can either bleed into the vitreous humour or onto the macula, causing macular edema. Macular edema can happen at any time during the disease.

If the bleeding is inside the vitreous humour, the sufferer can have total vision loss and the retina may even become detached from the surface. This is known as retinal detachment.

With treatment most sight-threatening diabetic problems can be prevented if diagnosed early enough.

It is vital to go for an annual visual acuity tests and dilated eye exams. It is also vital to have the pressure inside your eye tested to make sure that there is not an increase in eye pressure. Even if there is no sign of retinopathy, it is still imperative to have your eyes tested as changes can occur without the sufferer experiencing any symptoms.

Your optometrist will check your eyes for early signs of:
• Leaking blood vessels
• Damaged nerve tissue
• Any changes to blood vessels
• Retinal edema (swelling)

Prevention is better than cure, so take care of your eyes…. It is your most priced possession.

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