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Glossary
of Eye terms
Diabetic
Retinopathy
What
is diabetic retinopathy?
Diabetic
retinopathy is a potentially blinding complication of diabetes
that damages the eye's retina. This disease is a leading cause
of blindness in American adults.
What
is the Retina?
The
retina is light-sensitive tissue at the back of the eye. When
light enters the eye, the retina changes the light into nerve
signals. The retina then sends these signals along the optic
nerve to the brain.
Without
a retina, the eye cannot communicate with the brain, making
vision impossible.
How
does diabetic retinopathy damage the retina?
Diabetic
retinopathy occurs when diabetes damages the tiny blood vessels
in the retina.
As
the disease progresses, it enters its advanced, or proliferative,
stage. Fragile, new blood vessels grow along the retina and
in the clear, gel-like vitreous that fills the inside of the
eye. Without timely treatment, these new blood vessels can bleed,
cloud vision, and destroy the retina.
Some
people develop a condition called macular edema. It occurs when
the damaged blood vessels leak fluid and lipids onto the macula,
the part of the retina that lets us see detail. The fluid makes
the macula swell, blurring vision.
Who
is at risk for this disease?
All
people with diabetes are at risk—those with Type I diabetes
(juvenile onset) and those with Type II diabetes (adult onset).
During
pregnancy, diabetic retinopathy may also be a problem for women
with diabetes. It is recommended that all pregnant women with
diabetes have dilated eye examinations each trimester to protect
their vision.
What
are its symptoms?
Diabetic
retinopathy often has no early warning signs. At some point,
though, you may have macular edema. It blurs vision, making
it hard to do things like read and drive. In some cases, your
vision will get better or worse during the day.
How
is it detected?
Diabetic
retinopathy is detected during an eye examination that includes:
-
Visual
acuity test: This eye chart test
measures how well you see at various distances.
-
Pupil
dilation: This
is a procedure in which eye drops are placed into the eye
to widen the pupil. This allows a doctor to see more of
the retina and look for signs of diabetic retinopathy. After
the examination, close-up vision may remain blurred for
several hours.
-
Ophthalmoscopy:
This is an examination of the retina in which the doctor:
(1) looks through a device with a special magnifying lens
that provides a narrow view of the retina, or (2) looks
through a special magnifying glass and gains a wide view
of the retina.
-
Tonometry:
A standard test that determines the fluid pressure inside
the eye. Elevated pressure is a possible sign of glaucoma,
another common eye problem in people with diabetes and diabetic
retinopathy.
Your
doctor will look at your retina for early signs of the disease,
such as:
- retinal
swelling, such as macular edema;
- pale,
fatty deposits on the retina -- signs of leaking blood vessels;
- damaged
nerve tissue; and
- any
changes in the blood vessel
How
is it treated?
There
are two treatments for diabetic retinopathy. They are very effective
in reducing vision loss that results from this disease. In fact,
even people with advanced retinopathy have a 90 percent chance
of keeping their vision when they get treatment before the retina
is severely damaged. These treatments are:
- Vitrectomy:
If you have a lot of blood in the vitreous -- the transparent,
colorless mass of gel that lies behind the lens and in front
of the retina -- you may need an eye operation called a
vitrectomy to restore sight. It involves removing the cloudy
vitreous and replacing it with a salt solution.
How
often should people with diabetes have eye examinations?
At
least once a year, all people with diabetes should have an eye
examination while their pupils are dilated.
Learn
more on the next page
