Diabetic Retinopathy

Diabetes is a group of diseases in which there are abnormalities in the control of blood glucose (sugar) as a result of defects in either the production of the hormone insulin or in insulin's action in the body. Diabetes is more common in U.S. minority populations, especially African Americans, American Indians, and Hispanics, than in other groups. Seventeen million people have diabetes in the U.S. Diabetic eye disease is the most common cause of new blindness in all adults between 20-74 years of age. Vision loss from diabetes can be prevented in over 90% of cases. An estimated 50% of diabetic eye disease cases are found too late for treatment to be very effective.

Who is at risk for diabetic eye disease?

People with diabetes who are members of a high-risk ethnic group (African American, Hispanic American, Native American, Asian American, Pacific Islander)
Between 40-45 percent of those with diagnosed diabetes have some degree of diabetic retinopathy.
People who have been diabetic for more than 15 years
People who have poor control of their blood glucose level
People who have poor control of their blood pressure level

What can you do to reduce your risk?

Have an eye exam including pupil dilation performed by your eye doctor every year
Control your blood glucose and blood pressure levels
Prevents day to day changes in vision
Control your weight with good nutrition and regular physical activity
See your eye doctor if you notice sudden changes in your vision
Do not use tobacco products

If detected early, the outlook for individuals with diabetic retinopathy is promising. All individuals with diabetes should receive a thorough yearly eye examination including:

Visual Acuity Test: Measures vision at various distances.
Pupil Dilation: Widens the pupil allowing an eye care professional to see more of the retina and look for signs of retinopathy.
Opthalmoscopy: Examination of retina through a device that provides a narrow view of the retina or a device that shines light into the eye and pro-vides a wide view of the retina.
Tonometry: Determines fluid pressure in eye, elevated pressure may be a sign of glaucoma-another risk for people with diabetes.

What are the stages of diabetic retinopathy?

Diabetic retinopathy has four stages:

Mild Nonproliferative Retinopathy. At this earliest stage, microaneurysms occur. They are small areas of balloon-like swelling in the retina's tiny blood vessels.
Moderate Nonproliferative Retinopathy. As the disease progresses, some blood vessels that nourish the retina are blocked.
Severe Nonproliferative Retinopathy. Many more blood vessels are blocked, depriving several areas of the retina with their blood supply. These areas of the retina send signals to the body to grow new blood vessels for nourishment.
Proliferative Retinopathy. At this advanced stage, the signals sent by the retina for nourishment trigger the growth of new blood vessels. This condition is called proliferative retinopathy. These new blood vessels are abnormal and fragile. They grow along the retina and along the surface of the clear, vitreous gel that fills the inside of the eye.

By themselves, these blood vessels do not cause symptoms or vision loss. However, they have thin, fragile walls. If they leak blood, severe vision loss and even blindness can result.