Diabetic retinopathy

Diabetic retinopathy is a condition occurring in persons with diabetes, which causes progressive damage to the retina, the light sensitive lining at the back of the eye. It is a serious sight-threatening complication of diabetes.

Diabetic retinopathy can be diagnosed through a comprehensive eye examination. Testing, with special emphasis on evaluation of the retina and macula, may include:

* Patient history to determine vision difficulties experienced by the patient, presence of diabetes, and other general health concerns that may be affecting vision

* Visual acuity measurements to determine the extent to which central vision has been affected

* Refraction to determine the need for changes in an eyeglass prescription

* Evaluation of the ocular structures, including the evaluation of the retina through a dilated pupil

* Measurement of the pressure within the eye

Supplemental testing may include:

* Retinal photography or tomography to document current status of the retina

Treatment for diabetic retinopathy depends on the stage of the disease and is directed at trying to slow or stop the progression of the disease.

In the early stages of Non-proliferative Diabetic Retinopathy, treatment other than regular monitoring may not be required. Following your doctor's advice for diet and

exercise and keeping blood sugar levels well-controlled can help control the progression of the disease.

If the disease advances, leakage of fluid from blood vessels can lead to macular edema. Laser treatment (photocoagulation) is used to stop the leakage of blood and fluid into the retina. A laser beam of light can be used to create small burns in areas of the retina with abnormal blood vessels to try to seal the leaks.

When blood vessel growth is more widespread throughout the retina, as in proliferative diabetic retinopathy, a pattern of scattered laser burns is created across the retina. This causes abnormal blood vessels to shrink and disappear. With this procedure, some side vision may be lost in order to safeguard central vision.

Some bleeding into the vitreous gel may clear up on its own. However, if significant amounts of blood leak into the vitreous fluid in the eye, it will cloud vision and can prevent laser photocoagulation from being used. A surgical procedure called a vitrectomy may be used to remove the blood-filled vitreous and replace it with a clearfluid to maintain the normal shape and health of the eye.

Persons with diabetic retinopathy can suffer significant vision loss. Special low vision devices such as telescopic and microscopic lenses, hand and stand magnifiers, and video magnification systems can be prescribed to make the most of remaining vision.