Diabetic retinopathy > Common eye diseases and disorders

Diabetes (diabetes mellitus) is a serious disease which affects various organs of the human body. Eyes are also one of them. The consequences of diabetes for sight can be very serious and in the most extreme cases end up with sight loss. In developed countries, diabetic retinopathy is one of the most common causes of blindness. A risk of losing sight is approximately 10-20 times higher for diabetics than for non-diabetic people.

Until 2 years after diabetes has been diagnosed, symptoms of diabetic retinopathy occur only in 2-7% of Type 1 diabetics and approximately in 20% of Type 2 diabetics. After 25 years of suffering from diabetes 80-100% of Type 1 and 2 diabetics exhibit the symptoms of diabetic retinopathy. For adults between 20-74 years diabetes is the primary cause of new cases of blindness. Every year diabetic retinopathy is a cause of 12000 to 24000 new cases of blindness.

Diabetes can affect various parts of the eye but it mostly damages the retina. Retinal disorder in diabetes is characterized by specific changes. Mostly it is retinal capillaries which are being affected. This disorder can be demonstrated by formation of tiny swells on retinal arteries (microaneurysms) and formation of new blood vessels, tiny hemorrhages on the retina - caused by bursting of above mentioned tiny swells. Later new blood vessels can be formed on the retina, fibrosis occurs and this state can result in total blindness.

Phases of diabetic retinopathy

Diabetic retinopathy goes through couple of phases.

Nonproliferative phase

First phase of diabetic retinopathy (nonproliferative) is demonstrated by proliferation of retinal veins and capillaries. Tiny deposits of hemorrhage and outflow are formed and the retina is soaked. Macular swelling is formed - so-called macular edema. This causes blurry vision.

Insufficient blood supply of the optic nerve is a very serious state which can cause permanent damage or sight loss. To diagnose and check the state of the retina several examinations are performed including the examination of eye background, measuring the intraocular pressure and angiographic examination which displays vascular system of the retina with the help of a contrast agent which is applied to blood circulation. Thanks to this examination it is possible to identify the exact spot on the retina where fluids are leaking. This leak can be stopped by laser procedure.

Proliferative phase

So-called proliferative phase is a next phase of diabetic retinopathy. If insufficient blood supply of the retina occurs (ischemia) then thanks to some substances abnormal growth of new blood vessels occurs on the spot which is insufficiently supplied by blood. These are very brittle and thus they burst which leads to more hemorrhages. This process is called neurovascularization. It gradually affects even the vitreous body and scarring is formed.

Laser photocoagulation offers a solution for this very serious problem. Scarred tissue of the vitreous body can be also removed with the help of laser or classic surgical procedure. Diabetic retinopathy can lead to complication in the form of retinal detachment. Then it is necessary to fill the space in the vitreous body by air or some other gas which will return the retina back to its position.

Affected optic nerve, as a consequence of diabetes, leads to development of double vision. It is caused by imbalanced coordination of eye movement. Diabetics suffer more often from glaucoma, cataract or atherosclerosis. Basic prevention of the development of diabetic retinopathy and associated diseases lies in the best possible compensation of diabetes through diet or medications. The most important indicators, which are significant as far as the formation of diabetic retinopathy is concerned, include: diabetes duration and its wrong compensation. Other known external factors, which can influence formation and further course of diabetic retinopathy, include: smoking, alcohol consumption, high blood pressure, disorders of cholesterol levels in the blood, hormonal contraception.