Diabetic Retinopathy occurs in diabetic patients having damaged blood vessels of the retina. If you have a history of uncontrolled high sugar levels and have diabetes 1 or 2, this condition could develop. It may start with mild vision problems and could eventually cause blindness.
Types of Diabetic Retinopathy
The type depends on the seriousness of the damage in the eyes.
- Non-proliferative Diabetic Retinopathy (NPDR): When damaged blood vessels leak blood and fluid into the eye causing swelling. This could be mild, moderate, and severe.
- Proliferative Diabetic Retinopathy (PDR): An advanced stage in retinopathy in which abnormal new blood vessels begin to grow within the retina.
For those with mild Diabetic Retinopathy, your doctor may perform regular eye exams in case treatment becomes necessary. In advanced Retinopathy, treatment depends on the type and severity of Retinopathy. Photocoagulation is the only proven treatment for Diabetic Retinopathy. It is a laser surgery that helps prevent loss of vision by stopping or controlling leakage in the blood vessel by burning them to seal. There are three types of surgery:
- Scatter photocoagulation: Burning tiny holes in the eyes using a laser once or more.
- Focal photocoagulation: A specific leaky vessel is targeted using a laser.
- Vitrectomy: Removing a scar tissue and cloudy fluid from the eye.
Symptoms of Diabetic Retinopathy
The symptoms do not appear until there is severe damage in the eye. When symptoms appear, they could be seen in both the eyes such as:
- Seeing dark spots or floaters
- Difficulty with night vision
- Blurred vision
- Loss of vision
- Inability to distinguish colors
Causes of Diabetic Retinopathy
Prolonged high levels of blood sugar cause the normal supply of blood vessels to be blocked. As a result, new abnormal blood vessels are formed which worsens the retina by causing blood and fluid leakage thereby causing a blurry vision called Macular oedema.
If the condition deteriorates, scar tissues get blocked in new blood vessel of the retina causing extra pressure that detaches the retina. This can lead to glaucoma and blindness.
Indications of Diabetic Retinopathy
- Poor blood glucose control
- Protein in urine
- Raised fats in the blood
- Prolonged diabetes
- High blood pressure
Diagnosis and tests
- Physical examination of the eyes using dilated eye exam by using eye drops to check symptoms like swelling, abnormal blood vessels, scarring etc
- Fluorescein angiography using contrast dye
- Optical coherence tomography (OCT)
- A thorough physical examination will be performed on your eyes and overall health
- Diagnostic tests to be performed
- Familiarize your doctor with your medical history
- Some medicines will be stopped
- If your blood sugar is high, you will be given medicines to lower the level
- The surgery will be done on an out-patient basis
- It will take about 20 – 40 minutes generally
- You will be given eye drops to dilate your pupils
- You will be given local anaesthesia that will make you awake but pain-free
- You will be seated having your chin on a chin rest
- A special contact lens will be placed on your eyes to hold your eyes open and focus the laser on the retina
- An intense beam of laser will be focused on the bleeding vessels to seal or control them
- If the surgery is a Scatter treatment, the doctor will make multiple laser burns
- If it is Focal surgery, it is done on a small area of the retina
- With Vitrectomy, a small incision is made in the eye removing scar tissues and vitreous humor
- A laser is then used to prevent further deterioration
- The contact lens will then be removed after the surgery.
- Your eyes will be dazzled by the light for some time and your sight seemed darkened, hazy, or blurred
- Your sight will return to normal after some hour
- You will be able to be driven home after some hours
- Due to laser burns, small spots may appear in your vision which will gradually disappear
- You must control blood sugar level to have a healthy pair of eyes
- If you experience aches because of treatment, painkillers may be administered to you such as paracetamol
- Follow-up should be regularly attended for examination and tests.
Risks and side-effects
As with any surgery, risks and side-effects are things that could possibly occur. Since parts of the retina are burned, you may experience:
- Reduced night vision
- Mild loss of vision
- Blurred vision
- Difficulty focusing
- Reduced colour vision
- Blind spots
Factors affecting the cost of Diabetic Retinopathy
However, certain factors listed below can also affect the price:
- Choice of hospital
- Location of the hospital
- Surgeon’s fee
- Cost for blood tests and diagnostic tests
- Medical care