As I learn more about Diabetes, I am also learning about different complications thay may arise from it. One of the more serious complications is a type of eye damage called Diabetic Retinopathy.
According to the Canadian Diabetes Association (CDA) and the American Diabetes Association (ADA), Diabetes is the leading cause of blindness in Canada1 and the United States2. Symptoms of Diabetic Retinopathy include blurred vision, vision loss, flashes of light in the field of vision, blotches or spots in vision, and floaters.
Diabetic Retinopathy has two forms that it can take. The first is Non-Proliferative Diabetic Retinopathy (NPDR). NPDR occurs when diabetes damages small blood vessels within the retina. These vessels leak both fluid and blood. This gradually causes the retina to thicken or swell. Overtime the swelling, or edema, thickens the retina. This causes the vision to become blurred. The second form is Proliferative Diabetic Retinopathy (PDR). PDR occurs when new/fragile blood vessels grow abnormally and extend into the vitreous.3 According to the National Eye Institute, the vitereous is "a gel-like substance that helps the eye maintain a round shape."4 The abnormal growth of the blood vessels into the vitereous can cause bleeding, scarring, and contraction of the vitreous. The contraction of the viterous can, in severe cases, lead to retinal detachment. PDR can cause severe vision problems, including blindness.3
PDR can be treated with a laser treatment, called photocoagulation. The focused lasers are used to help seal the areas with abnormal blood vessels by creating small burns. The American Optometric Association have some excellent videos, created by Eyemaginations, Inc, that you can view here: http://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/diabetic-retinopathy?sso=y.
The best way to prevent retinopathy is by:
- Get your HbA1C tested every 3 months and know what it is at (check with your healthcare provider for your target level, most people with diabeties aim for a 7.0 or less). Check out these charts for a guide to interpret your HbA1C.1 For International System of Units, SI, mmol/L click here. For Conventional Unit (USA) click here.
- Maintain good glucose levels, blood pressure, and cholesterol levels.1
- Visit an optometrist at least once per year. Follow optimetrists recommendations for more frequent visits, if necessary.1
If you meet the following conditions, according to the CDA, you should be screened for retinopathy:
- Anyone over 15 with type 1 diabetes (T1D) should be screened yearly after five years from diagnosis of diabetes
- People with type 2 diabets (T2D) should be screened when diagnoses
- Women with T1D or T2D who are planning to become pregnant should be screened prior to conception, during their first trimester, as needed during pregnancy and within the first year post-partum.
Eveyone with T1D and T2D are at risk for diabetic retinopathy. The time between optometric appointments will vary between individuals. Based on the severity of the retinopathy, the frequency will likely increase. For people with no or minimal retinopathy, the recommended interval is one to two years. Please consult your optometrist and health care team to determine what suits your health best.
1. "Eye Damage (Diabetic Retinopathy)." Eye Damage (Diabetic Retinopathy) | Canadian Diabetes Association. Accessed March 07, 2016. http://www.diabetes.ca/diabetes-and-you/complications/eye-damage-diabetic-retinopathy.
2. "Complications." Complications: Diabetes Forecast. Accessed March 07, 2016. http://www.diabetesforecast.org/diabetes-101/complications.html.
3. "Diabetic Retinopathy." Diabetic Retinopathy. Accessed March 08, 2016. http://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/diabetic-retinopathy?sso=y.
4. "Facts About Vitreous Detachment." Facts About Vitreous Detachment. August 2009. Accessed March 08, 2016. https://nei.nih.gov/health/vitreous/vitreous.