When Sight Fades: A Journey Through Diabetic Retinopathy

By Alpro Pharmacy

October 25, 2024

Key Points:

Diabetic Retinopathy (DR) occurs when high blood sugar damages blood vessels in the retina, potentially causing vision loss.
It progresses from Non-Proliferative DR (NPDR) with swelling and blocked vessels to Proliferative DR (PDR), marked by abnormal blood vessel growth and vision issues.
Managing blood sugar, blood pressure, and cholesterol, along with treatments like laser therapy or injections, and regular eye exams are essential for preventing vision loss.

One day, Mr. Lim visited optometrist Anis due to persistent blurry vision despite wearing his glasses. After routine checks revealed no change in his prescription, Anis conducted further tests and referred him for a comprehensive examination. The hospital diagnosis confirmed he had diabetes, prompting Mr. Lim to realize the importance of taking his health seriously.

With guidance from a nutritionist and diabetes educator, Mr. Lim learned to manage his condition through dietary changes and exercise. He committed to regular eye check-ups with Anis, who monitored his eye health. Grateful for her timely intervention, Mr. Lim recognized that clarity came not just from his glasses but from actively caring for his health, leading to a newfound appreciation for his vision and well-being.

Diabetic Retinopathy

Diabetic retinopathy (DR) is an eye disease caused by diabetes. Diabetes can affect your eye care, making it especially important to get a regular eye exam. Damaged blood vessels and abnormal new ones can cause vision loss. This is when high blood sugar levels cause damage to blood vessels in the retina. These blood vessels can swell and leak. Or they can close, stopping blood from passing through. Sometimes abnormal, new blood vessels grow on the retina. All of these changes can steal your vision (“Diabetic Retinopathy” 2023).

Stages of Diabetic Retinopathy

Non-proliferative Diabetic Retinopathy (NPDR)
This is the early stage of diabetic eye disease.

Tiny blood vessels leak (retina swell)
Macula edema
Blood vessels in the retina close off (Macula Ischemia)
Formation of exudates

Proliferative Diabetic Retinopathy (PDR)
Advanced stage of diabetic eye disease.

Neovascularization (retina growing new blood vessels)
Floaters in vision

What are cause and symptoms?

Diabetic retinopathy is primarily caused by prolonged high blood sugar levels, which can damage blood vessels in the retina. The main risk factors include:

Type 1 and Type 2 Diabetes: Both types can lead to retinopathy.
Duration of Diabetes: The longer someone has diabetes, the higher the risk.
High Blood Pressure: This can exacerbate the condition.
High Cholesterol Levels: Contributes to blood vessel damage.
Smoking: Increases the risk of developing retinopathy.
Pregnancy: Can worsen existing retinopathy.

Symptoms

In the early stages, diabetic retinopathy may not cause noticeable symptoms. As the condition progresses, symptoms may include:

Blurred vision
Fluctuating vision (changes sometimes from blurry to clear)
Dark spots or increasing number of floaters in vision
Impaired color vision (colors appear faded or washed out)
Vision loss (in advanced stages)
seeing blank or dark areas in your field of vision
having poor night vision

Diabetic retinopathy symptoms usually affect both eyes.

Treatment Options

The treatment for diabetic retinopathy depends on its stage:

Early Stages:

- Blood Sugar Control: Maintaining good blood sugar levels can prevent progression.
- Regular Eye Exams: Monitoring eye health with regular check-ups.

Moderate to Severe Stages:

- Laser Treatment (Photocoagulation): Used to seal or destroy leaking blood vessels and reduce the risk of vision loss. Laser surgery can also help shrink blood vessels and prevent them from growing again.
- Vitrectomy: Surgical procedure to remove blood from the vitreous and scar tissue from the retina. This allows light rays to focus properly on the retina again. (Advanced PDR)
- Medications: Injections of anti-VEGF (vascular endothelial growth factor) drugs (ranibizumab (Lucentis), aflibercept (Eylea), brolucizumab (Beovu), bevacizumab (Avastin), and faricimab (Vabysmo)) can reduce swelling of the macula and prevent further vision loss.

Management of Underlying Conditions:

- Control of blood sugar, blood pressure, and cholesterol levels through lifestyle changes and medications.

Regular eye exams and early intervention are crucial for managing diabetic retinopathy. If you have diabetes, it’s important to work closely with your healthcare team to monitor your eye health and maintain overall wellness.

It is well known that the longer a patient has diabetes, the greater their risk of developing diabetic retinopathy (Drake, 2007). The majority of patients with diabetic retinopathy (DR) have good vision, with only 19% having visual acuity of 6/12 or worse in the better eye. As a result, many diabetic patients may delay seeking early treatment for DR (Ma et al., 2020).

The development of DR is closely linked to the duration of diabetes and the control of blood glucose levels, often measured by HbA1c levels, with odds ratios ranging from 1.07 to 8.62 (Wong et al., 2008).

Studies show that the prevalence of DR is nearly 9% among those aged 40 to 89. Additionally, other eye conditions, such as cataracts and glaucoma, can increase the risk of vision impairment in patients with diabetes (Konstantinidis et al., 2017).

Regular eye exams and early intervention are crucial for managing diabetic retinopathy. If you have diabetes, work closely with your healthcare team to monitor your eye health and overall wellness. Visit your nearest optometrist to check your eye condition.

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