Retinopathy

Background retinopathy

If retinopathy is detected in its early stages and little damage has occurred, then it is called background retinopathy. Tiny bulges (microaneurysms) appear in the veins in the rear of your eyes, which may release modest quantities of blood. This is normal for people with diabetes, and your optometrist will monitor you carefully to check whether the condition is progressing. If not treated, this can lead to proliferative diabetic retinopathy (PDR).

The retina is a membrane that covers the back of the eye. Its function is to receive light and transmit light signals to the brain. Once this information is sent, the signals are interpreted into images. However, if you have diabetes and the blood vessels are potentially damaged, the retina can no longer do this. This can lead to blood or fluid leaking into the macula (the centre of the retina), resulting in blurred, sometimes reduced vision, and can lead to vision loss if untreated.

Types

The most common types of retinopathy are:

Proliferative retinopathy

Proliferative retinopathy is development of new blood vessels (neovascularisation) on the inward surface of the retina or the vitreous humour (the clear gel inside the eyeball), which can threaten your vision by causing the retina to detach or blood to leak into the eye cavity. In this condition small blood vessels grow from the surface of the retina.

Non-proliferative diabetic retinopathy

Non-proliferative diabetic retinopathy (NPDR), also known as preproliferative diabetic retinopathy, is the early stage of the disease in which symptoms are mild or practically nonexistent. In NPDR, the blood vessels in the retina are weakened. Tiny bulges in the blood vessels, called microaneurysms, may leak fluid into the retina. This leakage may lead to swelling of the macula.

This condition is called pre-proliferative because it typically develops into proliferative retinopathy when new vessels develop.

Hypertensive retinopathy

High blood pressure can cause problems with blood vessels, including thickening of small arteries, vessel blockages and bleeding. As your blood pressure rises, the optic nerve may begin to swell, which affects your vision.

Symptoms of retinopathy

The symptoms you may experience are:

Blurry, hazy vision
Impaired colour vision
Floaters in your field of vision
Colourless and transparent strings in your field of vision
Inability to see clearly at night
Decreased vision due to patches and streaks
Permanent or partial loss of vision.

Complications of retinopathy

Here are some of the complications you may face if you have diabetic retinopathy:

Detached retina: This can occur when scar tissue present in the eye pulls or detaches the retina from the back of the eye. This causes floaters and flashes to appear suddenly in your field of vision. If this detachment isn't corrected through surgery, it can cause vision loss.
Vitreous haemorrhage: This can happen when blood vessels leak into your eye cavity, which stops light from reaching your retina, causing partial loss of vision. Other symptoms may include extreme sensitivity to light, and floaters in the field of vision.

The importance of early and regular eye health checks

Diabetic retinopathy can occur if your blood sugar has become too high and remains at a high level. You may not notice until you experience decreased vision. It is important to have regular eye examinations, particularly if you have diabetes.

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