Diabetic retinopathy (DR) is major cause morbidity in patients with diabetes mellitus. Most patients with DR have no symptoms till very late stage by which time loss of vision may be irreversible

What is diabetic retinopathy

Diabetes mellitus affects tiny blood vessels inside the retina which is the light sensitive layer of the eye.The retina lines inside of the eye and acts like film in the camera. Diabetes causes  the blood vessels in the retina to bleed or leak fluid distorting vision

Natural progression of Diabetic retinopathy

In its early non proliferative stage, the damaged blood vessels leak fluid and fat onto the retina. If this occurs in the central part of the retina macular edema  develops. This is the leading cause of blindness in adult onset diabetes patients

Later there is narrowing of blood vessels which restricts blood flow to retina. This lead to abnormal growth of blood vessels in the retina resulting in bleeding  into the eye. It may progress to growth of abnormal fibrous tissue in the eye. The retina then becomes separated from its attachment to the eyeball causing permanent loss of vision. Ultimately eye pressure  can increase causing painful blind eye.

Prevention of diabetic retinopathy

Risk factors for diabetic retinopathy include:

• Duration of diabetes. The longer you have had diabetes, the higher your risk of developing retinopathy. Around 9 in 10 people who have had diabetes for longer than 30 years can be affected.

            Studies have shown that those people with poor control of their diabetes are more likely to develop all complications, including retinopathy. However, one large study has shown that even a proportion of people who have very well controlled glucose levels still develop diabetic retinopathy in the future.

• High blood pressure. If your blood pressure is not well-controlled then this will increase your risk of developing retinopathy.
• Nephropathy (kidney disease). Having kidney disease as a result of your diabetes is associated with worsening retinopathy.
• Pregnancy. Being pregnant may make retinopathy worsen, especially if your blood sugar (glucose) is poorly controlled.
• Other risk factors include smoking, obesity and having a high cholesterol level.

Best defence against diabetic retinopathy is to have eye examination once your diabetes is diagnosed and once a year after that. DON’T WAIT UNTIL YOU NOTICE A CHANGE IN YOUR VISION. Retinopathy often has no symptoms until it is well advanced, and by this time treatment is more difficult