A diabetic retinopathy guide
If the person in your care has diabetes, you may already know that the condition can cause vision problems. The most common one is diabetic retinopathy, the leading cause of blindness in working-age Americans. In fact, almost half of Americans with diabetes have some form of diabetic retinopathy. What is it, and how can you help protect someone from its dangers?
The good news about diabetic retinopathy
By keeping blood sugar levels in check, a diabetes patient can help control the progression of the disease.
What happens with diabetic retinopathy?
Having diabetes causes blood sugar levels to rise. When these levels remain high for a period of time, tiny blood vessels (capillaries) that nourish the retina can become damaged. This damage, called diabetic retinopathy, is progressive, and it can eventually result in vision loss or blindness.
The disease has two main stages: nonproliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR). If someone is in the first stage, it means he has swelling and some bleeding in his eye. When this happens he may have no symptoms or he may have some mild vision loss.
In the second, more severe stage -- during which abnormal, fragile blood vessels grow and leak blood into the center of the eye -- his vision may become clouded or even blocked. If he reaches an advanced stage, the abnormal blood vessel growth and scarring can cause glaucoma and detachment of the retina (when scar tissue pulls the retina away from the wall of the eye).
Side effect: macular edema
About half of those people with diabetic retinopathy also develop what's called macular edema, which can cause a noticeable blurring of central vision. It happens when leaking fluid makes the macula swell.
Macular edema can happen at any stage of diabetic retinopathy and whether or not the blood sugar level is elevated -- though it's more likely to show up later in the disease. As the swelling increases or decreases, vision worsens or improves.
Risk factors for diabetic retinopathy
Type 1 or type 2 diabetes Almost half of those with diabetes have some degree of diabetic retinopathy. Those who've had diabetes the longest are at highest risk.
Other health conditions People with high blood pressure or high blood cholesterol are at higher risk of developing diabetic retinopathy.
Pregnancy A woman with diabetes has a higher risk of developing complications, including retinopathy, during her pregnancy.
Ethnicity Those of Hispanic or African American heritage are at higher risk of getting the disease.
