Diabetic Retinopathy

What is diabetic retinopathy?

Diabetic retinopathy, also called DR, is a disease caused by diabetes that usually affects both eyes. Diabetes is a condition that causes high blood sugar levels. The increased blood sugar levels affect the blood vessels of the retina. The retina is the part of the eye that captures light and sends information to your brain. With DR, the damaged retina causes vision problems that may cause you to lose your vision.

What causes diabetic retinopathy?

Having long standing uncontrolled type 1 or type 2 diabetes is the main cause of DR. With DR, the walls of the blood vessels in the retina may weaken and leak blood. This causes edema (swelling) and vision problems. Over time, new blood vessels may grow, leak blood, and cover the center of the retina. This may cause your eyesight to be completely blocked and cause blindness.

What puts me at risk of having diabetic retinopathy?

The longer you have diabetes, the more likely you will have DR. The following may increase your chances of having DR or of DR becoming worse:

• You had diabetes during puberty (ages 11 to 15)
  
  
• You have other eye problems or eye surgery
  
  
• You have other family members with DR
  
  
• You do not control your blood sugar
  
  
• You have high blood pressure
  
  
• You have high blood cholesterol (fat)
  
  
• You are pregnant, which may make DR worse
  
  
• You have other health problems, such as anemia or kidney problems

What are the signs and symptoms of diabetic retinopathy?

You may have any of the following signs or symptoms:

• Blurred vision
  
  
• Fast and painless worsening of vision
  
  
• Seeing red or black wavy lines that have a curtain-like or spider web effect
  
  
• Seeing light flashes or red, black, or grey floating spots (floaters)

How is diabetic retinopathy diagnosed?

Diabetic retinopathy may be diagnosed during a complete eye exam. You may also have the following:

• Dilated indirect ophthalmoscopy: This test uses a magnifying lens to see your retina and other parts of your eye. Eyedrops are placed into your eyes to dilate (widen) the pupils. The pupil is the dark circle in the middle of the eye.
  
  
• Fluorescein angiography: This test uses a dye called Fluorescein that is injected into a vein in your hand or arm. The dye flows into the blood vessels of your retina and then a special camera will take a picture.
  
  
• Stereo fundus: This test is also called fundus photography. You may have this test to diagnose DR or check your DR to see if it is getting worse.

How is diabetic retinopathy treated?

You may not need treatment right away if you have mild DR. For severe DR, surgery may be needed to slow or stop the disease from becoming worse. Laser treatment may slow DR and prevent blindness. This treatment shrinks the new blood vessels and seals the areas that have leaks. Surgery called a vitrectomy may be done if there is bleeding in the vitreous that does not clear. The vitreous is the gel-like material that fills the inside of the eye.

What can I do to prevent diabetic retinopathy?

You may decrease your risk of having DR with the following:

• Blood sugar control: Keep your blood sugar levels as close to normal as possible. Your blood sugar levels should be between 90 and 130 mg/dl (milligrams per deciliter) before meals. After meals, your blood sugar level should be less than 180 mg/dL. Ask your caregiver how, when, and how often to check your blood sugar levels. Check your blood sugar levels at least 3 times each day if you use an insulin pump or take multiple doses of insulin. You can control your blood sugar level by taking insulin, diabetes medicine, eating correctly, and exercising.
  
  
  • Hemoglobin A1c measurement: You need lab tests that measure the hemoglobin A1c level in your blood. The hemoglobin A1c shows what your average blood sugar level has been over the past 2 to 3 months. Your hemoglobin A1c level should be less than 7 percent.
    
    
  
  
• Blood pressure control: Your blood pressure should not be higher than 130/80 mmHg (millimeters of mercury). You may need to make lifestyle changes and take medicines to control your blood pressure.
  
  
• Blood cholesterol control: You need lab tests that measure the amount of cholesterol (fat) in your blood. Talk to your caregiver about your total blood cholesterol. You may need to make lifestyle changes or take medicines to control your cholesterol.
  
  
• Regular eye checks: You need to have regular eye exams.
  
  
  • Have your eyes checked starting 3 to 5 years after your type 1 diabetes is diagnosed, or during puberty (11 to 15 years). Your eyes should be checked soon after you learn you have type 2 diabetes.
    
    
  • Have your eyes rechecked every year.
    
    
  • Pregnancy:
    
    
    • If you are planning to get pregnant, have your eyes checked before the pregnancy.
      
      
    • If you are pregnant, have your eyes checked during the first 13 weeks of your pregnancy.
      
      
    • Have your eyes checked frequently throughout the pregnancy and throughout the year after the birth of your baby .

Where can I find support and more information?

You may want to join a support group to talk with other people who also have diabetes. Contact the following for more information:

• American Diabetes Association
  1701 North Beauregard Street
  Alexandria , VA 22311
  Phone: 1- 800 - 342-2383
  Web Address: http://www.diabetes.org
  

• National Diabetes Information Clearinghouse
  1 Information Way
  Bethesda , MD 20892-3560
  Phone: 1- 800 - 860-8747
  Web Address: www.diabetes.niddk.nih.gov/
  

• National Eye Institute, National Institutes of Health
  202 Vision Pl.
  Bethesda , MD 20892-3655
  Phone: 1- 301 - 496-5248
  Web Address: www.nei.nih.gov
  

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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