If you have diabetes, you need to take special care of your eyes. Diabetes can damage your eyes. This is called diabetic retinopathy. Simply put, this is when high blood sugar levels over a long period of time damage the delicate blood vessels in the sensitive part of the eye called the retina. Over time, this can lead to vision loss and even blindness. So it's important to be aware of this.
The best thing is that we can prevent this condition from occurring or slow it down. Not everyone with diabetes will develop it. But nearly half of people with diabetes have it to some degree. The biggest problem is that in the early stages, there are no symptoms. So you may not know you have the condition.
The four stages of diabetic retinopathy
Diabetic Retinopathy develops in four main stages. Let's now briefly discuss each of these stages. It will be easier for you to understand this information in a table.
| Stage | What happens inside the eye | Impact on vision and what to do |
|---|---|---|
| 1. Mild Nonproliferative Retinopathy | Microaneurysms form in the tiny blood vessels in the retina of the eye. These can cause small hemorrhages. | There is usually no problem with vision. Control diabetes, blood pressure, and cholesterol well. Get your eyes checked once a year. |
| 2. Moderate Nonproliferative Retinopathy | The blood vessels become swollen, and some become blocked, which reduces the blood supply to the retina. | Vision can be affected. A condition called DME (Diabetic Macular Edema) may occur. The doctor recommends having your eyes checked every 3-6 months. |
| 3. Severe Nonproliferative Retinopathy | More blood vessels become blocked. Since the retina is deprived of blood, signals are sent to create new blood vessels. Scar tissue can form. | The risk of vision loss is high. Vision may become blurred and floaters may appear. Treatment can stop further damage. |
| 4. Proliferative Diabetic Retinopathy (PDR) | Because the newly formed blood vessels (neovascularization) are weak, they rupture and bleed easily. This can lead to scar tissue formation and retinal detachment. | This is a very serious condition. Permanent vision loss can occur. Immediate treatment is required. |
Let's look at this stage in a little more detail.
Stages 1 and 2 (Mild and Moderate Retinopathy)
In the early stages, you may not notice any changes. But damage has already begun to occur inside the eye. In the second stage, blood vessels swell, leading to a condition called Diabetic Macular Edema (DME) . This is when blood and fluid accumulate in the part of the eye called the macula. Remember, the macula is what helps us see clearly, such as reading, driving, and recognizing people. When it swells, your vision starts to blur.
The most important thing is for everyone with diabetes to have their eyes checked at least once a year. This way, the disease can be detected at an early stage.
Stages Three and Four (Severe and Proliferative Retinopathy)
When it comes to the third stage, the situation is a little more serious. Many of the blood vessels are blocked. This means that the retina does not receive the oxygen and nutrients it needs. At that point, the retina sends a signal to the brain, saying, "I don't have enough blood, make new blood vessels."
In the fourth, or most severe stage (PDR), these new blood vessels are the problem. They are weak like leaves and break easily. They burst and bleed into the eye. This causes scarring, and as the scarring shrinks, the retina can detach from the back of the eye. We call this retinal detachment . If this happens, you can lose your vision permanently.
How do I know what stage I am in?
You can't decide this on your own. For this, you need to have an eye examination by a specialist. The doctor can perform several tests to accurately diagnose your condition:
- General eye exam: Checks how well you see at different distances.
- Measuring intraocular pressure: This measures the pressure inside the eye.
- Pupil Dilation: This involves dilating your pupil with eye drops and examining the inside of your eye with a special instrument. This is the best way to see if there is any damage to the blood vessels in your retina.
- OCT scan (Optical Coherence Tomography): This is like taking pictures of the inside of the eye. It uses light waves to take pictures of a cross-section of the retina to check for conditions like DME.
- Fluorescein Angiogram: This involves injecting a special dye into a vein in your arm. As the dye travels with the blood to your eye, your doctor uses a special camera to take pictures of the blood vessels inside your eye. This allows them to clearly see if there is any blood leaking from the blood vessels or if they are blocked.
After these tests, the doctor will explain to you what stage you are in.
What are the treatments for this?
Usually, in the early stages, your doctor will monitor your condition. The most important thing is to keep your diabetes, blood pressure, and cholesterol levels under good control.
If the condition worsens or DME develops, treatment may be required.
- Eye injections: Injections are given into the eye to stop the growth of new abnormal blood vessels.
- Laser Surgery: Laser rays are used to seal bleeding blood vessels and control the formation of new vessels.
- Steroid Drugs: Swelling is controlled by injections containing steroids or small devices (implants) placed inside the eye.
Sometimes more than one of these treatments may be needed at the same time. Remember, your doctor will decide which treatment is best for you. So be open and honest with your doctor about everything.
Take-Home Message
- The best way to protect your eyesight is to control your diabetes well. Keep your blood sugar levels within the right range.
- If you have diabetes, it is essential to have an eye exam at least once a year, even if you have no symptoms .
- If this condition is detected early , there is a much greater chance of preventing vision loss.
- If your doctor tells you that you have diabetic retinopathy, don't panic. Get your tests done on time and follow your doctor's instructions.
- Before deciding on any treatment, discuss it thoroughly with your doctor.
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