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Patient education: Diabetic retinopathy (The Basics)

Patient education: Diabetic retinopathy (The Basics)

What is diabetic retinopathy? — Diabetic retinopathy is an eye problem that can lead to vision loss and even blindness. It is most common in people with diabetes who do not control their blood sugar well.

What are the symptoms of diabetic retinopathy? — Most people with diabetic retinopathy have no symptoms during the early stages of the disease. This is when treatment works best. For this reason, is important to get screened for the condition early. That way, doctors can take steps to protect your eyes before your vision is damaged.

When symptoms start, they can include:

Blurry vision

Dark or floating spots (picture 1)

Trouble seeing things that are at the center of your focus when reading or driving

Trouble telling colors apart

Is there a test for diabetic retinopathy? — Yes. To check for diabetic retinopathy, you can get 1 of 2 main tests:

Dilated eye exam – During this exam, the eye doctor gives you eye drops to make your pupils open up. (The drops make it easier for the doctor to see the different parts of the inside of your eye.) After the drops have done their job, the doctor looks at the back of your eye, called the retina. That's the part of the eye that is damaged by diabetic retinopathy.

Digital retinal imaging – For this test, a technician takes pictures of the eye with a special camera. Then they send the pictures to an eye doctor, who checks for disease. It is OK to use this test if your past eye tests have all been normal. Otherwise, you should have a dilated eye exam.

If either the dilated eye exam or the digital retinal imaging test shows a problem, the eye doctor might suggest other tests, too.

People with diabetes should have their eyes checked regularly. If you have retinopathy, you will need to get checked at least once a year, maybe more. If not, you might only need to get checked every 2 years. Your doctor will work with you to decide on a schedule.

For people with type 1 diabetes, eye exams should start 3 to 5 years after diagnosis.

For people with type 2 diabetes, eye exams should start right after diagnosis.

Should I see a doctor or nurse? — If you notice any vision loss (or dark spots in your vision), see an eye doctor as soon as possible.

How is diabetic retinopathy treated? — Keeping your blood sugar and blood pressure levels in the goal range can prevent the condition from getting worse.

Other treatments for diabetic retinopathy can include:

Photocoagulation – This is laser surgery to seal or destroy leaking or growing blood vessels in the retina.

Medicines – Medicines that are injected into the vitreous humor are sometimes used alone or along with other treatments. Your eye doctor will let you know if medicines might help you.

Vitrectomy – This is surgery to remove blood from the part of the eye called the "vitreous humor" (figure 1). Doctors do this surgery if the blood vessels in the retina leak into the vitreous humor.

Can diabetic retinopathy be prevented? — Yes. If you have diabetes, you can reduce your chances of getting diabetic retinopathy by keeping your blood sugar and blood pressure levels as close to your goal as possible. It might also be important to keep cholesterol levels in the normal range.

More on this topic

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Patient education: Age-related macular degeneration (The Basics)
Patient education: Cataracts (The Basics)
Patient education: Open-angle glaucoma (The Basics)

Patient education: Preventing complications from diabetes (Beyond the Basics)

This topic retrieved from UpToDate on: Mar 03, 2022.
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