Diabetic retinopathy is an eye condition that affect the retina in some patients who have had diabetes for many years.  The retina is the light-sensitive nerve tissue that lines the back of the eye, like the film in your camera.  It is vital for vision.  Diabetes can affect the retina, and causes significant visual impairment even to total blindness.

There are two forms of retinopathy: background and proliferative retinopathy.  Background retinopathy generally progresses slowly over many years and eventually causes mild to moderate visual loss through circulation problem or retinal swelling. It is related to the length of time you have had diabetes, and it is more common in insulin-dependent diabetes than non-insulin-dependent diabetes. The earliest changes are subtle and only slightly different from normal. Some of the retinal blood vessels gradually enlarge; some become irregular in size and develop some tiny weak spots called micro-aneurysms.  They begin to leak exudates (fluid, fat, and protein) and blood.  At first, vision may be normal or only slightly affected, depending on where the leaks are located.  As it advances, some of the smaller retinal blood vessels gradually become obstructed, resulting in a patchy loss of retinal nourishment. In some patients this also leads to the development of proliferative retinopathy.

In proliferative retinopathy, abnormal new blood vessels begin to grow over the surface of the retina and optic nerve.  Unfortunately, these blood vessels are unusually fragile and frequently break and start to bleed.  If they bleed into the vitreous, vision can become clouded from the blood overnight.  At first the blood is rapidly absorbed, so vision tends to clear in a few weeks. As more new vessels grow, the risk of more bleeding increases. Eventually vision deteriorates greatly after recurrent bleeding. Scars form and may tug on or even tear the retina, which can lead to a retinal detachment.  All of these developments have the potential for leading to blindness.

For background retinopathy or even for minimal proliferative retinopathy, you may not need any treatment other than keeping your diabetes under good control.  If the condition is more serious and is threatening your vision, laser treatment may be recommended.  Laser beams may be used for "focal treatment" to stop retinal leakages, or for pan-retinal photocoagulation to create hundreds of tiny burns in the retina that reduce the number of abnormal blood vessels, thus reducing the risk of internal bleeding.  More than one series of laser treatment may be needed, but all can be done on an outpatient basis and are usually painless.  Lubbock Eye Clinic is equipped with state-of-the-art diagnostic and therapeutic modalities for management of all stages of diabetic retinopathy.  We recommend that you have a thorough eye exam, including a pupil dilated retinal exam, by an ophthalmologist at least annually if you have diabetes.  It is a serious condition that can potentially lead to total blindness.  However, laser treatment has been effective in preventing many blindness from diabetic retinopathy.