When we hear medical terms like diabetic retinopathy, we can assume that the issue is you either have it or you don’t. This isn’t the case with most health conditions. Just as diabetes can vary in severity, so can diabetic retinopathy. Unlike diabetes, which affects a person’s blood sugar levels, diabetic retinopathy is a progressive condition that may not be reversible. Once you go from one stage to the next, it may not be possible to correct the damage that has been done.
As you may have guessed, diabetic retinopathy is a complication of dysregulated diabetes. When there is too much, then too little, then too much glucose in the blood, the tiny blood vessels that line the back of the eye where the retina lives sustain damage. The retina is an integral structure in the formation of eyesight. When this part of the eye is damaged, there is the potential for vision loss. A fortunate aspect of diabetic retinopathy is that this condition typically does not develop until a person has had diabetes for 3 to 5 years or more. Not every person with diabetes will develop diabetic retinopathy.
When blood sugar is well managed, eyesight is typically not threatened. In the instance of poor blood sugar regulation, diabetic retinopathy may progress through four stages: mild, moderate, severe non-proliferative retinopathy, and proliferative retinopathy.
- Mild non-proliferative retinopathy is the earliest stage of blood vessel damage. In this stage, the tiny blood vessels develop what are called micro-aneurysms, which is swelling in the vessels.
- Moderate non-proliferative retinopathy occurs when some of the tiny blood vessels in the retina become blocked.
- Severe non-proliferative retinopathy has progressed farther, with a substantial blockage in several blood vessels. These blockages prevent the retina from receiving the necessary blood supply. Without sufficient circulation of blood, the retina grows new blood vessels.
- Proliferative retinopathy occurs because the new blood vessels that are grown to feed the retina are weak and fragile. These new vessels sit near the vitreous gel at the center of the eye. Being that they do not grow normally, these blood vessels may leak blood into the eye, causing severe vision loss. Proliferative retinopathy can cause permanent blindness.
Diabetic retinopathy can progress through these stages slowly or quickly. The speed of progression depends on several factors, including the patient’s blood sugar, cholesterol, and blood pressure. If you have diabetes, you must learn to manage your blood sugar with healthy lifestyle habits and prescribed medications, if necessary. You should also see an ophthalmologist with experience diagnosing and treating diabetic retinopathy. Visits should be scheduled yearly, or more often if the doctor advises.