Diabetic Eye Disease Stages
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What Are Diabetic Eye Diseases?
When you have diabetes, your eyes are more susceptible to a variety of eye diseases. These diseases can affect many parts of your eyes, including the retina, macula, lens and optic nerves.
It is important to check your eye health regularly if you have diabetes because all forms of diabetic eye disease can cause severe vision loss or blindness.
What Kinds of Diabetic Eye Diseases Are There?
The most common diabetic eye diseases are:
- Diabetic Retinopathy
- Diabetic Macular Edema (DME)
Diabetic Retinopathy occurs when retinal blood vessels bleed or leak fluid, distorting your vision. It is the most common cause of vision loss for people with diabetes and is one of the leading causes of blindness among working-age adults, according to the National Eye Institute.
Diabetic Macular Edema (DME) occurs when there is an accumulation of fluid in the macula due to leaking blood vessels. DME can occur as a result of diabetic retinopathy.
The Four Stages of Diabetic Retinopathy
When you have diabetes, you are at an increased risk for chronically high blood sugar. This, in turn, can damage the tiny blood vessels in your retina, and lead to diabetic retinopathy, which progresses in four stages.
The four stages of Diabetic Retinopathy are:
- Mild nonproliferative retinopathy: During this stage, the retina’s small blood vessels have microaneurysms, and begin to swell and leak fluid into the retina.
- Moderate nonproliferative retinopathy: During this stage, blood vessels that nourish the retina can become swollen and distorted. In some cases, they are inhibited from transporting blood to the retina altogether. These problems cause the retina to change characteristically, and can lead to DME.
- Severe nonproliferative retinopathy: During this stage, more blood vessels become blocked, and the blood supply to the retina becomes more deprived. The areas that are blocked begin secreting growth factors that tell the retina to start growing new blood vessels to compensate for the lack of blood supply.
- Proliferative Diabetic Retinopathy (PDR): During this advanced stage, the retina continues to grow new blood vessels which grow into the vitreous gel on the surface of the retina. These delicate vessels are more likely to bleed or leak, causing scarring and scar tissue, which then can contract causing retinal detachment. This can lead to permanent damage and vision loss.
What is Diabetic Macular Edema (DME) and how is it related to diabetic retinopathy?
The National Eye Institute states: “Macular edema occurs when there is abnormal leakage and accumulation of fluid in the macula from damaged blood vessels in the nearby retina. A common cause of macular edema is diabetic retinopathy, a disease that can happen to people with diabetes.”
They continue, “Macular edema can also occur after eye surgery, in association with age-related macular degeneration, or as a consequence of inflammatory diseases that affect the eye. Any disease that damages blood vessels in the retina can cause macular edema.”
However, for those with diabetic retinopathy, DME is the most common cause of vision loss. Nearly half of all individuals with diabetic retinopathy will develop DME.
Who Can Develop Diabetic Retinopathy?
Any person with type 1, type 2 or gestational diabetes are at risk for diabetic retinopathy. In fact, nearly 40-45 percent of Americans with diabetes are estimated to have some form of diabetic retinopathy.
Pregnant women with diabetes or who develop diabetes while pregnant are at increased risk as well.
Symptoms and Detection:
Diabetic Retinopathy is very difficult to recognise in its early stages, and many people with it don’t notice they have it until the disease has progressed to a stage where it affects their vision. This makes it extremely important to get regular eye exams when you have diabetes.
How are diabetic retinopathy and DME detected? The only way to comprehensively diagnose diabetic retinopathy and DME is through an eye exam with your eye care professional. They will perform a variety of tests that determine if your eyes are healthy and whether there are any leaking blood vessels or retinal problems.
Other Diabetic Eye Diseases
There are many other eye diseases related to diabetes too. They include:
Cataract, which occurs when the eye’s lens becomes clouded. Adults with diabetes are 2-5 times more likely to develop cataract than those who don’t have diabetes. It also affects diabetes sufferers earlier on in life than those without diabetes.
Glaucoma, which is a group of diseases that damage the optic nerve—or the nerve fibers that connect the eye to the brain. Individuals with diabetes are almost twice as likely to develop glaucoma than individuals without diabetes.
Each of these types of diabetic eye disease can cause severe vision loss and blindness if they aren’t detected early on.
How to Prevent Diabetic Eye Diseases
The best way to prevent diabetic eye diseases is to get eye exams frequently. In fact, the National Eye Institute recommends that people with diabetes get a comprehensive dilated eye exam at least once a year, while people with diabetic retinopathy may need eye exams more frequently. They also suggest that women with diabetes who become pregnant should have a comprehensive dilated eye exam as soon as possible.
How to Prevent Diabetic Eye Diseases
People with severe nonproliferative diabetic retinopathy are at risk for vision loss and PDR, and may need comprehensive dilated eye exams as frequently as every 2 to 4 months.
If you have diabetes, it is important to see your eye care professional frequently. He or she can help you avoid severe vision loss and vision problems with simple eye check ups. Not doing so can result in irreversible damage that can last a lifetime.