Why People with Diabetes Develop Diabetic Retinopathy

Early in 2005, my nephew, who just turned 25 then, was discovered to have diabetes. Aware of the fact that people diagnosed with diabetes before the age of 30 are prone to diabetic retinopathy, his parents (my sister and brother-in-law) had to schedule him for regular checkups with an ophthalmologist. He is also being made to undergo regular tests for abnormal or damaged vessels in the retinas. This is to ensure that he promptly gets laser treatment when needed. Also to minimize the risk, his blood sugar is being carefully controlled.

To control their sugar levels, many diabetics must take insulin. Insulin therapy, however, does not guarantee that there won't be damage to the eye. So why are those with diabetes prone to developing diabetic retinopathy? Ophthalmologists provide a detailed answer to this question.

The retina's numerous tiny blood vessels may undergo changes in their physical makeup. Such structural alterations can cause the blood vessels to leak and to deposit exudates (particles of protein and fat) on the retina that can impair vision. Likewise, these structural alterations can disrupt the provision of blood to the retina and, in the end, may stimulate the development of abnormal new vessels in the retina (proliferative diabetic retinopathy is the term used once the disease comes to this particular condition). The possibility of the abnormal blood vessels hemorrhaging heavily can leak blood into the eye's fluid, further obscuring vision. Even though the retina usually sucks up the blood again, scars may develop on the retina and begin to draw it away from its normal position on the eye's inner wall. This condition may eventually lead to retinal detachment.

Part of the tests my nephew goes through is an ophthalmologic procedure called fluorescein angiography. In this procedure, a dye is injected into the bloodstream; the back of the eye is then photographed with a special camera to identify and locate leaking blood vessels. So far, all tests, including this procedure, done on my nephew turned out negative results for any vessel damage.

For those discovered to have damaged or leaking blood vessels, it is very important that photocoagulation is performed early. This laser treatment is the only means of slowing the advance of diabetic retinopathy. A damaged retina, however, cannot be restored by photocoagulation; neither can this laser treatment keep the disorder from occurring again. In this laser treatment, which takes about thirty minutes to perform, a local anesthetic is administered as eye drops. It is usually done in two sessions but, depending upon the severity of the disorder, may require more.

Ophthalmologists say that a patient's peripheral vision may be reduced or his night vision impaired as a side effect of photocoagulation. In some cases, central or principal vision may also be decreased. The patient should have his condition monitored regularly by an ophthalmologist after laser treatments. Laser treatments, however, may not be of any help for cases of advanced diabetic retinopathy. Instead, vitrectomy, a delicate operation, may be necessary in such cases. [Read the Original Article]