Diabetes can affect the eyes in a number of ways. Diabetic retinopathy is one of the major complications of diabetes, along with neuropathy (damage of the peripheral nerves) and nephropathy (damage to the kidneys). Diabetic retinopathy usually affects both the eyes.

The human eye has three layers. The outermost layer is called sclera. The middle layer of the eye is called the uvea, and the innermost layer is called the retina. The retina is the light-sensitive membrane of the eye. When light enters the eye, the cornea and lens focus the light onto the retina. The central area of the retina, called the macula, contains millions of nerve endings packed closely together. These nerve endings are responsible for the sharpness of the visual image. The retina converts the image into electrical impulses that are carried to the brain by the optic nerve. So, without the retina, the eye cannot communicate with the brain and vision is lost.

Diabetic retinopathy can affect-

Type I (juvenile onset) diabetics

Type II (adult onset) diabetics

Pregnant women with diabetes.

Approximately 90% diabetic individuals will eventually develop some degree of retinopathy. On an average, the onset of retinopathy in diabetic individuals takes about 10-20 years following the diagnosis of diabetes.

Retinal changes due to diabetic retinopathy may initially be symptomless. Diabetic retinopathy can be divided into two stages based on examination of retina.

The stages are-

Non-proliferative diabetic retinopathy - Small balloon-like swellings called microaneurysms develop in the blood vessels of the retina. As the disease progresses, some of the blood vessels get blocked. Hence, several areas of the retina are deprived of blood supply and are damaged. These damaged areas signal the body to grow new blood vessels for nourishment.

Proliferative diabetic retinopathy (PDR) - Growth of new blood vessels is triggered. However, the new blood vessels are abnormal and fragile; and severe vision loss can occur if these vessels leak blood.

Treating diabetic retinopathy involves control of blood sugar levels and surgical correction with laser photocoagulation or vitrectomy.


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