Diagnosis Of Diabetic Retinopathy

A common misconception among people with diabetes is, "If I can see well, there's nothing wrong with my eyes." That's false confidence. The majority, of people who lose their sight because of diabetic retinopathy do so because they didn't seek early medical attention. It bears repeating: If you have diabetes, you are at risk even if you don't have any apparent vision problems. For this reason regular eye examinations are essential.
 

Diagnosis Of Diabetic Retinopathy

When and how often do you need your eyes checked? The American Academy of Ophthalmology recommends the following schedule:

• People who receive a diagnosis of diabetes before age 30 should have a comprehensive eye exam by the time diabetes has been present for 5 years or when the person is 10 years old, whichever is later.
• People who receive a diagnosis at age 30 or older should have a baseline eye exam at the time of the diagnosis.
• Women with diabetes who are pregnant or intending to become pregnant should have an eye exam before conception or early in the first trimester and thereafter every 3 months. 

After the initial exam, people with diabetes should have their eyes checked every year, unless they have eye conditions that require more frequent monitoring.

See your eye doctor promptly if your eyes become painful and red, your vision decreases, or you see floaters or light flashes. If diabetic retinopathy is found, the course of treatment will depend on the severity of the condition and whether your vision is currently impaired or threatened by the retinal changes.

Diagnosing retinopathy 

Your eye doctor will likely diagnose diabetic retinopathy, either nonproliferative or proliferative, if the eye examination reveals any of the following:

• Leaking blood vessels
• Microaneurysms
• A swollen retina 
• Fatty deposits (exudates) on the retina 
• Cotton wool spots (areas of nerve fiber damage) 
• Changes in blood vessels (closures, beading, loops) 
• Formation of new blood vessels (neovascularization) 
• Retinal hemorrhage 
• Vitreous hemorrhage 
• Scar tissue formation with retinal detachment 

Panretinal photocoagulation
 
For proliferative diabetic retinopathy, a form of laser surgery called panretinal or scatter photocoagulation is used. With this technique the entire retina except the macula is treated with randomly placed laser burns. The treatment causes the abnormal new blood vessels to shrink and disappear. Thus it reduces the chances of vitreous hemorrhage. Panretinal photocoagulation is usually done in two or more sessions. The treatment significantly reduces the risk of severe vision loss.
 
If the treatment is extensive, you may notice some loss of peripheral vision afterward. Panretinal photocoagulation is a trade-off. Some of your side vision is sacrificed to save as much of your central vision as possible. You may also notice more difficulties with your night vision and temporary blurring of your central vision. Panretinal photocoagulation doesn't always stop loss of vision from diabetic retinopathy, even with repeated treatments.

Self-care 

There's no doubt that diabetic retinopathy is a serious disease. It's equally certain that you can take steps to slow its progression.
 
Control your blood sugar. Tight control of blood sugar slows the onset and progression of retinopathy and lessens the need for surgery. Tight control means keeping blood sugar levels as close to normal as possible. A normal range before eating is 70 to 110 milligrams of sugar per deciliter of blood (mg/dL), but that may not be realistic for many people. Another measure of good control is a result of 8 percent or less on a glycated hemoglobin test (hemoglobin A-1C test), which measures how well you've controlled your blood sugar level over the previous 2 to 3 months.
 
Tight control isn't possible for everyone, including some older adults, young children and people with cardiovascular disease. Talk to your doctor, endocrinologist or diabetes educator about the best management plan for you. A plan frequently involves:

• Taking insulin or other medications
• Monitoring blood sugar levels
• Following a healthy eating plan 
• Getting regular exercise 
• Maintaining a healthy weight 

It may take some time before the benefits of lowering your blood sugar are realized. And it's important to note that better control lowers but doesn't eliminate your risk of developing retinopathy.
 
Keep an eye on vision changes. In addition to getting an annual eye exam, be alert to any sudden changes in your vision. Have your eyes checked promptly if you experience:

• Vision changes that last more than a few days or aren't associated with a change in blood sugar
• Eye pain, redness, floaters or light flashes

Keep your blood pressure down. Studies show that lowering blood pressure may slow the progression of diabetic refinopathy. To reduce your blood pressure, you may need to take medications or make lifestyle changes.

Diagnosis Of Diabetic Retinopathy

Stop smoking. Smoking is especially bad for people with diabetes because it promotes the closure of blood vessels.
 
Get support if you need it. Diabetes can take an emotional as well as physical toll. Stress, depression and anxiety are common among people with diabetes. In turn stress can cause swings in blood sugar levels. Don't hesitate to seek help from a counselor, therapist or support group. Relaxation techniques such as meditation also may be helpful. To find out more, you can check out Diagnosis Of Diabetic Retinopathy.