Advanced Treatment for Diabetic & Hypertensive Retinopathy

Let's simplify what Retinopathy means: it is a disease that has damaged the retina. (Retina is that part of the eye that senses light) Depending on the severity of retinopathy, it result in partial or complete loss of vision.
DiabeticRetinopathy-insideDiabetic retinopathy is a complication of diabetes that affects the eyes of people suffering from type 1 & type 2 diabetes. If you've had diabetes for long, you have greater chances of developing diabetic retinopathy. In the initial stages, it may only cause mild vision problems but can develop into complete blindness. Protect your vision by keeping your sugar level in control and regularly going for eye check-ups. Screening for diabetic retinopathy should be done at the time of diagnosis in the case of type 2 diabetes and at 5 years in type 1 diabetes. Controlling blood sugar and blood pressure can slow or halt the progress of this disease and appropriate treatment can.

Symptoms of diabetic retinopathy

There are hardly any symptoms visible in the early stages of diabetic retinopathy. Eye examinations are the only way to keep diabetic retinopathy at bay. As the condition worsens, the following symptoms may be experienced:
  • Spots or floaters (dark dots or empty areas in your vision)
  • Blurred vision
  • Fluctuating vision
  • Difficulty with colour perception
  • Vision loss in one or both eyes

Types of diabetic retinopathy

  • Non-proliferative diabetic retinopathy (NPDR), where blood vessels in the retina deteriorate, either becoming blocked or deformed. Fluids, fats and proteins leak out of these abnormal blood vessels and collect in the retina. The swelling caused due to this impairs vision.
  • Proliferative diabetic retinopathy (PDR), where new, but structurally unstable blood vessels grow on the surface of the retina. This in turn affects vision. One of the most serious consequences of proliferative retinopathy is tractional retinal detachment (separation of the layers of the retina) and vitreous hemorrhage.

Causes of diabetic retinopathy

Too much sugar in your blood can damage the tiny blood vessels that nourish the retina, sometimes blocking them completely. As more and more blood vessels become blocked, the blood supply to the retina gets cut, resulting in vision loss. To compensate the lack of blood supply, the eye tries to grow new blood vessels. But, these new blood vessels don't develop properly and are prone to leakage. Scar tissue may also form, which can exert a pull on the retina. Sometimes, this can cause tractional detachment of the retina. Elevated blood sugar levels can also affect the eyes' lenses. With high levels of sugar over long periods of time, the lenses can swell leading to cataract, providing another cause of blurred vision.

Factors that can increase chances of diabetic retinopathy

  • Long duration of diabetes
  • Poor control of your blood sugar level
  • High blood pressure
  • High cholesterol
  • Pregnancy
  • Tobacco use
Worse cases of diabetic retinopathy can result in complications like:
  • Vitreous hemorrhage: The new blood vessels may bleed into the clear substance that fills the centre of your eye. If the amount of bleeding is small, you might see only a few dark spots or floaters. In more severe cases, blood can fill the vitreous cavity and completely block vision.Vitreous haemorrhage by itself usually doesn't cause permanent vision loss. The blood often clears from the eye within a few weeks or months, returning your vision to its previous clarity. Non-resolving vitreous hemorrhage may require surgical intervention.
  • Retinal detachment
  • Glaucoma
  • Blindness

Preventing diabetic retinopathy

  • Controlling blood sugar is essential to prevent diabetic retinopathy.
  • Annual eye exams are crucial. Pay attention to vision changes.
  • Keep your blood pressure and cholesterol under control.
  • If you smoke or use other types of tobacco, ask your doctor to help you quit.
If severe problems of dark spots, etc. are being experienced, treatment can start before sight is affected, thus, helping in preventing vision loss.

How is diabetic retinopathy diagnosed and treated?

To diagnose diabetic retinopathy, a thorough examination of the retina is conducted. The ophthalmologist uses a lighted instrument called an ophthalmoscope. A dye may be used to reveal leaky blood vessels. The treatment for diabetic retinopathy depends on the nature of the problem:
  • Proliferative disease and swelling or leaking of the retina can be treated with laser therapy.
  • The formation of new blood vessels is treated with laser surgery. This creates scars that slow the growth of new blood vessels. Laser surgery is also used to secure the retina to the back of the eye in cases of retinal detachment.
  • Bleeding that clouds vision can be treated by surgical removal of all or part of the vitreous.
Blood sugar and blood pressure must be controlled to keep diabetic retinopathy from getting worse.

When to see a doctor?

Call a doctor if you notice changes in your vision, particularly if they are sudden. Changes may include:
  • Blurring
  • Spots
  • Flashes
  • Blind spots
  • Distortion
  • Difficulty reading or doing detail work
Hypertensive retinopathy is a complication that occurs in people who have high blood pressure. This high blood pressure often results in blood vessel abnormalities which may include thickening of the small arteries, blockages of retinal blood vessels and bleeding from them. Sudden and severe high blood pressure may also cause swelling of the optic nerve. All of this leads to hampering of vision. Lowering blood pressure can often stop ongoing damage to the retina. However, some existing damage can persist for which you must meet an experienced ophthalmologist.

Symptoms of hypertensive retinopathy

There are often no particular symptoms that can be observed. Though some possible symptoms include:

Preventing hypertensive retinopathy

Your primary aim should be to keep your blood pressure in check. Here are a few tips for it:
  • Exercising regularly
  • Maintaining a healthy body weight
  • Eating a healthy diet
  • Getting regular checkups
  • Taking blood pressure medications as directed

How is hypertensive retinopathy diagnosed and treated?

To diagnose hypertensive retinopathy, the ophthalmologist looks for pale or white areas of the retina using an ophthalmoscope (an instrument that projects light, to examine the back of your eyeball). During the examination, the ophthalmologist is looking for one of the following:
  • Narrowing of blood vessels
  • Fluid oozing from the blood vessels
  • Spots on the retina known as cotton wool spots and soft exudates
  • Swelling of the macula and optic nerve
  • Bleeding in the back of the eye
The only means of treating hypertensive retinopathy is to treat hypertension.

When to see a doctor?

Call a doctor if you notice changes in your vision, particularly if they are sudden. Changes may include:
  • Blurring of vision- especially with sudden diminution of vision
  • Spots
  • Flashes
  • Blind spots
  • Distortion
  • Difficulty reading or doing detail work