Diabetic retinopathy is a condition in which the retina is damaged to some degree secondarily to diabetes mellitus. Diabetes is a condition that compromises small blood vessels throughout the whole body. There are a lot of small blood vessels in the eye, especially the retina. This makes the retina a susceptible target for complications secondary to diabetes.
Just because someone has been diagnosed with diabetes does not mean they have or will develop diabetic retinopathy. It does, however, put them at a higher risk for developing retinal complications.
Uncontrolled blood glucose levels compromise the permeability of blood vessel capillaries. When the permeability is compromised, blood leaks out into places where it shouldn’t be. In the retina, for example, when blood leaks out, the retina is damaged because blood not contained in vessels is toxic to retinal tissue. Hemorrhages form and ocular nutrition is compromised. Hemorrhages can come and go depending on glucose levels and other factors over time. If too many hemorrhages develop, the nerve fibers (needed for sight) can become ischemic, meaning they are not getting the nutrition they need which causes the nerve fibers to die.
Generally speaking, there are two forms of diabetic retinopathy, non-proliferative and proliferative, the latter being more severe. When retinal nutrition is denied long enough, the retina will begin to grow new blood vessels in order to supply the absent nutrients. One may think this is a good idea, however, these new blood vessels are often fragile and tend to leak even more. New blood vessels forming is called neovascularization and is indicative of the more severe form, proliferative diabetic retinopathy.
Treatment for diabetic retinopathy is directed towards preventing any of those new blood vessels from forming. This is carried out by injecting Anti-growth factor type medications into the eye or using a specialized laser to eliminate further growth of newly formed blood vessels.
Diabetic retinopathy is not painful and if a person has retinal bleeding, it won’t be known unless a comprehensive visual examination is given. It is important to follow through on regular comprehensive vision examinations at intervals directed by the eye care professional.