Diabetic Retinopathy Stages: Symptoms, Treatment, and Prevention Guide
05 April 2019
Diabetic retinopathy is a common diabetes-related eye condition that can lead to vision loss if left untreated. It is the leading cause of blindness among working-age people in developed countries. As the rate of diabetes in Malaysia continues to rise, it is crucial for the population to be aware of eye conditions like diabetic retinopathy, which can go undetected until vision is severely affected.
According to the National Health and Morbidity Survey 2011, one in five people over 30 years old suffered from diabetes. Alarmingly, the National Eye Registry in 2007 found that 55% of people with diabetes never undergo an eye check or eye screening, and 20% of diabetics have sight-threatening retinopathy. Early eye check-ups and regular eye screenings are essential in preventing the progression of retinal damage and avoiding blindness.
What is Diabetic Retinopathy?
Retinal damage caused by diabetic retinopathy occurs when the blood vessels in the retina become damaged due to high blood sugar levels. Over time, this damage leads to blockages and leakiness in the small blood vessels that supply oxygen to the retina, the light-sensitive tissue at the back of the eye. Left untreated, this can result in vision loss.
The Importance of Identifying Diabetic Retinopathy Stages Early
Dr Tara George, Consultant Ophthalmologist at Sunway Medical Centre, emphasises that eye screening plays a crucial role in detecting diabetic retinopathy. Many people who had diabetes for over 10 years may not notice any eye vision problems symptoms until significant damage has occured. However, in cases of poorly controlled diabetes, eye damage can begin as early as one to two years after diagnosis. Regular eye tests are essential for identifying any early changes in the retina.
Unfortunately, in the early stages of diabetic retinopathy, there are often no noticeable eye illness symptoms. Therefore, it is vital to undergo routine eye check-ups to detect changes early, which can lead to more effective treatment and prevent severe vision impairment or blindness.
Can Diabetic Retinopathy Be Treated?
The primary causes of visual loss in diabetic retinopathy include macula edema (swelling at the center of the retina) and bleeding within the eye. Both conditions can result in significant impairment of vision if not addressed. Treatment options for these eye conditions vary but are essential to prevent further damage.
For macula edema, the swelling can be treated with medications injected directly into the eye, which helps reduce inflammation and stabilise vision. If bleeding occurs in the retina, laser eye surgery is typically the most effective solution. Laser treatment works by sealing leaking blood vessels and preventing further damage to the retina.
However, once retinal damage has occurred due to diabetic retinopathy, it is generally irreversible. “This is why it is so important for patients to present themselves at early stages to maintain their vision. Since our retina is nerve tissue, once it is damaged, it cannot regenerate to its original state. In other words, the damage is irreversible”, explained Dr Tara.
This makes early detection and timely intervention even more critical. With proper treatment at the right stage, it is possible to prevent further visual loss, but the key is to identify the condition before it progresses to a severe stage.
For those in the later stages of diabetic retinopathy, eye surgery and other treatments, such as vitrectomy (surgical removal of blood from the vitreous humor), can still offer improvements. In these cases, patients might experience symptoms like blurry vision, the presence of black spots or floaters, and distorted vision where straight lines appear wavy or crooked.
Although full restoration of vision may not be possible, these treatments can significantly improve the quality of life by managing symptoms and halting the progression of the disease.
Moreover, managing diabetes effectively plays a crucial role in preventing or slowing the progression of diabetic retinopathy. Keeping blood sugar levels under control, alongside managing blood pressure and cholesterol, significantly reduces the risk of developing or worsening diabetic retinopathy. Healthy lifestyle choices, including a balanced diet and regular physical activity, can help reduce the strain on blood vessels in the eye, preventing further retinal damage and promoting overall eye health.
Preventing Vision Loss Through Proper Management
Eye check-ups go beyond simple vision tests. The correct way to assess the health of the retina is by conducting a thorough examination of the back of the eye. An ophthalmologist can use techniques like pupil dilation or a fundus camera to capture images of the retina for detailed analysis. Early detection allows for timely interventions to halt the progression of retinopathy and prevent vision loss.
Effective diabetes management, including lifestyle changes, a balanced diet, and proper medication, is key to delaying or preventing diabetic eye problems. “New studies have also shown that if diabetes is well-controlled from the time of diagnosis, a diabetic can delay the progression of the complications for up to 20 years,” said Dr Tara.
“In the past, diabetic retinopathy was more commonly seen in the older age group. Now, with patients being diagnosed with diabetes at a younger age, we see diabetic retinopathy occurring more and more in the working age population”, Dr Tara elaborated. Thus, awareness of the complications of diabetes and the importance of screening cannot be emphasised enough.
Regular Eye Screening and Treatment Options
Annual eye screenings are recommended for anyone with diabetes. Once diabetic retinopathy is detected, the screening schedule may need to be adjusted to every two to nine months, depending on the severity of the condition.
Managing diabetes effectively can help prevent or delay the progression of diabetes eye problems like diabetic retinopathy. Therefore good control of diabetes from the start in terms of lifestyle, diet, medication and also blood pressure and cholesterol can help prevent or delay the complications of diabetes.
By staying informed about diabetic retinopathy stages and taking steps to manage diabetes effectively, you can prevent or delay vision loss and maintain a better quality of life.
At Sunway Medical Centre’s Eye Centre, we offer a comprehensive range of services focusing on screening, diagnosis and treatment of eye conditions for both adults and children. Apart from the usual eye examinations, the Eye Centre also performs ocular imaging with the fundus camera in diagnosis of Diabetic Retinopathy.
