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The 4 Stages of Diabetic Retinopathy

Diabetic retinopathy is an eye disease that develops when high blood sugar damages the tiny fragile blood vessels in the retina of people living with diabetes.

This progressive eye disease may lead to blurred vision or even irreversible vision loss. Regular eye exams are important, because, by the time noticeable symptoms appear, vision loss may have occurred. The sooner your eye doctor can diagnose diabetic retinopathy, the sooner you can take steps to slow its progression.

What Are the Stages of Diabetic Retinopathy?

There are two types of diabetic retinopathy, which progresses in four stages.

The two types of diabetic retinopathy are nonproliferative and proliferative. Nonproliferative refers to the early stages of the disease, while proliferative is an advanced form of the disease.

Stage 1: Mild nonproliferative diabetic retinopathy

This is the earliest stage of diabetic retinopathy, characterized by tiny swellings/bulges in the blood vessels of the retina. These areas of swelling are known as microaneurysms.

These microaneurysms can cause small amounts of fluid to leak into the retina, triggering swelling of the macula – the back of the retina. Despite this, there are usually no clear symptoms indicating there is a problem.

Stage 2: Moderate nonproliferative diabetic retinopathy

At this stage, the tiny blood vessels further swell up, blocking blood flow to the retina and preventing proper nourishment. This stage will only cause noticeable signs if there is a build-up of blood and other fluids in the macula, causing vision to become blurry.

Stage 3: Severe nonproliferative diabetic retinopathy

During this stage, a larger section of blood vessels in the retina becomes blocked, causing a significant decrease in blood flow to this area. The lack of blood triggers a signal to the body to start growing new blood vessels in the retina.

These new blood vessels are extremely thin and fragile and cause retinal swelling, resulting in noticeably blurry vision, dark spots and even patches of vision loss. If these vessels leak into the macula, sudden and permanent vision loss may occur. At this stage, there is a high chance of irreversible vision loss.

Stage 4: Proliferative diabetic retinopathy

At this advanced stage of the disease, new blood vessels continue to grow in the retina. These blood vessels, which are thin and weak and prone to bleeding, cause scar tissue to form inside the eye. This scar tissue can pull the retina away from the back of your eye, causing retinal detachment. A detached retina typically results in blurriness, reduced field of vision, and even permanent blindness.

What Are Common Symptoms of Diabetic Retinopathy?

During its first two stages, diabetic retinopathy doesn’t usually cause obvious symptoms, so it’s possible to have it and not even know it.

Unfortunately, many people don’t have symptoms until the disease progresses to the proliferative diabetic retinopathy stage.

However, an eye examination by your [eye doctor] can detect diabetic retinopathy in its earlier stages, before symptoms become noticeable and damage has become irreversible.

Symptoms of proliferative diabetic (stage 4) retinopathy include:

  • Blurry vision
  • Change in colors
  • Decrease in field of vision
  • Distorted vision
  • Increase of eye floaters
  • Loss of vision
  • Poor night vision

How to Treat Diabetic Retinopathy

While diabetic retinopathy may lead to irreversible vision loss, successfully managing your blood sugar levels can help prevent loss of vision. This includes watching your diet, increasing physical activity, and taking diabetes medication as directed.

Other treatments depend on the stage or extent of the disease. If caught very early — before damage to the retina occurs — blood sugar management might be the only treatment necessary.

If you’re in a nonproliferative stage but experience some eye damage, treatment options might include:

  • Eye injections – A steroid injection in the eye to stop inflammation and prevent new blood vessels from forming. Anti-VEGF injections may also be recommended, which can reduce swelling in the macula and improve vision.
  • Laser surgery – Laser surgery called photocoagulation reduces swelling in the retina and removes abnormal blood vessels.
  • Vitrectomy – If you are in the later stages of diabetic retinopathy, you might need a vitrectomy. This eye surgery treats problems with the retina and vitreous, a jelly-like substance in the middle of the eye. The surgery can remove blood or fluid, scar tissue, and some of the vitreous gel so light rays can focus properly on the retina. Retinal detachments can be corrected at the same time.

Diabetic retinopathy is a potentially serious eye disease that can result in permanent distorted vision or vision loss. Preserve your vision by contacting Sight Improvement Center to schedule your comprehensive eye exam today.

Our practice serves patients from New York City, Manhatten, The Bronx, and Brooklyn, New York and surrounding communities.
Book An Appointment
Call Us 646-846-7741
Learn More About Eye Disease Management
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How to Prevent Diabetic Retinopathy

Diabetic retinopathy (DR) is one of the leading causes of vision loss around the world. Of an estimated 285 million people with diabetes mellitus worldwide, approximately one-third have signs of diabetic retinopathy.

Fortunately, there are several steps people with diabetes can take to prevent or minimize vision loss.

What is Diabetic Retinopathy?

Diabetic retinopathy is an eye disease caused by high blood sugar levels that damage the small blood vessels clustered within your retina. This leads to swelling or fluid leakage and can result in vision loss and even blindness.

Diabetic retinopathy also raises the risk of retinal detachment and/or glaucoma.

Because the early stages of diabetic retinopathy tend to be symptom-free, permanent retinal damage may occur before any obvious signs are noticed and the disease is diagnosed.

Ways to Prevent Diabetic Retinopathy

There are a number of ways to preserve your vision and reduce the risk of vision and eye damage due to diabetic retinopathy.

Visit your eye doctor for annual eye exams

In its early stages, diabetic retinopathy typically does not present any noticeable symptoms. Therefore, it’s crucial for people with diabetes to have annual comprehensive eye exams in order to identify the disease long before symptoms appear.

During a comprehensive eye exam, your eye doctor will use special imaging technology and diagnostic tools to evaluate your retina, optic nerve and macula.

Control your blood sugar

Diabetes prevents the body from adequately storing and using sugar, resulting in an accumulation of sugar in the bloodstream. High blood glucose levels damage blood vessels all over the body, including your eyes.

To protect your eyes from injury and vision loss, it’s critical to keep your blood sugar levels under control.

Maintain healthy cholesterol levels and blood pressure

Maintaining healthy cholesterol levels and blood pressure will not only help keep your heart healthy but your eyes as well.

Speak with your doctor to learn about the most effective ways to maintain a safe and healthy level of cholesterol and blood pressure.

Exercise

We all know that exercise is good for our physical and emotional health. For those with diabetes, it is all the more important, as routine physical activity helps control and reduce blood sugar levels.

Please note that you should always consult your doctor before starting any new exercise regimen.

Quit smoking

Smoking is particularly dangerous for those with diabetes. Here’s why:

  1. When exposed to high levels of nicotine, the insulin that lowers your blood sugar becomes less effective. You may thus require higher insulin doses to maintain blood sugar levels.
  2. Smoking induces oxidative stress, which occurs when smoke-derived chemicals react with oxygen in the body. This, in turn, damages the cells in your body and eyes.
  3. Cigarette smoking disrupts normal cell function and induces inflammation. When blood vessels that are swollen, they are more likely to burst and cause fluid to leak into the retina, resulting in ocular damage and vision loss.

As you can see, it’s critical to quit smoking— and not just for the body, but also for the eyes. We highly recommend that you seek out professional guidance on the most effective ways to kick the habit.

If you have diabetes, you are at risk of developing diabetic retinopathy. To reduce your risk and protect your vision, schedule an eye exam with Sight Improvement Center today.

Our practice serves patients from New York City, Manhatten, The Bronx, and Brooklyn, New York and surrounding communities.
Book An Appointment
Call Us 646-846-7741
Learn More About Eye Disease Management
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