If you have diabetes mellitus, your body does not use and store sugar properly. High blood-sugar levels can damage blood vessels in the retina, the nerve layer at the back of the eye that senses light and helps to send images to the brain. The damage to retinal vessels is referred to as diabetic retinopathy.
Types of Diabetic Retinopathy
There are two types of diabetic retinopathy: nonproliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR).
NPDR, commonly known as background retinopathy, is an early stage of diabetic retinopathy. In this stage, tiny blood vessels within the retina leak blood or fluid. The leaking fluid causes the retina to swell or to form deposits called exudates.
Many people with diabetes have mild NPDR, which usually does not affect their vision. When vision is affected is the result of macular edema and/or macular ischemia.
PDR is present when abnormal new vessels (neovascularization) begin growing on the surface or the retina or optic nerve. The main cause of PDR is widespread closure of retinal blood vessels, preventing adequate blood flow. The retina responds by growing new blood vessels in an attempt to supply blood to the area where the original vessels closed.
Unfortunately, the new, abnormal blood vessels do not re-supply the retina with normal blood flow. The new vessels are often accompanied by scare tissue that may cause wrinkling or detachment of the retina.
Glaucoma is a leading cause of blindness in the U.S. It occurs when the pressure inside the eye rises, damaging the optic nerve and causing vision loss. The condition often develops over many years without causing pain or other noticeable symptoms - so you may not experience vision loss until the disease has progressed.
Sometimes symptoms do occur. They may include:
- Blurred vision
- Loss of peripheral vision
- Halo effects around lights
- Painful or reddened eyes
People at high risk include those who are over the age of 40, diabetic, near-sighted, African-American, or who have a family history of glaucoma.
To detect glaucoma, your physician will test your visual acuity and visual field as well as the pressure in your eye. Regular eye exams help to monitor the changes in your eyesight and to determine whether you may develop glaucoma.
Once diagnosed, glaucoma can be controlled. Treatments to lower pressure in the eye include non-surgical methods such as prescription eye drops and medications, laser therapy, and surgery.
Detached Retina / Torn Retina - Flashes and Floaters
What is the retina?
The retina is a nerve layer at the back of your eye that senses light and sends images to your brain.
An eye is like a camera. The lens in the front of the eye focuses light onto the retina. You can think of the retina as the film that lines the back of a camera.
What is a retinal detachment?
A retinal detachment occurs when the retina is pulled away from its normal position. The retina does not work when it is detached. Vision is blurred, just as a photographic image would be blurry if the film were lose inside the camera.
A retinal detachment is a very serious problem that almost always causes blindness unless it is treated.
What causes retinal detachment?
A clear gel called vitreous (vit-ree-us) fills the middle of the eye. As we get older, the vitreous may pull away from its attachment to the retina at the back of the eye.
Usually the vitreous separates from the retina without causing problems. But sometimes the vitreous pulls hard enough to tear the retina in one or more places. Fluid may pass through the retinal tear, lifting the retina off the back of the eye, much as wallpaper can peel off a wall.
Signs of retinal tear or detachment include flashes and floaters, a group or web of floaters, wavy or watery vision, a sense that there is a veil or curtain obstructing vision, or a sudden drop in vision quality. If you experience any of these symptoms, call your doctor immediately. Early treatment is essential to preserve your vision.
The following conditions increase the chance of having a retinal detachment:
- previous cataract surgery;
- severe injury;
- previous retinal detachment in your other eye;
- family history of retinal detachment;
- weak areas in your retina that can be seen by your ophthalmologist (Eye M.D.);
What treatment is needed?
Most retinal tears need to be treated with laser surgery or cryotherapy (freezing), which seals the retina to the back wall of the eye.
These treatments cause little or no discomfort and may be performed in your ophthalmologist's office. Treatment usually prevents retinal detachment.
Almost all patients with retinal detachments require surgery to return the retina to its proper position.
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