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Diabetic retinopathy is the leading cause of visual disability among working-age people.

What is diabetic retinopathy?
Diabetes can cause abnormalities in the blood vessels of the retina (the thin layer covering the back inside wall of the eye).  Diabetic retinopathy develops when the retinal blood vessels weaken and leak.  Leaking blood causes small hemorrhages within the retina.  Leaking fluid causes swelling of the retina ("macular edema").  This swelling can cause blurred vision.  These changes are called "non-proliferative diabetic retinopathy."

In more advanced disease, the retinal blood vessels can become obstructed, decreasing the amount of oxygen reaching the retina.  Areas of the retina not receiving enough oxygen cause the growth and proliferation of new blood vessels, a process termed "neovascularization." (see photo to right)  These new blood vessels are abnormal and can cause bleeding and formation of scar tissue within the eye.  These changes are termed "proliferative diabetic retinopathy."
How is diabetic retinopathy treated?

In early forms of non-proliferative diabetic retinopathy, often no treatment is required.  If macular edema (swelling of the retina) causes blurring or distortion of vision, laser treatment can be applied to the retina to reduce the edema.
Proliferative diabetic retinopathy can lead to serious bleeding in the eye.  A second problem is the growth of scar tissue, which can lead to retinal detachment.  These more serious problems are typically treated through intraocular surgery.


How can diabetic retinopathy be prevented?

-maintain normal weight and good diet
-control blood sugar levels as instructed 
  by your internist or endocrinologist
-maintain good blood pressure
-stop smoking
-PATIENTS WITH DIABETES SHOULD HAVE
  AN ANNUAL DILATED EYE EXAM, EVEN IF
  THEY ARE NOT EXPERIENCING ANY
  PROBLEMS.


  photos courtesy of National Eye Institute, NIH