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Diabetes is the leading
cause of new cases of legal blindness in the
United States among working-age adults. In fact,
vision loss is 25 times more common in persons
with diabetes than in those without diabetes.
What's more, the longer a person has had diabetes,
the greater the risk of vision loss. As unfortunate
as this is, this type of blindness is often
preventable. This article is an attempt to help
you understand the connection between diabetes
and diabetic retinopathy. It will also explain
tests and treatments for this condition.
WHAT IS RETINOPATHY, ANYWAY?
Retinopathy literally means "damage to
the retina." There are actually two types
of retinopathy that can occur if you have diabetes.
The most common type is early or background
diabetic retinopathy. In this condition, diabetes
has damaged the capillaries of the retina, and
microscopic leaks have formed in these vessels.
Leakage causes the retina to swell which interferes
with normal vision. Background diabetic retinopathy
may be associated with macula edema. The macula
is the part of the retina affected; edema refers
to the swelling caused by leakage. The macula,
which enables us to see sharp detail, is the
center of the retina, so macular edema can cause
problems with central vision.
The second type of retinopathy is proliferative
diabetic retinopathy. In this condition the
capillaries of the retina shut down. This causes
new blood vessels to grow in the retina (neovascularization).
These new vessels are very delicate and can
rupture and bleed easily. When they do, they
bleed into the vitreous gel, the clear substance
that fills the hollow part of the eye. This
clouds vision and makes objects seem blurry.
Retinal neovascularization may also lead to
scar tissue. This scar tissue may contract,
pull on the retinal surface, and result in a
retinal detachment. New blood vessels may grow
on the iris of the eye and cause a form of glaucoma.
These complications can cause a serious loss
of vision, or even total blindness.
HOW DO I KNOW IF I HAVE RETINOPATHY?
Regular eye examinations by an ophthalmologist*
with dilation of the pupil is the only certain
way to know if you have retinopathy. If you
have diabetes, early diagnosis of retinopathy
is also the best way to insure effective treatment
for you and to lessen the possibility of losing
your vision. But even if the diagnosis is made
late and diabetic retinopathy is advanced, effective
treatment is often still possible.
After your retina is examined, further testing
may be necessary to allow your doctor to develop
a plan of treatment for you. One such test is
called fluorescein angiography. Fluorescein
angiography is a diagnostic test to examine
the condition of the blood vessels of your retina.
In this procedure, a small amount of a special
dye called fluorescein is injected into a vein
in your arm. Once in your blood, the dye is
circulated to your eyes, where it highlights
your retina's blood vessels and makes them easier
to see. Photographs are taken of your retinas,
and the specialist will examine these pictures.
There are no X-rays or radiation used in this
test.
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