The retina is the light sensing tissue in the back of eye. There are many blood vessels on the retina necessary for proper function. With time, diabetes may damage these blood vessels causing the condition known as diabetic retinopathy.
There are several types of diabetic retinopathy: nonproliferative or background diabetic retinopathy and proliferative diabetic retinopathy are two common types. Non-proliferative diabetic retinopathy is an early stage in which blood vessels leak blood or fluid causing swelling of the retina. Many people have mild non-proliferative retinopathy, which usually does not affect their vision. When the swelling process affects the center vision area the condition is known as macular edema. This is the most common cause of vision loss in diabetes. Laser surgery is used to reduce the swelling and prevent the buildup of fatty deposits that may cause permanent visual loss. It is uncommon for people who have blurred vision from macular edema to recover normal vision, although some may experience partial improvement.
Proliferative diabetic retinopathy occurs when abnormal new blood vessels grow on the retinal surface. This is due to closure of previously normal retinal blood vessels. The retina responds by growing new blood vessels, however these do not provide any useful function and are dangerous as they frequently lead to bleeding or vitreous hemorrhage. The new blood vessels may also produce scar tissue that may cause wrinkling or detachment of the retina. Laser surgery is used to shrink these blood vessels and reduce the risk of bleeding. Occasionally, even after laser treatment these blood vessels may leak causing hemorrhage into the previously clear vitreous gel, known as the vitreous hemorrhage. The result is vision loss because the view is obscured. If the vitreous hemorrhage does not clear, an operation called a vitrectomy can be performed to remove the hemorrhage and the abnormal blood vessels that caused the bleeding.
Currently with improved methods of diagnosis and treatment, only a small percentage of people who develop diabetic retinopathy have serious vision problems. Early detection of retinopathy through routine eye exams is the best protection against loss of vision.
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