The Effects Of Retinopathy
The retina is a light-sensitive tissue at the back of the eye. When light enters the
eye, the retina changes the light into nerve signals. The retina then sends these signals
along the optic nerve to the brain. Without a retina, the eye cannot communicate with the
brain, making vision impossible.
Prolonged exposure to reflected light can lead to solar retinopathy, a disorder that
may result in some permanent loss of vision. Wearing sunglasses can help prevent this.
Retinopathy of prematurity (ROP), a potentially blinding eye disorder in low
birthweight infants, primarily affects premature infants weighing about 2.75 pounds
(1250 grams) or less and having a gestational age of less than 31 weeks. ROP is caused
when abnormal blood vessels grow and spread throughout the retina, the nerve tissue that
lines the back of the eye. The scarring and bleeding caused by the excess growth of these
blood vessels can lead to retinal scarring or detachment from the back of the eye,
resulting in vision loss.
The most effective proven treatments for severe ROP are cryotherapy and laser therapy,
which usually will stop the growth of abnormal blood vessels and prevent retinal detachment.
Cryotherapy and laser therapy are considered invasive surgeries on the eye, and doctors
don't know their long-term side effects.
Diabetic retinopathy occurs when diabetes damages the tiny blood vessels in the retina.
At this point, most people do not notice any changes in their vision.
Some people develop a condition called macular edema. It occurs when the damaged blood
vessels leak fluid and lipids onto the macula, the part of the retina that lets us see
detail. The fluid makes the macula swell, blurring vision.
As the disease progresses, it enters its advanced, or proliferative, stage. Fragile,
new blood vessels grow along the retina and in the clear, gel-like vitreous that fills the
inside of the eye. Without timely treatment, these new blood vessels can bleed, cloud
vision, and destroy the retina.
Diabetic retinopathy often has no early warning signs. At some point, though, you may
have macular edema. It blurs vision, making it hard to do things like read and drive. In
some cases, your vision will get better or worse during the day.
As new blood vessels form at the back of the eye, they can bleed (hemorrhage) and blur
vision. The first time this happens it may not be very severe. In most cases, it will
leave just a few specks of blood, or spots, floating in your vision. They often go away
after a few hours.
These spots are often followed within a few days or weeks by a much greater leakage of
blood. The blood will blur your vision. In extreme cases, a person will only be able to
tell light from dark in that eye. It may take the blood anywhere from a few days to months
or even years to clear from inside of your eye. In some cases, the blood will not clear.
You should be aware that large hemorrhages tend to happen more than once, often during
sleep.
There are two treatments for diabetic retinopathy. They are very effective in reducing
vision loss from this disease. In fact, even people with advanced retinopathy have a 90
percent chance of keeping their vision when they get treatment before the retina is
severely damaged.
These two treatments are laser surgery and vitrectomy. It is important to note that
although these treatments are very successful, they do not cure diabetic retinopathy. Once
you have proliferative retinopathy, you will always be at risk for new bleeding. This
means you may need treatment more than once to protect your sight.
Instead of laser surgery, you may need an eye operation called a vitrectomy to restore
your sight. A vitrectomy is performed if you have a lot of blood in the vitreous. It
involves removing the cloudy vitreous and replacing it with a salt solution. Because the
vitreous is mostly water, you will notice no change between the salt solution and the
normal vitreous.
The NEI urges all people with diabetes to have an eye examination through dilated
pupils at least once a year. If you have more serious retinopathy, you may need to have a
dilated eye examination more often.
A recent study, the Diabetes Control and Complications Trial (DCCT), showed that better
control of blood sugar levels slows the onset and progression of retinopathy and lessens
the need for laser surgery for severe retinopathy.