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Diabetic
Retinopathy is the leading cause of new blindness in adults.
In most cases, vision loss from diabetes can be prevented or restored
if caught in time. Patients require routine examination with treatment
applied before vision becomes blurry. Patients with diabetes should
be examined at least once a year. Laser surgery is often needed
to prevent vision loss in most diabetics. Clear vision does
NOT mean that the disease is absent.
Proliferative
Diabetic Retinopathy
Proliferative
diabetic retinopathy is a complication of diabetes caused by changes
in the blood vessels of the eye. If you have diabetes, your body
does not use and store sugar properly. High blood sugar levels create
changes in the veins, arteries and capillaries that carry blood
throughout the body. This includes the tiny blood vessels in the
retina, the light-sensitive nerve layer that lines the back of the
eye.
In
PDR, the retinal blood vessels are so damaged they close off. In
response, the retina grows new, fragile blood vessels. Unfortunately,
these new blood vessels are abnormal and grow on the surface of
the retina, so they do not resupply the retina with blood.
Occasionally,
these new blood vessels leak and cause a vitreous hemorrhage. Blood
in the vitreous, the clear gel-like substance that fills the inside
of the eye, blocks light rays from reaching the retina. A small
amount of blood will cause dark floaters, while a large hemorrhage
might block all vision, leaving only light and dark perception.
The
new blood vessels can also cause scar tissue to grow. The scar tissue
shrinks, wrinkling and pulling on the retina and distorting vision.
If the pulling is severe, the macula may detach from its normal
position and cause vision loss.
Laser
surgery may be used to shrink the abnormal blood vessels and reduce
the risk of bleeding. The body will usually absorb blood from a
vitreous hemorrhage, but that can take days, months or even years.
If the vitreous hemorrhage does not clear within a reasonable time,
or if a retinal detachment is detected, an operation called a vitrectomy
can be performed. During a vitrectomy, the eye surgeon removes the
hemorrhage and the abnormal blood vessels that caused the bleeding.
People
with PDR sometimes have no symptoms until it is too late to treat
them. The retina may be badly injured before there is any change
in vision. There is considerable evidence to suggest that rigorous
control of blood sugar decreases the chance of developing serious
proliferative diabetic retinopathy.
Because
PDR often has no symptoms, if you have any form of diabetes you
should have your eyes examined regularly by an ophthalmologist.
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