Recognising the First Signs and Stages of Diabetic Retinopathy

This blog aims to provide a comprehensive overview of diabetic retinopathy, focusing on the initial symptoms and stages of the disease. 

How big is the problem? 

Estimates for the UK are that the number of people with Type 2 diabetes will rise to 5.5 million people by 2030, affecting almost 9% of the population.  

Risk factors include being overweight, ethnicity, family history and diet quality. The number of people who are overweight around the middle is increasing and, with this, their risk of developing Type 2 diabetes increases. Type 2 is the type usually adult onset and is controlled by diet and tablets. Type 1 is in younger individuals and is treated with insulin. 

Both diabetes Type 2 and Type 1 are on the increase, with ever younger people becoming affected. With diabetes comes eventual cardiovascular and eye problems, particularly if the weight, blood sugar levels and blood pressure are not kept under strict control. The eye signs often go undetected for many years and gradually creep upon the unsuspecting diabetic. If you have diabetes, you are at risk of diabetic retinopathy, and the longer you are diabetic, the greater the risk. 

Could I have Diabetic Retinopathy?

Diabetic retinopathy is a serious complication of diabetes that affects the eyes, specifically the retina. It is essential to understand this condition’s early signs and stages to seek timely medical intervention and prevent vision loss.  

Stages of Diabetic Retinopathy  

Diabetic retinopathy progresses through four stages, each with distinct characteristics: 

Mild Non proliferative Retinopathy  

In this initial stage, microaneurysms, small bulges in the blood vessels, appear on the retina. These may leak blood or fluid, causing the retinal tissue to swell. Many patients with Type 2 diabetes have small microvascular changes whoch need to be detected.  

Moderate Non proliferative Retinopathy 

As the disease advances, the blood vessels that nourish the retina may become blocked, leading to inadequate blood supply. The retina sends signals to the body to grow new blood vessels. People with both Type 1 and Type 2 diabetes can reach this stage. 

Severe Non proliferative Retinopathy  

In this stage, a significant number of blood vessels become blocked, depriving the retina of oxygen. Consequently, the retina may signal the body to generate even more new blood vessels. This predominantly affects people with Type 1 diabetes. 

Proliferative Retinopathy

This is the most advanced stage, marked by the growth of fragile and abnormal blood vessels. These vessels are prone to leakage and can cause severe damage to the retina, leading to vision loss. This predominantly affects people with Type 1 diabetes. 

Seeking Medical Attention and Treatment   

If you experience any of the above-mentioned symptoms, or suspect you may have diabetic retinopathy, it is crucial to seek prompt medical attention. Early detection allows for timely intervention, reducing the risk of vision loss. An ophthalmologist with a special interest in the retina can perform a comprehensive eye examination, including the dilation of pupils and imaging diagnostic tests to evaluate the retina’s condition. 

Causes and Risk Factors of Diabetic Retinopathy

1. Diabetes duration: The longer a person has diabetes, the higher the risk of developing diabetic retinopathy. 
2. Poor blood sugar control: Consistently high blood sugar levels can damage the blood vessels in the retina. 
3. High blood pressure: Having hypertension or uncontrolled blood pressure can increase the risk of developing diabetic retinopathy. 
4. High cholesterol levels: Elevated cholesterol levels can lead to the blockage of retinal blood vessels. 
5. Pregnancy: Women with diabetes who become pregnant may experience a worsening of diabetic retinopathy during pregnancy. 
6. Smoking: Smoking can worsen the effects of diabetes on blood vessels, increasing the risk of diabetic retinopathy. 
7. Genetic factors: Some individuals may have a genetic predisposition to developing diabetic retinopathy. 

It is important for individuals with diabetes to have regular eye examinations by an ophthalmologist retinal specialist to detect and manage diabetic retinopathy in its early stages. Maintaining good blood sugar control, managing blood pressure and cholesterol levels, adopting a healthy lifestyle, and avoiding smoking can help reduce the risk and slow the progression of diabetic retinopathy. 

Here are some interesting facts about diabetic retinopathy

1. Diabetic retinopathy is a complication of diabetes: It is a condition that affects the eyes and is caused by damage to the blood vessels in the retina, the light-sensitive tissue at the back of the eye. It is a common complication of both type 1 and type 2 diabetes. 
2. It is a leading cause of blindness: Diabetic retinopathy is one of the leading causes of blindness in adults. It is estimated that around one-third of people with diabetes have some stage of diabetic retinopathy. 
3. Early detection and treatment are crucial: Regular eye examinations are essential for early detection and treatment of diabetic retinopathy. Early stages of the condition may not cause noticeable symptoms, so routine screenings are crucial for identifying the problem before it progresses. 
4. There are different stages of diabetic retinopathy: Diabetic retinopathy can be classified into different stages, including mild non proliferative retinopathy, moderate non proliferative retinopathy, severe non proliferative retinopathy, and proliferative retinopathy. Each stage represents a different level of severity and progression of the disease. 
5. High blood sugar levels contribute to diabetic retinopathy: High levels of blood sugar over time can damage the small blood vessels in the retina, leading to the development of diabetic retinopathy. Good blood sugar control is essential for preventing or delaying the onset and progression of the condition. 
6. Diabetic retinopathy often affects both eyes: While the severity of the condition can vary between the eyes, it typically affects both eyes in individuals with diabetes. It is important to monitor and manage the condition in both eyes, even if symptoms are present in only one eye. 
7. Other factors can influence the development and progression: While diabetes is the primary risk factor for diabetic retinopathy, other factors such as high blood pressure, high cholesterol levels, pregnancy, and smoking can also increase the risk and accelerate the progression of the condition. 
8. Treatment options are available: Depending on the stage and severity of diabetic retinopathy, various treatment options exist. These may include laser photocoagulation, intravitreal injections of medications, vitrectomy (removal of the gel-like substance in the eye), or other surgical interventions. The goal of treatment is to prevent further vision loss and, if possible, improve vision. 

Remember, if you or someone you know has diabetes, it is important to regularly monitor blood sugar levels and undergo regular eye and retina examinations to detect and manage diabetic retinopathy at the earliest stage possible. 

In order to make an appointment to see one of Clinica London´s Retinal Specialists, call 020 7935 7990