Retinopathy

Overview

Retinopathy is a disease that affects the blood vessels in the retina. It is often known as diabetic retinopathy which causes damage in the light-sensitive tissue of the eyes. There may be no symptoms at the beginning of the mild vision problems. However, such damage can lead to complete blindness. The condition is more prevalent in people who have type 1 and type 2 diabetes.

The primary symptoms of this condition include blurred vision, colour blindness, poor night vision and difficulty in seeing objects at a distance. Common causes of retinopathy include high blood sugar, increasing levels of blood pressure, deficiency in vitamin A, and premature labour. There are various treatment options available such as laser surgery and vitrectomy.

What is Retinopathy?

Retinopathy refers to the damaged areas in the light-sensitive tissues of the eyes. This happens due to various reasons including environmental factors and genetic conditions. The damage to the retina occurs especially because of oxidative stress. Such stress forms when the body has too many free radicals and lacks anti-oxidants to balance them.

Types of Retinopathy

Retinopathy, also known as retinal vascular disease, is an umbrella term. There are different types of retinopathy including:

Diabetic Retinopathy

This is an eye condition that happens because of the weakened blood vessels in the retina. Such diabetic eye condition is divided into the following types:

Non-proliferative Diabetes Related Retinopathy

This is an early onset of retinopathy causing blood vessels to seep out in the retina. At this stage, fluid or haemorrhage can impact the retina, resulting in the blood vessels closing due to ischemia or poor blood flow.

Proliferative Diabetes-Related Retinopathy

As the disease progresses in the advanced stage, it leads to the abnormal growth of blood vessels to combat ischemia. Due to such unnatural growth of blood vessels, vitreous, a viscous substance, fills the eyes and causes tractional retinal detachment.

Retinopathy of Prematurity

This condition is seen in infants born due to premature delivery or with low weight. It has five stages and the final stage is dangerous when the retina gets completely detached.

Hypertensive Retinopathy

Such complications occur because of high blood pressure. People who have uncontrolled blood pressure for a prolonged time can experience such retinal dysfunction.

Central Serous Retinopathy

The cause of such a condition is yet unknown. One with such a condition can face several symptoms such as blurry vision, nyctalopia, blind spots, and distorted shapes.

Solar Retinopathy

Such a condition occurs because of extreme exposure to the sun. Blurred vision is the primary symptom of such a condition leading to permanent damage to the eyes.

Radiation Retinopathy

This happens because of exposure to radiation sources such as external beams and plaque brachytherapy. This is a complete radiation-dose damage caused in the retina.

Symptoms of Retinopathy

In the early stage, there are little to no symptoms of such conditions. As the disease advances, one can notice blurred and fluctuating vision. Affected individuals can assume there are some dark spots floating in front of their eyes. Sometimes, a temporary vision loss can occur.

It is better to consult with an ophthalmologist if there are any recurring vision-related problems experienced within a stipulated period. Any underlying conditions like diabetes and hypertension should be managed and individuals should schedule a yearly eye exam with dilation.

Causes of Retinopathy

Multiple causes can result in the development of such an eye condition. High blood pressure is one of the leading causes that can damage the retina. High sugar consumption can result in blocking the tiny blood vessels of the retina. Due to ischemia or poor blood supply to the tissues, eyes try to make new blood vessels. However, such vessels grow abnormally and can leak easily.

High blood pressure that has not been managed properly for a longer time can cause hypertensive retinopathy. The sudden surge in blood supply to the blood vessels in the retina causes vasospasm. This is also known as abnormal tightening. Over time, blood vessels in the retina can be thickened leading to complications like permanent vision loss.

Vitamin A deficiency can cause retinopathy. As the level of vitamin A decreases, the whites of the eyes and corneas can be dry and unable to produce tears. Bitot, foamy spots, and open sores in the eyes can appear which often lead to complete vision loss.

Another cause of retinopathy which is prevalent in infants is retinopathy of prematurity. It happens when there is a disruption noticed in the normal process of blood flow in the baby's retina. These are primarily observed in babies born because of premature labour. Blood vessels in the retina are not formed properly and that is why such abnormality has been developed.

Retinopathy Diagnosis and Tests

An ophthalmologist can diagnose any type of retinopathy by conducting a simple exam. In this diagnostic process, the eye specialist can check visual acuity. Acuity means how clearly one can see. Next, the specialist checks for any sign of glaucoma and that is why they use intraocular pressure.

After conducting a thorough eye muscle function test, a specialist can screen how well one's eyes can function. By such an eye screening process, an individual's peripheral vision is also checked. Such a test also checks how well someone's pupils work in response to light. During this examination, the specialist also looks for the presence of any abnormal blood vessels or unnatural bleeding in the centre of the eyes.

Retinopathy Treatment and Medications

Treating retinopathy depends on several factors such as age, medical history, extent of retinal damage, visual acuity, and HgbA1c. Initially, healthcare providers usually go for the wait-and-watch approach. At this time, there may have been eye exams scheduled every two to four months.

Here are the other treatment options that include:

Injections: Eye specialists can use injections such as corticosteroids in the eyes. Such injections slow down the further progression of retinopathy and improve vision.
Laser Surgery: Laser is another option that can reduce swelling in the retina and form new blood vessels. Laser is also helpful in improving the blood supply in the eye.
Vitrectomy: When the condition reaches the severe stage, an eye specialist may recommend this outpatient eye surgery. In this process, doctors make small openings in the eye wall and separate the vitreous using a suction tool.

Preventive Measures

Following are some ways to prevent retinopathy from developing:

Diabetes Management: Keeping blood sugar levels in check is beneficial for not developing symptoms of retinopathy. One can adopt a healthy lifestyle by exercising daily, eating balanced food, and taking the medications prescribed for diabetes and hypertension.

Eating Healthy Food Items: Adding foods like kale, spinach, broccoli, carrots, and such items to a daily diet which are rich in vitamins A, B1, and C can help in preventing this condition.

Exercising Daily: People must try to incorporate at least 150 minutes of moderate activity to stay healthy.

Scheduling Frequent Eye Exams: Checking eye health frequently can help one reduce the scope of the development of retinopathy. Early intervention is beneficial to keep eyes healthy.

Avoiding Sunlight: It is essential to wear eyewear while exposed to sunlight. In case one is willing to watch solar events, they should take protection because exposure to sunlight can cause solar retinopathy.

Myths and Facts of Retinopathy

Following are the myths associated with the retinopathy and facts to clarify these:

Myth 1: If One Has Their Sugar Levels Under Check, There is No Scope of Retinopathy
Fact: Complications of retinopathy can occur because of other reasons as well. If the person has kept their sugar level under control but suffers from vitamin A deficiency, the symptoms of retinopathy can occur.

Myth 2: Frequent Eyeglasses' Power Checks are Not Necessary for Diabetic Retinopathy
Fact: Regular eye check-ups are necessary in preventing retinopathy. If the person is already suffering from this eye disease, they should timely schedule their eye checkups to keep proper vision. Diabetics should go for an entire eye examination that includes screening angles, cornea, pupillary response etc.

Myth 3: Diabetes with No Vision Problems Do Not Require a Dilated Retinal Test
Fact: Diabetes does not result in any vision-related problems until the macula is affected. There could be other issues associated with the development of diabetic retinopathy which may seem mild in the beginning. However, this condition requires immediate attention.