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Diabetic Eye Disease (cont.)

Diabetic retinopathy

The primary part of the eye affected by diabetes is the retina. The retinal abnormalities from diabetes are called diabetic retinopathy. Most people with diabetic retinopathy have the problem in both eyes, although the severity of the disease may vary between the eyes.

The retina can be thought of as the film in a camera. If the film in a camera is faulty, the resulting picture will be blurry. In a similar manner, if the retina of the eye is swollen, wrinkled, or otherwise structurally damaged, the vision in that eye will be blurry. Depending on the type, location, and extent of damage in the retina, the change in vision will range from minimal to severe and be temporary or permanent.

  • In people with diabetes, changes in the walls of the small blood vessels in the retina are caused by blood sugar abnormalities. These small blood vessels may begin to "balloon," forming what are called microaneurysms, as well as leak fluid, as well as leak fluid (called edema) and blood (called retinal dot and blot hemorrhages) into the retina. This process is called background diabetic retinopathy or nonproliferative diabetic retinopathy. If fluid accumulates in the central part of the retina (called the macula) and causes swelling there, the process is called diabetic macular edema.
  • As a response to decreased oxygen delivery to the retina, new abnormal blood vessels may begin to grow within the retina, a process called neovascularization. The presence of neovascularization defines proliferative diabetic retinopathy. Although new blood vessels may sound like a good thing, considering that the old blood vessels are damaged, the new blood vessels are actually more harmful than beneficial. The new blood vessels are extremely leaky and fragile, potentially leading to bleeding inside the eye (called vitreous hemorrhage) resulting in vision loss. If not treated appropriately, this vision loss may be permanent.
    • If the new blood vessels are extensive, they may cause scarring inside the eye, resulting in tractional retinal detachments, which is another cause of permanent vision loss.
    • In cases of severe proliferative diabetic retinopathy, new blood vessels may grow on the surface of the iris, causing neovascular glaucoma, a particularly severe form of glaucoma.
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Picture of the structures of the eye

Other signs and symptoms of poor blood circulation problems in diabetes

The feet and lower legs can also suffer from poor blood circulation and oxygen delivery, resulting in symptoms of:

  • Numbness and tingling
  • Poor healing of even minor wounds
  • Ulceration and infection
  • Not infrequently, the need for amputation of a toe, a foot, or the lower leg.
Medically Reviewed by a Doctor on 6/13/2016

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Read What Your Physician is Reading on Medscape

Macular Edema, Diabetic »

Over the last several decades, there have been a few large-scale trials that have influenced the management of diabetic complications in the eye.

Read More on Medscape Reference »


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