Unfortunately, by the time warning signs arise and the patient notices them, extensive damage may have already occurred. That's why a person who has this disease needs to have a yearly eye checkup as a regular part of his diabetic retinopathy treatment. A doctor can examine the eye to see if there has been any damage, even in those patients where there has not been any loss of vision. Some of the first problems that may come up are things that look like spiders or cobwebs floating in the eye, dark streaks or a red film in the eye, blurred vision, an empty spot in the middle of the vision field, a restricted ability to see at night, or having difficulty adjusting when walking from a brightly lit room to a dimly lit room. Any of these warning signs show that the condition of the eyes may have deteriorated and a vision check is a must.
For the diabetic, bad sugar levels in the blood cause many of the diabetic retinopathy symptoms. The body doesn't digest sugar properly. Too much sugar in the blood damages the small capillaries, the tiny blood vessels that carry the blood from the arteries to the veins. There are two types of this condition: nonproliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR). NPDR happens when the walls of the blood vessels start to weaken, sometimes causing bulges in the walls. This includes the tiny vessels in the retina of the eye. As these places swell, they start oozing blood into the eye. Many times, a person doesn't even know he has NPDR. PDR is the more advanced part of this condition. Abnormal blood vessels may grow in the retina, restricting vision. These vessels can also grow into the vitrous, which is a jelly-like substance in the eye.
People value their eyesight. The psalmist says about the importance of the eye in Psalm 17:8, "Keep me as the apple of the eye, hide me under the shadow of thy wings." One of the diabetic retinopathy symptoms can be blurred vision, caused by fluctuations in the blood-sugar levels. When these levels are elevated for a period of time, this weakens the walls of the vessels and more damage to the eye can occur. Sometimes this can happen even with good diabetic retinopathy treatment. Some risk factors include high blood pressure, conditions associated with pregnancy, high cholesterol, or a background of an African-American or Hispanic. People also experience one problem in dealing with this disease--they feel that if they have no diabetic retinopathy symptoms, they don't need to worry. But that attitude is wrong. The damage can be happening even when vision remains good and the person feels healthy.
When a patient comes into a physician's offices complaining of diabetic retinopathy symptoms, the doctor may order a test called a fluorescein angiography. This will look into the eye to look for any blood present. To do this, the doctor injects a dye into the patient's bloodstream, which circulates through the eyes and highlights any problems. A camera with special filters will then take pictures of these areas, giving the doctor a good idea of how much damage has been done so far. Another diabetic retinopathy treatment is an optical coherence tomography (OCT) exam. This takes pictures of the eyes that give high resolution images. This diagnostic tool can monitor the progression of the disease.
Photocoagulation is a way of stopping the blood leaking in the eye by coagulating those areas. Eye physicians use this regimen for more progressive diseases, not as a first-seen therapy. An eye doctor may order this procedure in cases of macular edema, a swelling of the retina, severe cases of the disease, PDR, and certain types of glaucoma. First, he numbs the eye, and then a high-energy laser burns places in the retina to seal any leaking. It is similar to how a welder crafts a weld in a leaking pipe. The doctor usually does this procedure in his office, and the patient can go home after completing the test. However, the patient won't be able to drive for some hours because of blurry vision. With PDR, eye surgeons sometimes use a laser surgery called panretinal or scatter photocoagulation. The entire retina except for the macula is treated with burns, which often stops hemorrhages. But this surgery can also cause a loss of side vision for that patient. Therefore, medical professionals don't risk this type of treatment unless the loss of vision is severe. But still, medical professionals advocate that a patient must keep current with doctor's visits and eye exams.
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