What is diabetic retinopathy?
Diabetic retinopathy, the most common diabetic eye disease, is caused by changes in the blood vessels of the retina. There are two types of diabetic retinopathy:

• Background or nonproliferative diabetic retinopathy (NPDR); and
• Proliferative diabetic retinopathy (PDR).

Nonproliferative diabetic retinopathy (NPDR)
Nonproliferative diabetic retinopathy (NPDR) is the earliest stage of diabetic retinopathy. With this condition, damaged blood vessels in the retina begin to leak extra fluid and small amounts of blood into the eye. Sometimes, deposits of cholesterol or other fats from the blood may leak into the retina. Many people with diabetes have mild NPDR, which usually does not affect their vision. However, if their vision is affected, it is the result of macular edema and macular ischemia.

Proliferative diabetic retinopathy (PDR)
Proliferative diabetic retinopathy (PDR) occurs when abnormal blood vessels begin to grow on the surface of the retina or optic nerve. This is called neovascularization.

PDR mainly occurs when many of the blood vessels in the retina close, preventing enough blood flow. The retina responds by growing new blood vessels in an attempt to supply the area where the original vessels closed. However, the new blood vessels are abnormal and do not supply the retina with normal blood flow. The new vessels are also often accompanied by scar tissue that may cause the retina to wrinkle or detach.

PDR may cause more severe vision loss than NPDR because it can affect both central and peripheral vision.

Diabetes can cause vision in both eyes to change, even if you do not have retinopathy. Rapid changes in your blood sugar alter the shape of your eye’s lens, and the image on the retina will become out of focus. After your blood sugar stabilizes, the image will be back in focus. You can reduce episodes of blurred vision by maintaining good control of your blood sugar.

When to schedule an eye examination?
Diabetic retinopathy usually takes years to develop, which is why it is important to have regular eye exams. Because people with Type 2 diabetes may have been living with the disease for some time before they are diagnosed, it is important that they see an ophthalmologist (Eye M.D.) without delay. The American Academy of Ophthalmology recommends the following schedule for people with diabetes:

• Type 1: Within five years of being diagnosed and then yearly.
• Type 2: At the time of diabetes diagnosis and then yearly.
• During pregnancy: Pregnant women with diabetes should schedule an appointment with their ophthalmologist in the first trimester because retinopathy can progress quickly during pregnancy.

For more information, please visit
http://www.geteyesmart.org/eyesmart/diseases/dr.cfm