Most people who aren't familiar with diabetes aren't aware of the host of side effects that accompany this debilitating disease. Diabetic retinopathy is just one of the problems that plague diabetics. 

Diabetic retinopathy is a complication from diabetes that affects the eyes. Over time, diabetes can cause retina damage, which often leads to vision loss. As it turns out, the longer you have diabetes, the more likely you are to experience retina problems. 

The tiny blood vessels leading to the retina in the eyes become damaged from high blood sugar, making them particularly sensitive to light. The vessels then leak blood into the retinas, causing them to become swollen and result in cloudy vision, explains the American Optometric Association (AOA). 

According to the AOA, the early stages of diabetic retinopathy may not need medical attention, but as the condition progresses, it can lead to macular edema. At that point, doctors may recommend laser surgery to prevent the blood from leaking into the retina and causing any further damage. In the case of proliferative diabetic retinopathy, a scattered laser is used to save central vision, but in the process, the patient may lose peripheral vision. 

Understanding Diabetic Retinopathy 

In the beginning, most patients aren't aware they're developing eye problems. This stage is known as nonproliferative diabetic retinopathy (NPDR.) In this early stage of the disease, the blood vessels weaken. New blood vessels no longer grow. 

As diabetic retinopathy progresses, symptoms are easier to spot because they involve: 

• dark spots in your vision;
• blurriness;
• floaters; and
• trouble differentiating colors. 

This more advanced stage is called proliferative diabetic retinopathy (PDR). At this point, the leakage occurs, and the eyes may fill with a jelly-like substance, explains the Mayo Clinic. As it continues to advance, the swollen blood vessels grow and push part of the eye out of place, thus detaching the retina. As the pressure builds beneath the eye, the patient may develop glaucoma and nerve damage. 

Prevention of Diabetic Retinopathy 

Preventing diabetic retinopathy generally involves maintaining good health, which includes: 

• getting annual checkups;
• seeing an eye doctor;
• taking diabetic medication as needed; and
• controlling blood sugar spikes. 

The more unstable the blood sugar is, the more likely a diabetic is to have diabetes-related eye problems. According to Nancy Klobassa Davidson, R.N. and Peggy Moreland, R.N., writing for the Mayo Clinic, "Improving blood glucose levels can help, even if blood glucose hasn't been controlled in the past." 

Prevention also includes incorporating daily exercise into your lifestyle. It can be as little as a 30-minute walk after dinner each night, but it is important to keep moving. Other lifestyle changes that can help protect eyesight include following a diet low in cholesterol and avoiding smoking. 

Researchers are still studying the condition in an effort to better understand how it occurs and how to prevent it. In March 2013, Alan W. Stitt et al. published a report in Clinical Science called "Advances in our Understanding of Diabetic Retinopathy." Experts looked closely at the complexity of the eye disease, which involves biomedical and metabolic abnormalities in the retina cells. They note that pharmacological treatments may be available that are based on a better understanding of causative mechanisms of the condition. This may include vascular and neuroprotection therapies that may help "halt the progression of retinopathy in the early stages." 

Who is at risk? 

Basically, anyone who has high blood sugar and lives with diabetes is at risk for diabetic retinopathy. This includes people with Type 1 and Type 2 Diabetes. The National Eye Institute estimates that roughly 40 to 45 percent of people diagnosed with diabetes in the U.S. have a form of diabetic retinopathy. 

According to a study published in the Journal of the American Medical Association (JAMA) in 2010 by Xinzhi Zhang et al., certain people are more prone to getting the eye disease. Experts performed a cross-sectional analysis of adults over 40 who had diabetes from 2005 to 2008. The condition was more prevalent in men than women and in non-Hispanic black individuals. They also note that diabetic retinopathy is the leading cause of blindness in U.S. adults ages 20 to 74. The overall prevalence of diabetic retinopathy in the study sample was 28.5 percent. 

Aside from having diabetes, the Mayo Clinic reports that those at greater risk are people who: 

• smoke;
• have high cholesterol;
• have high-blood pressure; or
• are pregnant. 

Several tests may allow doctors to diagnose the condition. The first step is a common eye exam. Getting these at regular intervals is really important for those with risk factors.  

Eye doctors may use the following tests to diagnose diabetic retinopathy: 

• visual acuity test;
• pupil dilation exam; and
• tonometry test. 

The Future of Treating Diabetic Retinopathy 

Surgery may be a common treatment plan for retina problems, but surgery only treats the immediate symptoms; it is not a cure for diabetic retinopathy. It simply slows down the effects of the eye disease and prolongs vision loss as long as possible, according to the Mayo Clinic. 

While treating diabetic retinopathy before it leads to vision loss is imperative, the future of eyecare as it relates to this disease is really dependent on early detection. It is important to test those who are at risk and perform therapies to prevent the blood vessels in the eye from leaking into the retina. Experts hope to improve screening rates to identify at-risk patients. 

A new eye scanner could hit the market soon, and it may help identify high-risk patients and provide early detection. Epipole, based in Rosyth, Scotland, has developed a small camera that acts as an eye scanner and can spot blood clots at the back of the eye and other signs of the condition. Using such a tool could reduce vision loss caused by prolonged diabetes. 

In 2007, EyeNet Magazine quoted Dr. Donald Fong, director of clinical trials research at Southern California Kaiser Permanente Medical Group, "We're in a time of evolving management, and what is evolving is our use of the variety of treatments out there and sorting out which are better than laser." 

The idea of losing eyesight is scary. Be sure to talk to the doctor about any concerns and the long-term effects of eye surgery or other treatments. Also enlist the support of family and friends to help prevent or cope with vision loss.