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The Issue of Diabetic Retinopathy

People who suffer from diabetes are susceptible to changes in their retina, a condition known as diabetic retinopathy. The retinal capillary structure experiences changes in blood flow that leads to retinal ischemia and a further breakdown in the blood-retinal barrier. Diabetic retinopathy is the leading cause of blindness in people between the ages of 25 and 74.

Diabetic retinopathy has three stages of development:

• 1st Stage: Nonproliferative retinopathy. Dilated veins, microaneurysms, edema of the macula, and the presence of exudates characterize this stage.

• 2nd Stage: Preproliferative retinopathy. Retinal ischemia causes infarcts of the nerve fiber layer, with characteristic "cotton wool" patches on the retina. Shunts form between occluded and patent vessels.

• 3rd Stage: Proliferative retinopathy. As fibrous tissue and new vessels form in the retina or optic disk, traction on the vitreous humor may cause hemorrhage or retinal detachment.

Almost all people who have had type 1 diabetes and 60% of people with type 2 diabetes will suffer from some degree of vision impairment due to diabetic retinopathy according to the American Diabetes Association.

If exudates, edema, hemorrhage, or ischemia occurs near the fovea, the diabetic can experience visual impairment at any stage of the disease. People with diabetes are also at an increased risk for the development of cataracts because of the increased glucose levels in the lens of the eye.

It is important that all diabetics get regular screenings for diabetic retinopathy because the use of laser photocoagulation surgery has been proven beneficial in helping to prevent the loss of vision.