9
In the initial stages of the disease, the patients are usually
asymptomatic.
The appearance of symptoms depends on the type of damage
diabetes has imposed on the inner eye. The leakage of fluid from the
microaneurisms can cause focal or general retinal edema, resulting
in deterioration of vision. Macular edema is the most common cause
for loss of vision.
Quite often the quality of vision can appear to fluctuate in
uncontrolled diabetes, depending on the levels of sugar in the blood.
Leakage of blood from the new vessels towards the vitreous in the
proliferative disease may completely block vision. Small leakage
can be interpreted as ‘floaters’ or ‘cobwebs’ best seen on a white
background.
Larger hemorrhages can cause black scotomas (losses in the field
of vision) up to full loss of vision as light cannot pass to the retina.
In none of these cases there is no pain in the eye or elsewhere.
There is the exception of proliferative diabetic retinopathy causing
neurovascular glaucoma, where the sudden rise in intraocular
pressure causes unbearable pain, photophobia and vomiting, but
this is uncommon.
In very advanced proliferative diabetic retinopathy, the neovascular
membrane can shrink, causing retinal detachment which can involve
the macula. This complication if left untreated will lead to permanent
visual loss.
What are the symptoms of Diabetic
Retinopathy?
Ophthalmological examination in
the diabetic patient
Every patient who is diagnosed with diabetes, needs to have a full
ophthalmological examination. The ophthalmologist will test the
visual acuity and will examine the anterior segment under the slit
