You must always remember that your retina can be badly damaged before you notice any change in vision. Most people with nonproliferative retinopathy have no symptoms. Even with proliferative retinopathy, the more dangerous form, people sometimes have no symptoms until it is too late to treat them.

And yet, retinopathy is easily diagnosed through an ophthalmoscopic examination. If your doctor sees any evidence of retinal changes, he may then ask you to undergo more tests so that he can treat the problems and prevent further progression to a severe state when vision is seriously affected. There is also some evidence that if diagnosed at an early stage, some of the damage can even be reversible!

For this reason, you MUST have your eyes examined regularly.

Who is most likely to get diabetic retinopathy?

Anyone with diabetes. The longer someone has diabetes, the more likely he or she will get diabetic retinopathy. Nearly half of all people with diabetes will develop some degree of diabetic retinopathy during their lifetime.

Several factors influence whether you get retinopathy. These include your blood sugar control, your blood pressure levels, how long you have had diabetes, and your genes.

The longer you've had diabetes, the more likely you are to have retinopathy. Almost everyone with Type 1 diabetes will eventually have nonproliferative retinopathy. And most people with Type 2 diabetes will also get it. But the retinopathy that destroys vision, proliferative retinopathy, is far less common.

What can be done to prevent serious eye problems?

There are steps you can take to avoid eye problems.

First and most important, keep your blood sugar levels under good control.

Many studies have shown the importance of a good control of your blood glucose levels. If you do not have diabetic retinopathy and do NOT keep your diabetes under control, your have FOUR times the chances of getting retinopathy as compared to someone who does keep his diabetes well controlled!

In people who already had retinopathy, the condition progresses in those with good control only half as often as those not well controlled.

In fact, it has been shown that for each 1% rise in the HbA1c, ( we have discussed HBA1c or glycoisylated hemoglobin in the section on monitoring control) the retinopathy gets worse at the rate of 32%. So if your HbA1c is 9%, your retina is getting damaged twice as fast as someone with a level of 6% (3 x 32% = 92% additional deterioration).

High blood pressure is fairly common in people with diabetes. Again you should aim for a good control of your blood pressure 130/80 or less [lower still if there is protein in your urine]). With blood pressure, for each 10mmHg rise, the retinopathy gets 11% worse. So if your blood pressure is 150/90, your retina is getting 22% worse that someone whose pressure is 130/80.

Similarly Smoking literally doubles the rate of damage that diabetes causes to the bodies larger arteries, making amputations and heart disease far more likely. Smoking triples the rate of retinopathy progression

These impressive results show that you have a lot of control over what happens to your eyes!

To sum up,