What is Diabetic Retinopathy?
There are two types of diabetic retinopathy, non-proliferative or proliferative.

Nonproliferative retinopathy is the common, mild form. It accounts for about 80 percent of all cases.It usually has no effect on vision and needs no treatment. But after it is diagnosed, have your eyes checked at least yearly to make sure it's not getting worse.

For an excellent interactive look at all these retinal changes from the normal to the most serious, click here.

In nonproliferative retinopathy, capillaries balloon and form pouches. Although retinopathy does not usually cause any vision loss at this stage, the retinal vessels weaken and develop bulges (microaneurysms) that may leak blood (hemorrhages) or fluid (exudates) into the surrounding tissue.

The ability to control the passage of substances between the blood vessels and the retina may be lost. As a result, the retina becomes swollen and fatty deposits form within it. If this swelling affects the center of the retina, the "macula", this called macular edema and vision loss can result, as we have seen above.

Your doctor must have either sent examined the inside of your eyes or sent you to an "eye" specialist to have a fundus examination. This is nothing but examining the retina in your eye with the help of an instrument called the "ophthalmoscope" .

This is how the retina appear to the doctor if your eyes have not been affected by diabetes.

In order to understand this more clearly, this is a schematic view of a normal eye

The number of microaneurysms, the little red dots the doctor sees, indicate the likelihood of more severe problems in the years to come.

For an excellent interactive look at all these retinal changes from the normal to the most serious, click here.

Let us call it a prepropliferative stage.

In this stage the retina has been damaged by the higher than normal sugar levels over several years. Small haemorrhages (flecks of blood) and tiny abnormal blood vessels are present.

If this progresses and many new vessels start developing in the retina, one has progressed to the proliferative stage.

The blood vessels can make a special growth chemical (VEGF= vascular endothelial growth factor) that makes other tiny, tiny blood vessels grow. These are called 'new' blood vessels.These new vessels are very delicate and very easily bleed, and this blood can (if the eye is not lasered) damage your eye badly.

If the blood vessels are severely damaged, they close off. In response again, new blood vessels start growing in the retina.

This is 'proliferative retinopathy'.

Usually in this condition, without laser treatment ( see below), the sight is very badly affected and people may become blind.

These new vessels are weak and can leak blood, blocking vision, which is a condition called vitreous hemorrhage. The new blood vessels can also cause scar tissue to grow. After the scar tissue shrinks, it can distort the retina or pull it out of place -- this is called retinal detachment.

If the macula is involved, this is a very serious matter. We have seen above that when the macula is involved, the central vision is affected!

But this can still be treated in its early stages with laser therapy.

An excellent composite view of the changes which take place in the vessels as retinopathy progresses is given below.