What Is It?
Retinopathy refers to diseases that affect the retina, the collection of light-sensitive cells lining the back half of each eye. The retina contains nerve cells that translate what you see into electrical impulses. These impulses are transmitted to the brain, where they are interpreted.
The retina contains many blood vessels. Abnormalities in these vessels cause several forms of retinopathy. Retinopathy can cause partial loss of vision or complete blindness. It can develop slowly or occur suddenly. Retinopathy can get better on its own at any time or it can cause permanent damage, depending on what's causing it and how far it has progressed.
Some types of retinopathy (for example, central serous retinopathy) do not have an obvious cause. Most forms of retinopathy, though, are caused by a known medical illness. Types of retinopathy caused by illnesses include:
Retinopathy of prematurity. There are no outward physical signs. Only an experienced ophthalmologist examining the eye through a dilated pupil can find signs of this illness.
Diabetic retinopathy. Symptoms may not be noticed until the late stages of the illness and can include:
Hypertensive retinopathy. There are often no symptoms, though some people complain of blurred vision.
Central serous retinopathy. Symptoms include:
Retinopathy of prematurity. An ophthalmologist examines the inside of the eye, including the retina and its blood vessels, as well as the optic disc, macula and retinal blood vessels for abnormalities.
Diabetic retinopathy. An ophthalmologist examines the retina and inside of the eye with an instrument called an ophthalmoscope. A dye may be injected into a vein in the arm. The dye then travels to the retina, where it can reveal leaky blood vessels.
Hypertensive retinopathy. A physician examines the eye with an ophthalmoscope and looks for tiny areas of the retina that look pale or white compared to the rest because these areas are not getting enough blood. The doctor also may see areas of bleeding from ruptured blood vessels. Occasionally, the retina may show areas of swelling, particularly at the area that controls fine vision (macula), or swelling of the optic nerve.
Central serous retinopathy. A doctor or ophthalmologist uses an ophthalmoscope to detect clear fluid that has seeped between one layer of the retina and another. Fluid between these layers can resemble bubbles on the retina, visible with an ophthalmoscope.
Retinopathy of prematurity. In most affected babies, this condition gets better on its own without treatment, and abnormal vessels disappear. More serious cases (about 6% of babies with this condition) will continue to get worse without treatment. Babies who need treatment are treated in the first few months of life. Within several months after treatment, it is usually possible to know whether there is any significant long-term damage to vision.
Diabetic retinopathy. Controlling blood sugar and blood pressure can slow or halt the progress of the disease, and treatments, usually with LASER, can repair existing damage.
Hypertensive retinopathy. Lowering blood pressure often can stop ongoing damage to the retina, although some damage that is established can persist.
Central serous retinopathy. Most cases go away without any treatment within three to four months. In cases that persist, laser is often used. Full vision can return within six months.
Retinopathy of prematurity. The first line of defense is regular prenatal care to prevent premature birth and complications during childbirth. Premature and low-birth-weight infants should be screened for retinopathy of prematurity if they are born at less than 36 weeks of gestation or weigh less than 4 pounds 6 ounces (2,000 grams) at birth. Because retinopathy of prematurity can be caused by or get worse from not having enough oxygen after birth or having too much, oxygen levels are monitored closely and adjusted accordingly.
Diabetic retinopathy. Controlling blood sugar and blood pressure are essential to prevent diabetic retinopathy. Doctors monitor blood sugar control by measuring a type of hemoglobin protein in the blood, hemoglobin A1C. If you are able to reduce your blood sugar average by the equivalent of one A1C point, you will reduce your risk of retinopathy by 35% over the next 10 years. Annual eye exams are crucial for people with diabetes. If proliferative and nonproliferative retinopathies are discovered during an annual exam, your doctor probably will recommend more frequent eye exams. Treatment can start before sight is affected and can delay vision impairment. The most commonly used treatment is laser.
Hypertensive retinopathy. Avoid high blood pressure by getting regular exercise, maintaining proper body weight, eating a healthy diet and seeing your doctor for regular checkups. Many Americans do not control their blood pressure well enough. It is important to take blood pressure medications as directed by your doctor if your blood pressure remains high even after you have made lifestyle changes.
Central serous retinopathy. Because the possible causes of this disease are still not understood, prevention is difficult. Many cases of central serous retinopathy have been associated with prescription corticosteroid treatment, so it's important to limit the amount of corticosteroids you take.
Retinopathy of prematurity. No treatment is recommended during the early stages, but close monitoring is essential. An ophthalmologist should examine high-risk infants before they are discharged from the newborn nursery and again at 8 weeks of age. If the disease is active, the infant should be examined every 1 to 2 weeks until he or she is 14 weeks old, and every 1 to 2 months after that. More advanced disease may require treatment to get rid of abnormal blood vessels. Treatment includes a procedure called cryotherapy, in which cold is used to destroy abnormal cells, and laser treatments. A detached retina can be reattached.
Diabetic retinopathy. To keep diabetic retinopathy from getting worse, blood sugar and blood pressure must be controlled to avoid complications. Specific treatment for diabetic retinopathy depends on the nature of the problem:
Hypertensive retinopathy. Medications can lower blood pressure and improve changes in the retina. People with very high blood pressure and swelling of the optic nerve require emergency treatment in a hospital.
Central serous retinopathy. This condition usually goes away on its own, but an ophthalmologist should monitor you closely for three to six months to make sure the condition improves. If it does not, laser treatment may be used to speed healing.
When To Call a Professional
Call a doctor if you notice changes in your vision, particularly if they are sudden, including blurring, spots, flashes, blind spots, distortion, or difficulty reading or doing detail work.
Retinopathy of prematurity. In up to 85% of affected babies, this condition gets better on its own without treatment, and the abnormal vessels disappear. However, more advanced cases can lead to a number of eye problems, including blindness. Children with retinopathy of prematurity have an increased risk of retinal detachment, cataract, glaucoma, crossed eyes, lazy eye and nearsightedness.
Diabetic retinopathy. The outlook depends on how well blood pressure and blood sugar are controlled, how far the disease has progressed, and how closely it is monitored. Treatments can repair damage and slow the progress of the disease. Advanced stages of diabetic retinopathy lead to blindness.
Hypertensive retinopathy. Most changes in the retina caused by hypertensive retinopathy disappear after blood pressure has been lowered, although some signs of damage can remain.
Central serous retinopathy. Most cases go away on their own within three to four months. Full visual acuity usually returns within six months. Lasting symptoms can include distortion, decreased contrast sensitivity and difficulty with night vision. It's common for this condition to return.
American Academy of Ophthalmology
P.O. Box 7424
San Francisco, CA 94120-7424
National Eye Institute
2020 Vision Place
Bethesda, MD 20892-3655
National Institute of Diabetes & Digestive & Kidney Disorders
Office of Communications and Public Liaison
Building 31, Room 9A06
31 Center Drive, MSC 2560
Bethesda, MD 20892-2560
National Diabetes Information Clearinghouse
1 Information Way
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American Academy of Pediatrics (AAP)
141 Northwest Point Blvd.
Elk Grove Village, IL 60007-1098
National Heart, Lung, and Blood Institute (NHLBI)
P.O. Box 30105
Bethesda, MD 20824-0105