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Retinopathy: Definition, causes and treatment

Retinopathy is any disease of the retina, which is the light-sensitive membrane at the back of the eye.

There are several types of retinopathy, depending on the underlying cause, including:

  • Diabetic retinopathy (caused by diabetes)

  • Hypertensive retinopathy (caused by high blood pressure)

  • Retinopathy of prematurity (caused by premature birth)

  • Solar retinopathy (caused by staring at the sun)

Retinopathy can occur gradually, over a long period of time, or suddenly without much warning. The underlying cause and other factors will determine how much vision loss occurs.

Causes and risk factors

Retinopathy does not occur on its own; it is caused by an underlying disease or condition. Common risk factors include:

Diabetes

Diabetes can damage blood vessels that feed and detoxify the retina, leading to diabetic retinopathy. 

If not detected and treated early, diabetic retinopathy can cause permanent vision loss.

The prevalence of diabetic retinopathy has increased significantly in many parts of the world in recent years — particularly in the United States, where retinopathy from diabetes is a leading cause of blindness among adults.  From 2010 to 2050, the number of Americans with diabetic retinopathy is expected to nearly double, from 7.7 million to 14.6 million, according to the U.S. Centers for Disease Control and Prevention (CDC)

In many cases, successfully managing blood glucose levels can help slow or even stop the progression of diabetic retinopathy.

SEE RELATED: Can diabetes cause glaucoma?

High blood pressure

High blood pressure (hypertension) is another common cause of retinal damage. This is known as hypertensive retinopathy. Blindness is less common with hypertensive retinopathy, but it is still cause for concern.

When uncontrolled blood pressure affects the eye’s blood vessels, it can be a sign that blood vessels in other parts of the body are being affected too. Actively maintaining your blood pressure levels with medication and a healthy lifestyle can help to stabilize your condition.

Direct sun exposure

Radiation from the sun can also damage the macula, which is the center of the retina. This sun damage is called solar retinopathy or photic retinopathy.

Solar damage to the macula can result in a blind spot in the center of your field of vision. Fortunately, most people recover from solar retina damage on their own in a matter of weeks or months. In more severe cases, however, partial or even complete vision loss can occur.

Premature birth

While uncommon, retinopathy of prematurity (ROP) is a major cause of childhood vision loss. The condition can affect premature babies (born before 31 weeks).

Retinopathy of prematurity sometimes goes away on its own as a child grows up. When it doesn’t, it will need to be treated to avoid permanent eyesight damage.

Macular degeneration

Macular degeneration (AMD) is a type of retinopathy that affects the macula. There are two types of macular degeneration: dry AMD and wet AMD.

Dry AMD is more common, causing gradual central vision loss over many years. Wet AMD is caused by leaky blood vessels in the eye. Wet AMD can lead to immediate vision loss in severe cases.

Symptoms

Retinopathy symptoms depend on the type and severity of the underlying condition. For some types of retina disease, vision loss is the only symptom.

Other symptoms of retinopathy can include:

  • Blurry vision

  • Reduced visual acuity (sharpness)

  • Floaters or spots in vision

  • The appearance of flashing lights

  • Difficulty seeing small details or text

Some types of retinopathy increase the risk of a retinal detachment, which is a medical emergency that requires prompt surgical treatment to avoid permanent vision loss. 

SEE RELATED: Symptoms of diabetic eye problems

Diagnosis

Retinopathy is detected and diagnosed by your eye doctor during a comprehensive eye exam. Early diagnosis is one of the best ways to reduce or eliminate the vision loss associated with advanced retinal damage.

Your optometrist or ophthalmologist will closely examine your retina during a procedure called ophthalmoscopy (or a fundoscopic exam).

If abnormalities are seen in the blood vessels of your retina, you may be referred to a retina specialist for further testing and treatment.

Treatment

Treatment options for retinopathy vary depending on the type and severity of retina disease you have. 

Sometimes retinopathy will go away on its own, while being monitored by an eye doctor. Other forms of retinopathy don’t cause symptoms in their early stages and only need to be monitored.

Treatment may be suggested when retina disease progresses to the point at which it could damage your vision. Methods of treatment may include:

  • Oral medications

  • Laser therapy to slow blood vessel swelling

  • Freezing therapy (cryotherapy) to slow blood vessel swelling

  • Injecting special medications directly into the eye

  • Removing and replacing the fluid inside the eye (vitrectomy)

READ MORE: Diabetic retinopathy treatment

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Gary Heiting, OD

Gary Heiting, OD, is a former senior editor of AllAboutVision.com. Dr. Heiting has more than 30 years of experience as an eye care provider, health educator and consultant to the eyewear ... Read more