Retinopathy: Causes, Symptoms, Signs, Treatment
Retinopathy (pronounced ret-in-AH-puh-thee) is a long word simply meaning a disease of the eye’s retina. It can take many forms, is typically painless, and can range in severity from minor to sight-threatening. Some forms of retinopathy can cause blindness.
Types of Retinopathy
These are typically named after their cause:
This refers to a number of diabetes-related eye conditions resulting from poorly controlled diabetes. High blood sugar levels damage the eye’s small blood vessels. The weakened blood vessels then leak and wreak havoc on the retina.
Macular edema is another diabetic eye complication. It causes swelling of the macula and the retina’s center and may be associated with an increased risk of retinal detachment, a true medical emergency.
When diabetes is properly controlled, meaning blood glucose levels usually fall within normal limits, diabetic eye disease may be limited or avoided.
Hypertension is the medical term for high blood pressure. In addition to kidney and heart damage, high blood pressure can also damage the retina.
This damage is typically spotted as part of a comprehensive eye exam before vision loss occurs. This is why regular eye exams are so important.
Hypertensive eye damage occurs when excessively high blood pressure causes the retina’s blood vessels to thicken. This restricts blood flow to the retina and damages its cells over time. However, hypertensive retinopathy can also result in sudden vision loss, eye strokes, and optic nerve damage.
About one in three American adults has high blood pressure. It may be associated with being overweight, a poor diet, a lack of exercise, or stress.
Retinopathy of Prematurity (ROP)
This condition occurs in premature infants, particularly those born before 31 weeks of gestation. During prenatal life, blood vessels in the unborn baby’s retinas develop and grow from the retina’s center outwards. Somewhere between eight months and full-term gestation, this process is normally completed.
Babies born before this time may have deranged retinal blood vessels that grow out of control. These weak blood vessels break open, bleed, and cause scarring of the retinal area.
This scarring damages the retina and may also cause it to detach from its position at the back of the eye, threatening sight. ROP can range from mild to severe, but in more advanced cases, it can blind.
ROP typically affects both eyes and is a leading cause of childhood blindness and visual impairment.
This is entirely preventable and results from staring into the sun. It often occurs from sungazing, a foolish practice of looking directly at the sun during dusk or dawn. Some people may do this as part of a religious practice routine.
Solar damage can also occur from watching the sun without proper protective eyewear.
The sun’s UV rays cause a type of sunburn on the retina’s macula, its center, and where the clearest, sharpest vision is formed. Also called solar retinitis or eclipse retinopathy, solar retinopathy may cause mild to moderate vision loss with a possible central or paracentral blind spot.
Vision loss may be temporary or permanent. Some people may experience a return to normal vision within three to six months.
Age-Related Macular Degeneration (ARMD or AMD)
Age-related macular degeneration (ARMD) when the retina’s macula or center breaks down. There are two forms: dry and wet. The dry form is more common and is characterized by yellow deposits on the macula called drusen. It typically causes a slow vision loss over many years.
The wet form is caused by the growth of new, abnormal blood vessels that break open and bleed. They may also grow underneath the macula, pushing it upwards and making lines that should be straight appear, wavy. The retina is supposed to be flat.
Up to 70 percent of people with HIV and AIDS have some type of retinopathy. In fact, a suspected case of HIV may first be detected through changes seen in the eye.
Treatment of the virus aimed at reducing the viral load in the blood may help to decrease the chances of vision loss.
Hydroxychloroquine or HCQ is a drug used to manage lupus and several other autoimmune diseases. It’s effective, but it has the unfortunate side effect of being toxic to retinal cells.
Retinopathy occurs in roughly 7.5 percent of patients after about five years of HCQ use and rises to nearly 20 percent after 20 years of taking the drug.
In the news, you may recall reading about an HCQ derivative, chloroquine, when a couple accidentally poisoned themselves with it while using it to protect against the COVID-19 virus. No HCQ derivatives are currently approved for this purpose.
Sickle Cell Retinopathy
This inherited condition causes a blockage of the blood vessels that become clogged with abnormally-shaped red blood cells. This blockage can also occur in the retinal blood vessels, preventing the retina cells from getting oxygen and nutrients.
Valsalva is a diving maneuver used to equalize ear pressure. When done deliberately, it’s similar to holding your breath. Valsalva retinopathy may occur when someone exerts themselves while holding their breath. This may cause retinal blood vessels to burst.
An example would be to lift a heavyweight without breathing. In addition to possible retinopathy, this could also cause blood vessels in the eye’s conjunctiva to break, resulting in the whites of the eyes turning red.
Valsalva retinopathy could also result from vomiting, sneezing, straining while constipated, weight lifting, sexual intercourse, and coughing.
Vision loss from this type of retinopathy is typically self-limiting and will clear on its own.
Symptoms of Retinopathy
This may include:
1. Floaters or spots that appear or increase suddenly
2. Flashing lights
3. Difficulty reading small text or seeing small details
4. Blurry vision and decreased acuity
In addition to other studies, your eye doctor will perform a comprehensive eye exam with pupil dilation to examine your retina for signs of disease and confirmation of diagnosis.
Treatment of Retinopathy
Treatment depends on the cause. Retinopathy cannot always be reversed or treated if it’s advanced. Any vision loss may be permanent. However, some possible treatments include:
1. Oral medications
2. Medications injected into the eye
3. Laser therapy
4. Removing and replacing the vitreous (liquid inside the eyeball)
5. Cryo (cold) therapy
Find a Top Eye Doctor Near You
If you’re concerned about retinopathy, see an eye care professional immediately. If there’s a developing problem, it can be treated while the chances of vision loss are lowest.
If there is no problem, you’ll have peace of mind knowing your eyes are healthy.
We can help you find a great eye doctor right near you. Our top-rated physicians practice across the country, and all warmly welcome new patients.
We can help you set your appointment and look forward to assisting you.