Diabetic retinopathy is an eye condition that can affect the retina of people who have diabetes.

The retina is the light-sensitive tissue that lines the back of the eye, and it detects light that is then processed as an image by the brain. Chronically high blood sugar or large fluctuations in blood sugar can damage the blood vessels in the retina. This can result in bleeding in the retina or leakage of fluid.

Diabetic retinopathy can be divided into non-proliferative or proliferative diabetic retinopathy.

Non-proliferative diabetic retinopathy: In the early stage of the disease, there is weakening of the blood vessels in the retina that causes out-pouching called microaneurysms. These microaneurysms can leak fluid into the retina. There can also be yellow deposits called hard exudates present in the retina from leaky vessels.

Diabetic macula edema is when the fluid leaks into the region of the retina called the macula. The macula is important for sharp, central vision needed for reading and driving. The accumulation of fluid in the macula causes blurry vision.

Proliferative diabetic retinopathy: As diabetic retinopathy progresses, new blood vessels grow on the surface of the retina. These blood vessels are fragile, which makes them likely to bleed into the vitreous, which is the clear gel that fills the middle of the eye. Bleeding inside the eye is seen as floaters or spots. Over time, scar tissue can then form on the surface of the retina and contract, leading to a retinal detachment. This is similar to wallpaper contracting and peeling away from the wall. If left untreated, retinal detachment can lead to loss of vision.

Symptoms of diabetic retinopathy:

  • Asymptomatic: In the early stages of mild non-proliferative diabetic retinopathy, the person will usually have no visual complaints. Therefore, it is important for people with diabetes to have a comprehensive dilated exam by their eye doctor once a year.
  • Floaters: This is usually from bleeding into the vitreous cavity from proliferative diabetic retinopathy.
  • Blurred vision: This can be the result of fluid leaking into the retina, causing diabetic macular edema.

Risk factors for diabetic retinopathy:

  • Blood sugar. Lower blood sugar will delay the onset and slow the progression of diabetic retinopathy. Chronically high blood sugar and the longer the duration of diabetes, the more likely chance of that person having diabetic retinopathy.
  • Medical conditions. People with high blood pressure and high cholesterol are at greater risk for developing diabetic retinopathy.
  • Ethnicity. Hispanics, African Americans and Native Americans are at greater risk for developing diabetic retinopathy.
  • Pregnancy. Women with diabetes could have an increased risk of developing diabetic retinopathy during pregnancy. If they already have diabetic retinopathy, it might worsen during pregnancy.

Fall brings a lot of fun, with Halloween bringing loads of it.

But did you know that some Halloween practices could harm your vision? Take Halloween contacts, for instance. They vary widely, with everything from monster eyes to goblin eyes to cat eyes to sci-fi or a glamour look. They can be just the added touch you need for that perfect costume. However, some people do not realize that the FDA classifies contact lenses as a medical device that can alter cells of the eye and that damage can occur if they are not fit properly.

Infection, redness, corneal ulcers, hypoxia (lack of oxygen to the eye) and permanent blindness can occur if the proper fit is not ensured. The ICE, FTC, and FDA are concerned about costume contacts from the illegal black market because they are often unsafe and unsanitary. Proper safety regulations are strictly adhered to by conventional contact lens companies to ensure that the contact lenses are sterile and packaged properly and accurately.

Health concerns arise whenever unregulated black-market contacts come into the US market and are sold at flea markets, thrift shops, beauty shops, malls, and convenience stores. These contacts are sold without a prescriber's prescription, and are illegal in the US. There have also been reports of damage to eyes because Halloween spook houses ask employees to share the same pair of Halloween contact lenses as they dress up for their roles.

So the take home message is, have a great time at Halloween, and enjoy the flare that decorative contacts can bring to your costume, but get them from a reputable venue and be fit by an eye care professional with a proper legal prescription. Don't gamble with your eyes for a night of Halloween fun!