The tiny retinal blood vessels in diabetics are more prone to leakages. This can result in leakage of blood in the retina (retinal haemorrhage) or into the jelly of the eye in front of the retina (vitreous haemorrhage). In case fluid containing protein leaks out into the retina, it tends to collect in the centre i.e. the macular area causing macular oedema. Fatty material, cholesterol etc may also leak into the retina, either in the centre or in the periphery. All leakages, whether of blood, fluid or cholesterol in the macular area will result in distorted vision or a drop in vision. This may be sudden, such as when bleeding occurs, or gradual, when fluid oozes slowly into the macular area. The patient will detect this provided he has been educated to examine his vision at home at regular intervals, covering one eye at a time. This vision testing should be done with the correct glasses worn, for both distance and near. He should obviously visit his eye doctor, the moment he detects this fall in vision. However, if the same leakages are not in the centre of the retina, the patient may not notice them till much damage has occurred. Therefore it is essential that he visit his eye doctor at regular intervals as suggested by him. The eye doctor will dilate his pupils as required and carefully examine the macula and periphery of the retina using an instrument called an ophthalmoscope. If he does detect these leaking areas, he may ask for a fluorescein angiography test to detect the site of leakage. He may decide to use laser treatment to treat these leakages.
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