Phil is a 54-year-old with type 2 diabetes. After he was initially diagnosed with the condition, his physician referred him to an ophthalmologist for a comprehensive eye examination. Phil had been struggling with the lifestyle changes he was required to m He was able to return to a healthy weight with physical exercise and dietary changes, but he worked long hours and ate poorly when on business trips. Phil missed his second annual checkup with his ophthalmologist because of such a trip. When he finally made it in, she examined him and stated there was now evidence of small retinal hemorrhages and cotton-wool exudates. She emphasized his need to reduce his hypertension and hyperlipidemia and wrote up a report for his physician. How do visual disturbances arise from background and proliferative retinopathy? How might blindness occur with a prolonged detached retina? Explain using your knowledge of pathophysiology. What are the similarities and differences between traction retinal de

Phil is a 54-year-old with type 2 diabetes. After he was initially diagnosed with the condition, his physician referred him to an ophthalmologist for a comprehensive eye examination. Phil had been struggling with the lifestyle changes he was required to m He was able to return to a healthy weight with physical exercise and dietary changes, but he worked long hours and ate poorly when on business trips. Phil missed his second annual checkup with his ophthalmologist because of such a trip. When he finally made it in, she examined him and stated there was now evidence of small retinal hemorrhages and cotton-wool exudates. She emphasized his need to reduce his hypertension and hyperlipidemia and wrote up a report for his physician. How do visual disturbances arise from background and proliferative retinopathy? How might blindness occur with a prolonged detached retina? Explain using your knowledge of pathophysiology. What are the similarities and differences between traction retinal de

Background retinopathy affects the capillary endothelium and results in a breakdown of the blood-retinal barrier. As plasma leaks from the compromised capillaries, macular edema and subsequent loss of vision result. In proliferative retinopathy, neovascularization is responsible for visual change. These new vessels tend to bleed into the vitreous cavity and decrease visual acuity. Because of their mode of attachment, these new vessels also have the tendency to adhere the vitreous to the surface of the retina. As the vitreous moves, it exerts mechanical forces on the retina, leading to retinal detachment and progressive loss of vision.

The neural retina receives nutrients from the choroid. When the neural retina is detached from the pigment layer, the transport of nutrients is severed. With prolonged detachment, the receptors of the neural retina become ischemic, die, and cause loss of vision in that portion of the retina.

Traction retinal detachment is a result of mechanical forces that pry the retina away from the choroid. The traction forces are frequently from the lay down of fibrotic tissue that have developed secondary to injury, infection, or inflammation. In rhegmatogenous detachment, a retinal tear is present. The detachment occurs when the liquid vitreous enters the tear and separates the neural retina from the pigment layer.