In more advanced cases, a proliferation of abnormal blood vessels occurs, causing hemorrhages.

The presence of blood in the vitreous space (a transparent gel that fills the eyeball) causes it to become opaque, causing a decrease in vision, which generally occurs suddenly.

The more years of evolution there are, the more chances there are of developing retinopathy.

Frequently, the patient is not aware of the disease until the damage is severe, hence the importance of performing periodic retinal checks.

Symptoms of diabetic retinopathy can be:

• Blurred vision and gradual vision loss
• Vision of spots or “floaters”
• Shadows or missed areas of vision
• Difficulty seeing at night

There are other factors that negatively influence diabetic retinopathy such as obesity, smoking and a sedentary lifestyle.

These patients require periodic retinal check-ups, since diabetic retinopathy generally does not cause symptoms until the lesion is severe.

Retinopathy can affect the macula (central area of the retina responsible for detailed vision) or its periphery.

Depending on the affected area and the degree of development of the disease, specialists have different treatment options, such as laser photocoagulation, intravitreal injections or surgery (vitrectomy).

Other visual complications associated with diabetes, such as glaucoma or cataracts, require specific treatments.

Any of these symptoms should lead to immediate consultation with an ophthalmologist to carry out an in-depth study of the structure of the eye and if the diagnosis is confirmed, it can be treated immediately.

• Vision of floaters (black dots that move when you move the eye). They are caused by changes in the vitreous
• Vision of luminous flashes. It is a more important symptom, which reflects the existence of traction on the retina. It usually appears when the breakage has already occurred
• Vision of a black curtain that falls through some area of the visual field. It occurs when there is already a retinal detachment, so the consultation with an ophthalmologist must be immediate.
• Distortion in images and subsequent significant decrease in visual acuity. This symptom appears if the central area of the retina (macula) is damaged.

It is important that the at-risk population undergo regular eye check-ups, at least once a year.

Furthermore, the sudden appearance of floaters or a sudden increase in existing ones, as well as the appearance of light flashes or any other of the symptoms described, should be a reason for urgent consultation with an ophthalmologist.

It is advisable to perform preventive laser treatment when there are retinal tears, even if they have not yet caused a detachment.

This preventive laser treatment may also be useful for high-risk patients with peripheral retinal degenerative lesions that may lead to retinal rupture.

There are different surgical techniques, depending on the degree and phase of retinal detachment:

• Laser photocoagulation. Using the laser, controlled burns are caused around the detached area. These burns eventually heal and seal the retinal break, preventing the vitreous humor from infiltrating between both layers.
• Vitrectomy. It consists of the extraction of the vitreous humor from inside the eye. The retina is then applied using heavy liquids and using lasers from inside the eye.
• Scleral surgery. A solid silicone band is placed around the outermost layer of the eye wall (the sclera) to maintain external pressure on the eyeball, making it easier to close the tear.

Consequently, the symptoms of macular edema affect central vision, with blurred vision, distortion of lines, and alteration in the shape of objects. If not treated properly, the patient may have very limited central vision.

Intraocular drugs allow the inflammation of the center of the macula to be controlled.

Other treatment options focus on laser photocoagulation of the points on the blood vessels where fluid loss occurs and accumulates in the macula, altering its functionality.

In more serious cases, vitrectomy surgery may be necessary.

Vitrectomy is a surgical intervention in which the transparent gel that fills the eyeball (vitreous humor) is removed to access the retina and treat the abnormal vessels and eliminate possible fibrous bands that may exert traction on the retina, with the subsequent risk of retinal tearing and detachment.

Here's what to look for:

1. Small patches of vision loss
2. Colors appear to be “washed out” or changed
3. Straight lines look bent or crooked

Even if you don't have symptoms, you should have a dilated eye exam every year. A dilated eye exam is the only way to know if diabetes is affecting your retina or macula.

RISK FACTOR'S

The following list includes some of the factors that may put you at higher risk for macular edema:

1. Having diabetes for more than 10 years.
2. High blood sugar levels and high fasting blood glucose levels.
3. Other risk factors for macular edema include high blood pressure, high cholesterol, and smoking.

A healthy macula looks like a dent in the retina.

• If it is the anterior part, we may notice greater sensitivity to light (photophobia), redness of the eyes, blurred vision or eye pain.
• If the affected area is the back, it is likely that we will not notice pain, although we will experience loss of vision or floater vision.

There are various types of factors that cause uveitis:

• Infectious diseases such as toxoplasmosis (the most common cause of uveitis in Colombia). This process results in a gradual destruction of the retina that, if it affects the macula (central part of the retina), can cause significant irreversible vision loss.
• Rheumatic diseases of inflammatory and non-degenerative origin, which mainly affect young people, such as rheumatoid arthritis, ankylosing spondylitis, among others.
• Autoimmune diseases caused by viruses, germs or environmental factors, such as sarcoidosis or Behçet's disease, a pathology of unknown origin that causes sores and skin changes.
• Trauma

The majority of those affected by uveitis are between 20 and 50 years old.

• Anterior uveitis is treated, in most cases, with anti-inflammatory eye drops.
• Non-infectious posterior uveitis is treated with steroids administered orally or by injections around the eye.
• Chronic forms of uveitis may require the use of immunomodulatory drugs
• Surgery is not a common treatment to cure uveitis, but it can be effective in controlling associated complications caused by uveitis that was not diagnosed and/or treated in time, such as cataracts or glaucoma (which affect the anterior segment). retinal detachment, vitreous opacity or macular edema (affecting the back of the eye)

The collaboration of an internist, infectious disease specialist and/or rheumatologist is usually necessary to complement the study and treatment of the disease causing uveitis. In some cases, treatment of these pathologies or infections can help prevent it.