The retina lines the back two thirds of the
eye and is responsible for receiving visual images. Retinopathy means disease of the retina. There are several types of retinopathy
but all involve disease of the small retinal blood vessels. Signs of retinopathy
(see photograph) can be seen when the retina is viewed through the pupil with
an ophthalmoscope. The January 5, 2005, issue of JAMA includes
an article about retinopathy as an early sign of cardiovascular disease.
Hypertension (high blood pressure) and vascular (blood vessel) diseases can affect the small blood
vessels of the retina just as they can affect other blood vessels. Retinopathy
may therefore be an indicator of vascular damage elsewhere in the body. Visual
changes sometimes develop due to advanced retinopathy and may be a sign of
undiagnosed or poorly controlled hypertension. Although rare, blindness may
The most common type of retinopathy is related to diabetes. Diabetic
retinopathy can be proliferative (growing) or nonproliferative (not growing) regarding the growth of
abnormal blood vessels in the retina. Nonproliferative retinopathy is much more common and usually requires no treatment. In proliferative retinopathy, abnormal blood vessels start to grow when
the existing blood vessels close off. The proliferative type of retinopathy
can lead to impaired vision. Regular eye examinations are important to check
for progression of retinopathy from nonproliferative to proliferative stages.
Preventing retinopathy starts with early diagnosis and treatment of
conditions that cause retinopathy. For persons with diabetes, good control
of blood glucose levels, proper control of high blood pressure, and regular
medical examinations are crucial to preventing retinopathy. Persons with diabetes
should have an annual eye examination including pupil dilation for the best
possible view of the retina. Good blood pressure control is essential for
anyone with hypertension. Individuals with eye disorders or other health problems
that put them at risk for visual impairment should see an ophthalmologist (doctor with specialized education for diagnosis and
treatment of eye diseases). Once retinopathy is detected, early treatment
is essential to prevent blindness. Several forms of treatment are available
for persons with proliferative retinopathy.
"Floaters" or spots in vision
Eye pain and redness that does not resolve
Decreased peripheral vision
American Diabetes Association 800/DIABETES (342-2383)http://www.diabetes.org
National Eye Institute 301/496-5248 http://www.nei.nih.gov
To find this and previous JAMA Patient Pages, go to the Patient Page
link on JAMA's Web site at http://www.jama.com. A Patient Page on causes of visual impairment was published in the
October 15, 2003, issue.
Sources: American Diabetes Association; National Eye Institute; National
Heart, Lung, and Blood Institute; National Diabetes Education Program; American
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate
in most instances, but they are not a substitute for medical diagnosis. For
specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied
noncommercially by physicians and other health care professionals to share
with patients. Any other print or online reproduction is subject to AMA approval.
To purchase bulk reprints, call 718/946-7424.
TOPIC: EYE HEALTH
Torpy JM, Glass TJ, Glass RM. Retinopathy. JAMA. 2005;293(1):128. doi:10.1001/jama.293.1.128