Symptoms are not visible properly in the case of hypertensive retinopathy. Some patients might report reduced vision or headaches. Arteriolar changes like narrowing of arteries, advanced retinopathy lesions, like micro aneurysms, flame hemorrhages, ischemic changes and hard exudates around the retina called visual acuity loss. The affected patients might be asymptomatic or have reduced visual acuity in radiation retinopathy. Ophthalmic examination will show signs of retinal vascular disease that includes retinal hemorrhages, perivascular sheathing, disc edema and macular edema. Solar retinopathy has symptoms of long term reduced visual acuity and paracentral scotoma.

• Inflammation

  Inflammation and Diabetic Retinopathy By Hongbin Lü 1649 Open access peer-reviewed 8. [intechopen.com]

  Autoimmune retinopathy was suspected on the basis of the clinical presentation, electrophysiology, absence of fundus lesions, retinal degenerations or dystrophies, or intraocular inflammation and temporal association with varicella infection. [ncbi.nlm.nih.gov]

  Treatment of rhinophyma is usually limited to avoiding stimulating factors, proper cleaning and treatment of secondary infections and inflammation. [termedia.pl]

  These include: topical and oral antibiotics to reduce inflammation and redness, such as metronidazole, sulfacetamide, tetracycline, erythromycin (Erythrocin Stearate), and minocycline (Minocin) topical medications that help minimize inflammation, such [healthline.com]

• Surgical Procedure

  If you suffer from advanced PDR, your Texas Retina physician may recommend a surgical procedure called vitrectomy. [texasretina.com]

  Surgical removal of the vitreous gel can also help improve vision if there is no real damage to the retina. As with any surgical procedures, there is the chance for problems to develop. [threetreasures.com]

  Vitrectomy surgery Vitrectomy is a surgical procedure performed in a hospital or ambulatory surgery center operating room. It is often performed on an outpatient basis or with a short hospital stay. Either a local or general anesthetic may be used. [annapoliseyecare.com]

  In this surgical procedure, small instruments are inserted into the eye under microscopic visualization, and both the vitreous hemorrhage and scarring are removed and replaced with clear fluids. [improveyourvision.com]

• Falling

  The incidence of diabetes is increasing, but that of diabetic retinopathy is falling, probably owing to better management of glucose levels, lipid abnormalities, and hypertension. [nejm.org]

  The second mechanism is direct damage to the retina usually caused by free radicals that causes oxidative damage to the retina itself.[10] Radiation, solar retinopathy, and retinopathy of prematurity fall under this category. [en.wikipedia.org]

  Other cases of RP, where family history has been determined, fall into three main categories: autosomal recessive, autosomal dominant, and X-linked recessive. [genome.gov]

  Reading impairment and difficulties in undertaking daily activities are typically seen when visual acuity falls below 0.5 (20/40). [institut-vision.org]

  One of the major health concerns was having frequent accidents such as falls and bumping into things. 'The other fear is that I keep bashing into things and falling over things and hurting myself and getting bruises and scrapes and stuff like that.' [nature.com]

• Nausea

  Most patients have no difficulty with this testing, although a low percentage of patients will experience some nausea. [improveyourvision.com]

  There may be mild nausea during the procedure. The skin and urine may turn yellow for 24 to 48 hours. These angiograms show areas of leakage, areas of oxygen-starved retinas, and weak, fragile new vessels. [coopereyecare.com]

  Excessive doses may cause nausea, vomiting, headache, blurred vision, dizziness, liver problems, and clumsiness. It may also increase a person's risk of developing osteoporosis. Vitamin A appears safe in pregnant women if taken at recommended doses. [columbiaeye.org]

• Vomiting

  Excessive doses may cause nausea, vomiting, headache, blurred vision, dizziness, liver problems, and clumsiness. It may also increase a person's risk of developing osteoporosis. Vitamin A appears safe in pregnant women if taken at recommended doses. [columbiaeye.org]

• Hypertension

  Hypertensive retinopathy. Hypertensive retinopathy occurs in people who have high blood pressure. High blood pressure causes blood vessel abnormalities. [drugs.com]

  Mostly, retinopathy is observed as an ocular manifestation of systemic diseases like diabetes and hypertension. Symptoms are not visible properly in the case of hypertensive retinopathy. Some patients might report reduced vision or headaches. [symptoma.com]

  Hypertension alone is capable of producing hypertensive retinopathy characterized by macro- and microaneurysms, flame hemorrhages, cotton wool spots, and macular exudates. [institut-vision.org]

  It's unusual for hypertension to impair vision, but hypertensive retinopathy can lead to blockage of retinal arteries or veins, which in turn may eventually result in the loss of vision. [medbroadcast.com]

• Vascular Disease

  Background: Retinopathy of prematurity (ROP) is a retinal vascular disease occurring in infants with short gestational age and low birth weight and can lead to retinal detachment (ROP stages 4 and 5). [doi.org]

  There are several types of retinopathy, like diabetic retinopathy, hypertensive retinopathy, retinopathy of prematurity, radiation retinopathy, solar retinopathy, sickle-cell disease, retinal vascular disease and purtscher’s retinopathy. [symptoma.com]

  Retinopathy, or retinal vascular disease, can be broadly categorized into proliferative and non-proliferative types. [en.wikipedia.org]

  4 (1): 91-98 http://emjreviews.com/wp-content/uploads/Treatment-Strategies-for-Chorioretinal-Vascular-Diseases-Advantages-and-Disadvantages-of-Individualised-Therapy.pdf ■ Fatores de risco e incidência da retinopatia diabética. [internetmedica.com.br]

  diseases -- Lacrimal system -- The management of orbital disease in children -- Neurogenic tumors -- Orbital rhabdomyosarcoma -- Other mesenchymal abnormalities -- Metastatic, secondary and lacrimal gland tumors -- Histiocytic, hematopoietic, and lymphoproliferative [worldcat.org]

• Visual Impairment

  Visual impairment in Nordic children. II. Aetiological factors. Acta Ophthalmol. 1992 ; 70 : 155 – 164 ↵ Rahi JS, Cable N; British Childhood Visual Impairment Study Group. Severe visual impairment and blindness in children in the UK. [pediatrics.aappublications.org]

  Retinal detachment is the main cause of visual impairment and blindness in ROP. Several complex factors may be responsible for the development of ROP. [web.archive.org]

  Among adults presenting with visual acuity impairment, the prevalence of depression (PHQ-9 score of >10) was 10.7%, compared with 6.8% among those without visual acuity impairment. [ajmc.com]

  impairment -- Delivering bad news -- Common issues arising in children with visual impairment -- Visual conversion disorders : fabricated or exaggerated symptoms in children -- Dyslexia -- Neurometabolic disease and the eye -- Pupil anomalies and reactions [worldcat.org]

• Visual Impairment

  Visual impairment in Nordic children. II. Aetiological factors. Acta Ophthalmol. 1992 ; 70 : 155 – 164 ↵ Rahi JS, Cable N; British Childhood Visual Impairment Study Group. Severe visual impairment and blindness in children in the UK. [pediatrics.aappublications.org]

  Retinal detachment is the main cause of visual impairment and blindness in ROP. Several complex factors may be responsible for the development of ROP. [web.archive.org]

  Among adults presenting with visual acuity impairment, the prevalence of depression (PHQ-9 score of >10) was 10.7%, compared with 6.8% among those without visual acuity impairment. [ajmc.com]

  impairment -- Delivering bad news -- Common issues arising in children with visual impairment -- Visual conversion disorders : fabricated or exaggerated symptoms in children -- Dyslexia -- Neurometabolic disease and the eye -- Pupil anomalies and reactions [worldcat.org]

• Background Retinopathy

  Background retinopathy Background retinopathy is the earliest stage of changes to your retina caused by diabetes. Background retinopathy is common. At this stage, diabetes has started to affect the small blood vessels in your retina. [gov.uk]

  Background retinopathy (an early stage of diabetic retinopathy) is characterized by damaged blood vessels that leak serum or fat from the circulating blood into the retina. [uclahealth.org]

  The categories of retinopathy are: Background retinopathy Background retinopathy occurs in the early stages and damage is limited to tiny bulges (microaneurysms) in the blood vessel walls. [diabeticretinascreen.ie]

  This type of diabetic retinopathy eye surgery is called vitrectomy. Read more on treating retinopathy Background retinopathy Background retinopathy, also known as simple retinopathy, involves tiny swellings in the walls of the blood vessels. [diabetes.co.uk]

• Night Blindness

  The short duration and rapid progression of symptoms along with the lack of family history of night blindness prompted a diagnosis of autoimmune retinopathy (AIR). [ncbi.nlm.nih.gov]

  Retinitis pigmentosa (RP) is the name given to a group of retinal diseases that are characterized by loss of peripheral (side) vision, and frequently by difficulty seeing in dimly lighted areas (night blindness). [uclahealth.org]

  blindness, autosomal dominant 3; Night blindness, congenital stationary, type 1g GNAT2 Achromatopsia 4 GNPTG Mucolipidosis III gamma GPR143 Ocular albinism, type I; Nystagmus 6, congenital, X-linked GPR179 Congenital stationary night blindness, type [asperbio.com]

  As the disease progresses, rod cells degenerate causing night blindness and peripheral vision. [genome.gov]

• Retinal Hemorrhage

  Case 1 highlights extensive choroidal detachment with subhyaloid haemorrhage and multiple intra-retinal hemorrhages in the posterior pole seen on first post-operative day in a 6 year old child with congenital glaucoma who underwent Trab & Trab. [ncbi.nlm.nih.gov]

  Research Highlights • A clinical study on 48 eyes was done to measure the ability of the Ayurvedic preparation called saptamrita lauha in absorption of retinal hemorrhages. [chrysalisnaturalmedicine.com]

  Any NVD with vitreous hemorrhage 3. NVE ≥ ½ disc area with vitreous hemorrhage High-risk PDR was also defined as three or more of the following high-risk characteristics (HRC’s): 1. Presence of vitreous hemorrhage or pre-retinal hemorrhage 2. [bu.edu]

  These symptoms are typically caused by vitreous hemorrhage or traction retinal detachment. [msdmanuals.com]

• Renal Insufficiency

  Retinal vessel diameters and the incidence of gross proteinuria and renal insufficiency in people with tipe1 diabetes. Diabetes 2004; 53: 179-184. [ Links ] 11. Aiello LP, Bursell S, Clermont A, et al. [scielo.isciii.es]

  The 10-year incidence of renal insufficiency in people with type 1 diabetes. Diabetes Care. 1999;22:743-751. Resumo 32. Nelson RG, Wolfe JA, Horton MB, et al. Proliferative retinopathy in NIDDM. Incidence and risk factors in Pima Indians. [bestpractice.bmj.com]

• Kidney Failure

  This damage can cause foot ulcers, nerve numbness and kidney failure. In the eye, it can cause retinal damage, known as diabetic retinal disease, or diabetic retinopathy. [pennmedicine.org]

  Information for People with Diabetes Diabetes is a very serious disease that can cause problems like blindness, heart disease, kidney failure, and amputations. [masseyeandear.org]

• Headache

  Late-stage diabetic retinopathy symptoms include: Blurred vision Eye strain Headaches. Causes Diabetic retinopathy is an eye disease caused by complications of diabetes. [betterhealth.vic.gov.au]

  […] detachment in childhood -- Congenital anomalies of the optic discs -- Hereditary optic neuropathies -- Other acquired optic disc abnormalities in children -- Demyelinating, inflammatory, infectious, and infiltrative optic neuropathies -- The optic chiasm -- Headache [worldcat.org]

  Some patients might report reduced vision or headaches. [symptoma.com]

  However, as the condition progresses, symptoms include: headaches vision changes sudden loss of vision in one or both eyes double vision Making the Diagnosis Diabetic retinopathy is a long-term complication of diabetes. [medbroadcast.com]

  Rare complications of treatment may include blurred vision, headache, glaucoma, difficulty seeing in the dark, decreased peripheral and color vision, and bleeding. In most cases when treatment is recommended, the benefits outweigh the risks. [webmd.com]

• Clumsiness

  Excessive doses may cause nausea, vomiting, headache, blurred vision, dizziness, liver problems, and clumsiness. It may also increase a person's risk of developing osteoporosis. Vitamin A appears safe in pregnant women if taken at recommended doses. [columbiaeye.org]

  As their visual field becomes restricted, patients often trip over things and appear clumsy. People with RP often find bright lights uncomfortable, a condition known as photophobia. [nei.nih.gov]

• Burning Sensation

  Patients were asked if they had symptoms of neuropathy (numbness, pain and burning sensation of the hands and feet, and paresthesia) and the responses were recorded on the questionnaire. [bmcresnotes.biomedcentral.com]

Some of the methods used for diagnosing diabetic retinopathy include visual acuity test, optical coherence tomography and ophthalmoscopy. The healthcare professional has to look for leakage in blood vessels, for damaged nerve tissue and retinal swelling. The findings of active retinopathy of prematurity are explained by the international classification of retinopathy of prematurity, which has several parameters for describing the disease. Examination of the back of the eye with funduscope will help in diagnosing purtscher’s retinopathy. The reduction in the blood flow to the white areas of the eye is measured by fluorescein angiography [8].

• Hyperglycemia

  It is critical for these patients to know which type of insulin to use when, to avoid the dangers of hypoglycemia and the long-term effects of hyperglycemia, such as DR. [uspharmacist.com]

  Am J Manag Care. 2019;25:-S0 Introduction to Diabetic Retinopathy Background and Epidemiology Diabetic retinopathy (DR) is a common complication of chronic, poorly controlled diabetes mellitus.1 In addition to chronic hyperglycemia, major modifiable risk [ajmc.com]

  Type 2 Diabetes is caused from insulin resistance and a deficiency of insulin that results in chronic hyperglycemia. Risk factors for Type 2 diabetes are: overeating, obesity and a sedentary lifestyle. [mastereyeassociates.com]

  Hyperglycemia, hypertension, hyperlipidemia, and renal disease are considerable risk factors. [institut-vision.org]

  After duration of diabetes, hyperglycemia has been the most consistently associated risk factor for retinopathy. [care.diabetesjournals.org]

Three major treatment methods used for diabetic retinopathy are laser surgery, vitrectomy, and injection of corticosteroids. Laser photocoagulation, modified grid laser and panretinal photocoagulation, intravitreal triamcinolone acetonide are some treatment methods used for diabetic retinopathy [9]. Treatment for hypertension can reduce hypertensive retinopathy. Main treatment for retinopathy of prematurity is peripheral retinal ablation. Anti-vascular endothelial growth factors were used for treating radiation retinopathy. Purtscher’s retinopathy is treated using triamcinolone and if this is caused by any systemic disease, then they have to be treated [10].

Prognosis of retinopathy in newborns will be better by itself and the abnormal vessels will disappear after sometime. Advanced stage of retinopathy of prematurity can lead to blindness, retinal detachment, crossed eyes, nearsightedness, glaucoma, lazy eye and cataract. Diabetic retinopathy leads to blindness [7].

Alterations in the retina due to hypertensive retinopathy will slowly disappear when the blood pressure is reduced. The symptoms of damage will still remain in some cases. Retinopathy of prematurity is described as the threshold disease, which has 50 percent chance of progressing to retinal detachment, at stage 3 of zone I or zone II. Progression to stage 4 and 5 will lead to loss of vision. Purtscher’s retinopathy can also lead to vision loss.

Retinopathy can develop slowly or suddenly, which can result in permanent damage. Premature birth can lead to retinopathy, which can also end up in retinal detachment causing blindness. Type1 or type2 diabetic patients develop retinopathy when the blood vessels in their retina deteriorate. Thickening or blockage of small arteries or swelling of optic nerve causes hypertensive retinopathy. Non-traumatic systemic diseases and bone fractures leads to purtscher’s retinopathy. Disorganized growth of retinal blood vessels ending up in retinal detachment is thought to be a cause of Terry syndrome or premature retinopathy [3].

By 2012, of nearly 93 million people with diabetic retinopathy, 17 million were with proliferative retinopathy, 21 million people were suffering from diabetic macular edema and 28 million people were suffering from vision threatening diabetic retinopathy worldwide [4]. Research studies showed that degree and duration of hypertension enhances the retinopathy incidence. Another study reveals that large number of survived immature newborns correlate with increased risk of advanced retinopathy of premature stages. The frequency of this disease is inversely proportional to the gestational weight and age of the newborn. Prevalence of prematurity retinopathy varies from five to eight percent in developed countries to thirty percent in developing countries.

The formation of blood-retinal barrier is altered by the damages from thickening of the basement membrane and hyperglycemia induced intramural pericyte death leading to vascular wall incompetence. Tiny blood vessels filled with glucose cannot be exposed to glucose control methods. Therefore, initial stage of diabetic retinopathy is called non-proliferative and the advanced form is called proliferative [5].

If the growth of blood vessels is abnormal from the plane of retina, and if it bleeds inside the eye, then the baby develops retinopathy of prematurity. Radiation retinopathy involves damage of the endothelial cells of the retinal capillaries by radiation. Retinal damage occurring from photochemical injury is observed in solar retinopathy. Appearance of cotton wool like spots in the retina and atrophy of the optic nerve is observed in purtscher’s retinopathy [6].

Prevention of retinopathy of prematurity can be done by addressing certain questions like how to identify the population at risk for this disease, ideal treatment needed for the affected people, what to do when treatment fails. Regular screening of blood sugar levels and high blood pressure can keep diabetic and hypertensive retinopathy under control.

There are several types of retinopathy, like diabetic retinopathy, hypertensive retinopathy, retinopathy of prematurity, radiation retinopathy, solar retinopathy, sickle-cell disease, retinal vascular disease and purtscher’s retinopathy. Diabetic retinopathy is due to microvascular retinal changes, which also result from radiation. Hypertensive retinopathy occurs due to the damage in the arterial and arteriolar circulation from high blood pressure. The eye disease that affects prematurely-born babies has received intensive neonatal care due to retinopathy of prematurity [2]. Solar retinopathy results due to eye damage from the sun. Head injuries can lead to purtscher’s retinopathy and sickle-cell anemia also leads to retinopathy.

• Definition: A permanent or temporary damage occurred to the retina of the eye is termed as retinopathy. Ocular manifestation of systemic diseases like diabetes and hypertension, prematurely born babies, radiation, and other reasons can lead to retinopathy.
• Cause: Enhanced blood sugar levels and blood pressure, bone fractures, disorganized growth of retinal blood vessels in the newly born, radiation and sun effect are some of the causes for retinopathy. 
• Symptoms: Changes in the arterial wall, advanced retinopathy lesions, micro-aneurysms, ischemic changes, flame hemorrhages, visual acuity loss, retinal detachment, perivascular sheathing, disc edema, macular edema and paracentral scotoma are some of the symptoms of retinopathy.
• Diagnosis: Some of the tests used for diagnosing diabetic retinopathy include visual acuity test, optical coherence tomography and ophthalmoscopy. Purtscher’s retinopathy is screened using funduscope. Fluorescein angiography is used for measuring the flow of blood to the eye. 
• Treatment: Laser surgery, vitrectomy, and injection of corticosteroids are the major methods used for treating diabetic retinopathy. Peripheral retinal ablation is done for treating retinopathy of prematurity. Anti-vascular endothelial growth factors and triamcinolone are used in the treatment of radiation retinopathy and purtscher’s retinopathy respectively. 

1. Federman JL, Gouras P, Schubert H, et al. Systemic diseases. In: Podos SM, Yanoff M, eds. Retina and Vitreous: Textbook of Ophthalmology. Vol 9. 1994:7-24.
2. Ashton N. Oxygen and the retinal blood vessels. Trans Ophthalmol Soc U K. Sep 1980;100(3):359-62.
3. Csak K, Szabo V, Szabo A, et al. Pathogenesis and genetic basis for retinopathy of prematurity. Front Biosci. Jan 1 2006;11:908-20.
4. Williams R, Airey M, Baxter H, Forrester J, Kennedy-Martin T, Girach A. Epidemiology of diabetic retinopathy and macular oedema: a systematic review. Eye (Lond). Oct 2004;18(10):963-83.
5. Benson WE, Tasman W, Duane TD. Diabetes mellitus and the eye. In: Duane's Clinical Ophthalmology. Vol 3. 1994.
6. Fielder AR, Shaw DE, Robinson J, et al. Natural history of retinopathy of prematurity: a prospective study.Eye. 1992;6 (Pt 3):233-42.
7. Quillen DA, Gardner TW, Blankenship GW. Clinical Trials in Ophthalmology: A Summary and Practice Guide. In: Kertes C, ed. diabetic retinopathy study. 1998:1-14.
8. Lajoie A, Koreen S, Wang L, et al. Retinopathy of prematurity management using single-image vs multiple-image telemedicine examinations. Am J Ophthalmol. Aug 2008;146(2):298-3.
9. Laser ROP Study Group. Laser therapy for retinopathy of prematurity. Arch Ophthalmol. Feb 1994;112(2):154-6.
10. Harrison P. Monthly Ranibizumab Improves Diabetic Retinopathy. Medscape Medical News. Sep 5 2013.