What is diabetic retinopathy?

Many people with diabetes develop a problem with their eyes called diabetic retinopathy. Diabetes damages the small blood vessels in the retina. This is the part of the eye that captures images and sends the information to your brain. Diabetic retinopathy can lead to poor vision and even blindness. You can help avoid damage to the retina by keeping your blood sugar and blood pressure levels near normal. This can slow the progress of retinopathy and prevent vision loss.

Diabetic retinopathy is a progressive condition. During the early stage, the tiny blood vessels in the eye weaken. The blood vessels develop small bulges that may burst and leak into the retina and into the gel-like fluid inside the eye called the vitreous gel.

As the condition progresses, new fragile blood vessels grow on the surface of the retina. This is called proliferative retinopathy. These abnormal blood vessels may break easily, bleeding into the middle of the eye and clouding vision. This bleeding can also cause scar tissue to form, which can pull on the retina and cause the retina to detach from the wall of the eye.

What causes diabetic retinopathy?

Diabetic retinopathy develops when high blood sugar damages the tiny blood vessels of the retina. These blood vessels weaken and develop small bulges, which may burst and leak into the retina. Later, new fragile blood vessels grow on the surface of the retina that may break and bleed into the eye, clouding vision and causing scar tissue to form.

What are the symptoms?

Symptoms occasionally occur early in the disease, but typically they are not noticed until significant damage has occurred and complications have developed. Regular screening exams can identify diabetic retinopathy early in the disease and can help prevent vision loss.

Complications of diabetic retinopathy include swelling in the central part of the retina (macular edema) and retinal detachment. If the disease progresses, permanent damage to the retina and other parts of the eye can develop, leading to severe vision loss or blindness.

How is diabetic retinopathy diagnosed?

Regular screening for eye disease can detect retinopathy before it damages vision. You may not notice symptoms until the disease becomes severe or a complication develops.

The American Diabetes Association recommends screening starting at age 10 or within 3 to 5 years after diagnosis of type 1 diabetes, immediately after diagnosis of type 2 diabetes, and during the first 3 months of pregnancy for a woman who has diabetes. Some experts recommend that an eye exam be done immediately after a person is diagnosed with type 1 diabetes.

People with diabetes should have their eyes examined by an ophthalmologist every year, even if they do not have symptoms of eye disease. However, a decision may be made that you should be examined more or less often, depending on the results of your initial exam.

Many people with diabetes do not have yearly eye exams to check for diabetic retinopathy (or other eye diseases caused by diabetes). As a result, they do not find out that they have the condition until significant vision loss is likely to occur or has already occurred.

Can diabetic retinopathy be prevented?

You can prevent vision loss due to diabetic retinopathy by keeping your blood sugar levels and blood pressure near normal. This can help lower your chance of developing damage to small blood vessels, which decreases the risk of damage to the retina. It can also help slow the progression of retinopathy, if it is already present, and prevent future vision loss.

Experts believe that many cases of vision loss and blindness could be prevented with early detection and treatment and careful long-term follow-up care. ¹

How is it treated?

Laser treatment (photocoagulation) is usually very effective in preventing vision loss if it is done before the retina has been severely damaged. Surgical removal of the vitreous gel (vitrectomy) may also help improve vision if the retina has not been severely damaged. At this time, there is no cure for diabetic retinopathy.