Diabetic Retinopathy

What is Diabetic Retinopathy?

When long-term diabetes causes progressive damage to the eye's retina, this condition is referred to as Diabetic Retinopathy. It is the most common diabetic eye disease that occurs when blood vessels in the retina change. Sometimes these vessels swell and leak fluid or even close off completely. In other cases, abnormal new blood vessels grow on the surface of the retina. There are two stages of Diabetic Retinopathy: Nonproliferative diabetic retinopathy (NPDR) and Proliferative diabetic retinopathy (PDR). NPDR is an early stage of Diabetic Retinopathy in which damaged blood vessels in the retina begin to leak extra fluid and small amounts of blood into the eye. Sometimes, deposits of cholesterol or other fats from the blood may leak into the retina. Diabetic Retinopathy is the leading cause of blindness in working-age Americans.

What Causes Diabetic Retinopathy?

The disease occurs when blood-sugar levels are high for extended periods of time, it can cause damage to the capillaries (tiny blood vessels) that supply blood to the retina. Over time, these blood vessels begin to leak fluids and fats, causing edema (swelling). Eventually, these small blood vessels can close off (called ischemia). These problems are a sign of NPDR and can lead to vision problems if existing blood vessels leak fluid into the retina. PDR can lead to visual disruption if abnormal new blood vessels hemorrhage and leak fluid.

As diabetic eye problems are left untreated, PDR can develop. Blocked blood vessels from ischemia can lead to the growth of new abnormal blood vessels on the retina (called neovascularization) which can damage the retina by causing wrinkling or retinal detachment. Neovascularization can even lead to glaucoma, damage to the optic nerve that carries images from your eye to your brain.


What are the Symptoms of Diabetic Retinopathy?

  • There Often are No Symptoms at First
  • Decreased Visual Acuity
  • Seeing Floating Spots, dots or cobweb-like dark strings floating in your vision(Floaters)
  • Vision changes periodically from blurry to clear
  • Blank or dark areas in your field of vision
  • Colors appear washed out or different
  • Vision loss
  • Vision Change in Only One Eye
  • Vision Changes Lasting More than a Few Days
  • Decreased Visual Acuity
  • Blurred Vision
  • Vision Changes Not Associated with a Change in Blood Sugar

How is Diabetic Retinopathy Detected?

The only way to detect diabetic retinopathy and to monitor its progression is through a comprehensive eye exam

There are several parts to the exam:

  • Visual acuity test
  • Slit-lamp exam
  • Dilated exam
  • Fluorescein angiography
  • Optical coherence tomography (OCT)
  • Ultra Sound

Who is Most at Risk?

People with both Type 1 and Type 2 diabetes are at risk as well as women with gestational diabetes.

Several factors can influence the development and severity of diabetic retinopathy, including:

  • Blood sugar levels
  • Blood pressure
  • Duration of diabetes
  • Blood lipid levels (cholesterol and triglycerides)
  • Ethnicity
  • Pregnancy

How is Diabetic Retinopathy Treated?

Treatment of diabetes is also considered treatment for Diabetic Retinopathy. The best treatment for diabetic retinopathy is to prevent it. Strict control of blood sugar will significantly reduce the long-term risk of vision loss. Treatment usually won't cure diabetic retinopathy nor does it usually restore normal vision, but it may slow the progression of vision loss.

Retinopathy Laser surgery can be used to treat Diabetic retinopathy. It shrinks abnormal new vessels and reduces macular swelling.

How can Diabetic Retinopathy Be Prevented?

Management of diabetes is the best way to prevent vision loss. Yearly diabetic retinopathy screenings with a dilated eye exam is important to detection in the early stages. If pregnant, it is recommended to have regular eye exams throughout the pregnancy, because pregnancy can sometimes worsen diabetic retinopathy.

This document is provided for informational purposes only. Please consult an eye care professional about symptoms that may require medical attention and may or may not be covered by your medical plan and/or routine vision plan.

Sources: American Academy of Ophthalmology (AAO) -

Kd: Diabetic Retinopathy 10-13