PATIENT EDUCATION
Diabetic Retinopathy
Diabetes can affect the retinal blood vessels before vision changes occur. Regular dilated examinations are one of the most important ways to prevent avoidable vision loss.
Sudden symptoms need urgent evaluation
Call immediately for a sudden shower of floaters, flashes, a curtain or shadow, severe blur, or sudden vision loss. Bleeding or retinal detachment from advanced diabetic eye disease can be painless.
HOW DIABETES AFFECTS THE EYE
Retinal changes may begin without symptoms
Diabetic retinopathy develops when chronically elevated blood sugar damages small retinal blood vessels. The vessels may leak, close off, or stimulate fragile new blood vessels. Anyone with type 1 or type 2 diabetes can develop diabetic retinopathy, and risk generally increases with duration of diabetes.
Nonproliferative retinopathy
The earlier stage. Small blood vessels may leak or become blocked. Severity ranges from mild to severe and may progress without noticeable symptoms.
Diabetic macular edema
Fluid leaks into the macula, causing swelling that may blur or distort central vision. It can occur at different stages of diabetic retinopathy.
Proliferative retinopathy
Abnormal new blood vessels grow on the retina. They can bleed into the vitreous, form scar tissue, and lead to tractional retinal detachment.
Possible symptoms
Early diabetic retinopathy often has no symptoms. As disease progresses, you may notice:
- Blurred or fluctuating vision
- Dark spots or floaters
- Difficulty seeing at night
- Colors appearing faded
- Blank or missing areas of vision
- Sudden loss of vision
Factors that affect risk
- How long you have had diabetes
- Blood-sugar control over time
- High blood pressure or cholesterol
- Kidney disease
- Pregnancy in someone with pre-existing diabetes
- Smoking
SCREENING
Do not wait for vision changes
A comprehensive dilated eye examination can identify diabetic changes before you notice them. People with type 2 diabetes should have an eye examination around the time of diagnosis. People with type 1 diabetes generally begin screening within several years of diagnosis. Many patients need at least yearly examinations, but your schedule may be more frequent based on retinal findings, pregnancy, treatment, or changes in diabetes control.
Tell your eye doctor if you are pregnant or planning pregnancy and have pre-existing diabetes. Retinal monitoring may need to occur before pregnancy or early in pregnancy and continue afterward.
WHAT TO EXPECT
How diabetic retinopathy is evaluated
Dilated retinal examination
Allows a detailed view of the macula, retinal blood vessels, and peripheral retina.
Retinal photography
Documents the appearance of the retina and helps compare changes over time.
Optical coherence tomography
OCT measures the retinal layers and detects macular swelling or fluid.
Additional imaging
Fluorescein angiography or OCT angiography may be used to evaluate leakage, blocked vessels, or abnormal new vessels.
TREATMENT
Treatment is based on the stage and threat to vision
Observation and systemic control
Early disease may be monitored. Blood sugar, blood pressure, cholesterol, kidney health, and smoking cessation remain important alongside eye care.
Medication injections
Anti-VEGF medicine can reduce macular swelling and abnormal blood-vessel growth. Steroid treatment is appropriate in selected situations.
Laser treatment
Laser may treat proliferative retinopathy or selected areas of leakage. The goal is to lower the risk of severe vision loss.
Vitrectomy surgery
Surgery may be needed for non-clearing vitreous hemorrhage, traction on the retina, or retinal detachment.
COMMON QUESTIONS
Diabetic eye disease FAQ
My vision is good—do I still need an exam?
Yes. Sight-threatening diabetic retinopathy can begin before you notice any change.
Can diabetic retinopathy be reversed?
Treatment can reduce leakage, control abnormal vessels, and lower the risk of further loss. Existing damage may not be fully reversible.
Is a routine glasses check enough?
A diabetic eye examination must include evaluation of the retina. Dilation and retinal imaging are used as appropriate.
PATIENT EDUCATION VIDEO
Learn more about diabetic retinopathy
This video provides general education and does not replace a dilated examination or individualized medical advice.
THE EYE CENTERS
Diabetes deserves regular retinal care
Schedule a dilated diabetic eye examination and keep the follow-up interval recommended for your retinal findings.