Diabetic Retinopathy

Key Points

Overview

Commonly affected areas:

Diabetic retinopathy is an eye condition caused by long-term high blood sugar damaging the tiny blood vessels of the retina, the light-sensitive layer at the back of the eye. In the early, non-proliferative stage, vessels weaken, bulge and leak fluid or blood. In the advanced, proliferative stage, fragile new vessels grow on the retina and can bleed into the eye or form scar tissue that pulls the retina away. Fluid collecting in the macula, called diabetic macular edema, can blur central vision at any stage. Because early disease is usually painless and silent, regular eye screening is the key to catching it in time.

Signs and Symptoms

People with diabetic retinopathy may experience:

• No noticeable symptoms at all in the early stages of the disease
• Blurred or fluctuating vision that may change with blood sugar levels
• Dark spots, strings or floaters drifting across the field of vision
• Difficulty seeing clearly at night or in low light
• Faded or washed-out colours
• Sudden, severe vision loss if bleeding occurs inside the eye

Things That Increase the Risk

Your risk of diabetic retinopathy is higher if you have:

• Had diabetes for many years
• Poorly controlled blood sugar levels
• High blood pressure
• High cholesterol
• Kidney disease related to diabetes
• Pregnancy while living with diabetes

Diagnosis

Diagnosis typically involves:

• Dilated eye examination of the retina
• Retinal (fundus) photography
• Optical coherence tomography (OCT) scan of the macula
• Fluorescein angiography to show leaking vessels
• Visual acuity and eye pressure testing

Treatment & Management

• Keep blood sugar within your target range
• Take blood pressure and cholesterol medicines as prescribed
• Stop smoking
• Attend every scheduled eye check-up

• Anti-VEGF or steroid eye injections
• Laser photocoagulation
• Vitrectomy surgery for bleeding or retinal detachment
• Ongoing monitoring with retinal scans

Prevention

To lower your risk:

Diabetic retinopathy cannot always be prevented, but the risk of serious vision loss can be greatly reduced with good diabetes control and regular screening.

• Have a dilated eye exam at least once a year
• Keep blood sugar, blood pressure and cholesterol under control
• Avoid smoking
• Get your eyes checked early during pregnancy if you have diabetes
• Report any change in vision promptly

Related Conditions

You might also want to learn about:

• Diabetic Macular Edema
• Glaucoma
• Cataract
• Diabetic Nephropathy