What is Diabetic Retinopathy? Understanding Causes, Symptoms, and Treatments

What is Diabetic Retinopathy?

Ever wondered what diabetic retinopathy is? Well, it’s a serious eye condition linked to diabetes, and it can really mess with your vision if not managed properly. In this post, we’ll dive into the nitty-gritty of diabetic retinopathy, from its causes and symptoms to the latest treatments available. So, let’s get started and shed some light on this important topic.

Can Diabetes Cause Blindness?

Yes, unfortunately, chronic, uncontrolled diabetes can lead to blindness. Diabetes, a condition that prevents the body from using and storing sugar properly, results in excessive sugar levels in the bloodstream. This high sugar concentration causes damage to the smallest blood vessels all over the body, including those in your eyes.

How Does Diabetic Retinopathy Develop?

Diabetes damages the small blood vessels throughout the body, including the tiny capillaries in the retina. Eventually, these tiny blood vessels leak blood and other fluids into the eye, causing the retinal tissue to swell. This leads to cloudy or blurred vision. As these blood vessels are damaged, new abnormal blood vessels are produced. These new vessels are fragile and even more susceptible to leaking and bleeding fluid into the eye.

Moreover, diabetes also affects the focusing lens of the eyes. When blood sugar remains high for long periods, fluid accumulates inside the focusing lens, leading to changes in the curvature of the lens and blurry vision. However, if blood sugar levels are controlled, the lens will usually return to its normal curvature, and vision improves.

Types of Diabetic Retinopathy

There are three main types of diabetic retinopathy:

Non-Proliferative Retinopathy (NPR)

Also called Background Retinopathy, this is the earliest stage. In this stage, high blood sugar concentration in the retina causes microaneurysms, in which damage to the walls of the tiny retinal capillaries occurs. Microaneurysms eventually rupture and bleed, causing “dot-and-blot” hemorrhages.

Proliferative Retinopathy (PR)

This is the more severe form. In this stage, abnormal blood vessels begin to grow in the retina. If these new blood vessels break, it can trigger bleeding into the vitreous, the gelatinous matter that fills the eye, causing retinal scarring, severe vision difficulties, and even blindness.

Diabetic Macular Edema (DME)

This is a complication of diabetic retinopathy. DME occurs when damaged blood vessels leak fluid into the macula, the part of the retina responsible for sharp central vision that allows you to see fine details. DME may cause blurry or wavy vision, blind spots, and cause colors to appear dull. These symptoms can impact reading, writing, driving, and facial recognition.

Symptoms of Diabetic Retinopathy

Diabetic retinopathy usually does not present symptoms in its early stages, so by the time the symptoms are noted, it’s essential to seek medical care. Symptoms can include:

  • Blurry or cloudy vision
  • Double vision
  • Seeing floaters
  • Increasing scotomas (dark spots)
  • Near vision difficulty
  • Poor night vision

How is Diabetic Retinopathy Diagnosed?

Regular comprehensive eye exams are crucial for people with diabetes to detect signs of the disease even before symptoms are noticed. Many diabetic eye exams will include the following tests:

  • Patient history to determine vision difficulties, presence of diabetes, and other general health concerns.
  • Visual acuity measurements to determine the visual acuity.
  • Refraction to determine if a new optical prescription is required.
  • Evaluation of the ocular structures through a dilated pupil.
  • Measurement of eye pressure within the eye.

Special diagnostic tools used to identify any signs of damage in your retina include:

  • Fluorescein Angiography: This test provides a definitive diagnosis of diabetic retinopathy. A dye is injected into your arm through an IV, and is illuminated in the blood vessels of the retina to detect any changes or fluid leakage.
  • Optical Coherence Tomography (OCT) Scan: A non-invasive tool that obtains high-resolution colored images of the retina’s layers, accurately detecting any changes or fluid leakage.

How is Diabetic Retinopathy Treated?

Treatment for diabetic retinopathy depends on the stage of the disease. In the early stages of non-proliferative diabetic retinopathy, regular monitoring is crucial. Consuming a healthy diet, getting regular exercise, and controlling your blood sugar levels can all help to control the progression of the disease.

Treatment Methods Include:

Anti-Vascular Endothelial Growth Factor (Anti-VEGF) Treatments

These treatments block the protein that causes blood vessels to leak fluid and abnormal blood vessels to grow. Anti-VEGF medication is administered by eye injections using a tiny needle. Types of anti-VEGF medications include Avastin (bevacizumab), Lucentis (ranibizumab), and Eylea (aflibercept).

Laser Photocoagulation

This involves sealing the blood vessels that are leaking into the eye, thereby inhibiting abnormal blood vessel growth. A laser beam creates small burns in areas of the retina with abnormal blood vessels to seal them.

Pan-Retinal Photocoagulation

A laser procedure on the peripheral retina used to maintain unaffected vision by destroying tissue on the outside of the retina, increasing blood supply to the inner retina.


This procedure removes the blood that has leaked into the vitreous humor. It is generally performed if all other treatments were ineffective.

Risk Factors for Diabetic Retinopathy

The longer you have had diabetes, the higher your risk of developing diabetic retinopathy. Other factors that may increase your risk include:

  • Type 1 or type 2 diabetes
  • Gestational diabetes
  • Poorly controlled diabetes
  • Hispanic or African American descent
  • High blood pressure
  • High cholesterol


Follow these recommendations to help reduce your risk of the disease, as well as control its progression:

  • Take medication as prescribed
  • Control blood sugar levels
  • Consume a healthy diet
  • Avoid excessive alcohol
  • Quit smoking
  • Get regular exercise
  • Schedule routine eye exams

If you or a loved one has been diagnosed with diabetes, it’s crucial to schedule annual comprehensive eye exams to monitor any changes in your ocular health and enable early detection of disease. Early detection of diabetic eye changes is a key factor in both controlling and treating diabetic retinopathy.