Retinopathy (eye)

Some people with diabetes develop serious complications with their eyes, called diabetic retinopathy. If you don’t get this treated properly, it can lead to sight loss. This is a frightening fact. Losing your sight could affect your career, your family life and your independence.

That’s why it’s vital that you know why you’re at risk of eye problems and what you can do to prevent them. And if eye complications do start to develop, they can nearly always be treated to avoid long-term problems – as long as they’re spotted and diagnosed in time. So you need to know the facts and what to look out for.

What is diabetic retinopathy and what causes it?

Diabetic retinopathy is an eye disease that people living with diabetes are more at risk of getting. If your blood sugar levels and blood pressure are consistently high, you can seriously damage your blood vessels.  And there are lots of important blood vessels in your eyes. These vessels help supply blood to the seeing part of the eye (called the retina). When these blood vessels are damaged, they can get blocked, leak or grow randomly. This means the retina can’t get the blood it needs and so can’t work properly. Which means you won’t be able to see properly. There are lots of things you can do to keep your blood sugars and your blood pressure in your target range. And the more you do this, the lower your risk of developing serious problems with your eyes.

What are the symptoms of diabetic eye disease?

Often there are no early symptoms of diabetic eye disease. You may have no pain and no change in your vision as damage begins to grow inside your eyes, particularly with diabetic retinopathy. When symptoms do occur, they may include:

  • blurry or wavy vision
  • frequently changing vision—sometimes from day to day
  • dark areas or vision loss
  • poor color vision
  • spots or dark strings (also called floaters)
  • flashes of light
Diabetic retinopathy may progress through four stages
  1. Mild nonproliferative retinopathy. Small areas of balloon-like swelling in the retina’s tiny blood vessels, called microaneurysms, occur at this earliest stage of the disease. These microaneurysms may leak fluid into the retina.
  2. Moderate nonproliferative retinopathy. As the disease progresses, blood vessels that nourish the retina may swell and distort. They may also lose their ability to transport blood. Both conditions cause characteristic changes to the appearance of the retina and may contribute to DME.
  3. Severe nonproliferative retinopathy. Many more blood vessels are blocked, depriving blood supply to areas of the retina. These areas secrete growth factors that signal the retina to grow new blood vessels.
  4. Proliferative diabetic retinopathy (PDR). At this advanced stage, growth factors secreted by the retina trigger the proliferation of new blood vessels, which grow along the inside surface of the retina and into the vitreous gel, the fluid that fills the eye. The new blood vessels are fragile, which makes them more likely to leak and bleed. Accompanying scar tissue can contract and cause retinal detachment—the pulling away of the retina from underlying tissue, like wallpaper peeling away from a wall. Retinal detachment can lead to permanent vision loss.
What is diabetic macular edema (DME)?

DME is the build-up of fluid (edema) in a region of the retina called the macula. The macula is important for the sharp, straight-ahead vision that is used for reading, recognizing faces, and driving. DME is the most common cause of vision loss among people with diabetic retinopathy. About half of all people with diabetic retinopathy will develop DME. Although it is more likely to occur as diabetic retinopathy worsens, DME can happen at any stage of the disease.

Talk with your eye doctor if you have any of these symptoms.