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Person with big purple hair covers one eye and looks out through the other, revealing a beam of veins and vision spots in her pathway.

Diabetic Retinopathy

The sense of sight is often regarded as the most valued and relied on of the 5 senses. If you have diabetes, you have a greater risk of developing eye disease which means your cherished sense of sight may become compromised. Doing activities of daily living (i.e. showering, dressing, preparing meals, managing medication, etc.) can be especially challenging and potentially impossible if your vision is impaired.

What is diabetic retinopathy?

Diabetic eye diseases include: diabetic retinopathy, diabetic macular edema, cataracts, and glaucoma.1 The focus of this article will be on diabetic retinopathy as it is the most common culprit of vision loss among those living with diabetes.1

Diabetic retinopathy is a microvascular complication of diabetes that affects the blood vessels in the tissue of the retina.1 The retina lines the back of the eye. Its light-sensitive tissue senses light and sends signals to your brain allowing you to see.2

The good news is, if diabetic retinopathy is caught and treated in the early stages, vision loss can be protected. 1

Four stages of diabetic retinopathy

Mild non-proliferative retinopathy

The earliest stage of retinopathy which involves “small areas of balloon-like swelling in the retina’s tiny blood vessels”. 1

Moderate non-proliferative retinopathy

Blood vessels responsible for nourishing the retina continue to swell and become deformed which may result in inadequate blood flow to the retina.

 Severe non-proliferative retinopathy

“Many more blood vessels are blocked, depriving blood supply to areas of the retina.”1 Such areas secrete growth factors that cue the retina to form new blood vessels.

Proliferative diabetic retinopathy

The advanced stage of retinopathy. New blood vessels, that have been formed as a result of growth factors being secreted, are fragile. These fragile blood vessels have a greater risk of leaking and bleeding.

Symptoms of diabetic retinopathy

Regular and timely screening is imperative due to the fact that a person in the early stages of diabetic retinopathy will typically have no symptoms.1 As diabetic retinopathy progresses the following symptoms may occur:2

  • Spots floating in your vision
  • Blurred vision
  •   Fluctuations in vision
  • Impaired color vision
  •   Dark areas in your vision
  •    Loss of vision

Screeening for diabetic retinopathy

An ophthalmologist or optometrist can detect diabetic retinopathy during a comprehensive eye exam. The 2019 Standards of Medical Care in Diabetes recommend the following protocol for screening:3

For people with type 2 diabetes, an initial comprehensive eye exam should be done at the time of diabetes diagnosis. Thereafter, screenings are typically done annually. However, if diabetic retinopathy is detected more frequent examinations will be necessary.

Risk factors for diabetic retinopathy

  • Duration of diabetes
  • Chronic hyperglycemia
  • Hypertension (high blood pressure)
  • Dyslipidemia (abnormal blood lipid levels)
  • Nephropathy (kidney disease)2

Prevention of diabetic retinopathy

  • Tight glycemic control
  • Lowering blood pressure
  • Normalizing blood lipids1

Treatment of diabetic retinopathy

The 2019 Standards of Medical Care in Diabetes recommend the following treatments:1,2,3

Photocoagulation surgery: Laser eye surgery to help slow the progression of leaking blood vessels.

Anti-vascular endothelial growth factor treatment: Injections that block growth factor from being released. The growth factor can stimulate the growth of new and abnormal blood vessels.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Type2Diabetes.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. National Eye Institute. Facts About Diabetic Eye Disease. https://nei.nih.gov/health/diabetic/retinopathy. Published September 2015. Accessed March 7, 2019
  2. Mayo Clinic. Diabetic Retinopathy. https://www.mayoclinic.org/diseases-conditions/diabetic-retinopathy/symptoms-causes/syc-20371611. Published May 18, 2018. Accessed March 7, 2019.
  3. American Diabetes Association. Diabetes Care 2019; 42(1): S124-S138. .https://doi.org/10.2337/dc19-S011

Comments

  • Christopher Hughes moderator
    4 weeks ago

    I’ve been neglecting a full comprehensive diabetic eye exam but going to get one tomorrow just in case. My diabetes is well controlled but I do know there could still be some unforeseen damage.

  • Thomas A McAtee Jr. moderator
    2 months ago

    Good article. Like it. Learned some new things tonight.

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