Diabetic Retinopathy

Topic Overview

What is diabetic retinopathy?

Retinopathy is a disease of the retina. The retina is the nerve layer that lines the back of your eye. It is the part of your eye that "takes pictures" and sends the images to your brain. Many people with diabetes get retinopathy. This kind of retinopathy is called diabetic retinopathy (retinal disease caused by diabetes).

Diabetic retinopathy can lead to poor vision and even blindness. Most of the time, it gets worse over many years. At first, the blood vessels in the eye get weak. This can lead to blood and other liquid leaking into the retina from the blood vessels. This is called nonproliferative retinopathy. And this is the most common retinopathy. If the fluid leaks into the center of your eye, you may have blurry vision. Most people with nonproliferative retinopathy have no symptoms.

If blood sugar levels stay high, diabetic retinopathy will keep getting worse. New blood vessels grow on the retina. This may sound good, but these new blood vessels are weak. They can break open very easily, even while you are sleeping. If they break open, blood can leak into the middle part of your eye in front of the retina and change your vision. This bleeding can also cause scar tissue to form, which can pull on the retina and cause the retina to move away from the wall of the eye (retinal detachment). This is called proliferative retinopathy. Sometimes people don't have symptoms until it is too late to treat them. This is why having eye exams regularly is so important.

Retinopathy can also cause swelling of the macula of the eye. This is called macular edema. The macula is the middle of the retina, which lets you see details. When it swells, it can make your vision much worse. It can even cause legal blindness.

What causes diabetic retinopathy?

If you are not able to keep your blood sugar levels in a target range, it can cause damage to your blood vessels. Diabetic retinopathy happens when high blood sugar damages the tiny blood vessels of the retina.

When you have diabetic retinopathy, high blood pressure can make it worse. High blood pressure can cause more damage to the weakened vessels in your eye, leading to more leaking of fluid or blood and clouding more of your vision.

What are the symptoms?

Most of the time, there are no symptoms of diabetic retinopathy until it starts to change your vision. When this happens, diabetic retinopathy is already severe. Having your eyes checked regularly can find diabetic retinopathy early enough to treat it and help prevent vision loss.

If you notice problems with your vision, call an eye doctor (ophthalmologist) right away. Changes in vision can be a sign of severe damage to your eye. These changes can include floaters, pain in the eye, blurry vision, or new vision loss.

How is diabetic retinopathy diagnosed?

An eye exam by an eye specialist (ophthalmologist or optometrist) is the only way to detect diabetic retinopathy. Having a dilated eye exam regularly can help find retinopathy before it changes your vision. On your own, you may not notice symptoms until the disease becomes severe.

Can diabetic retinopathy be prevented?

You can lower your chance of damaging small blood vessels in the eye by keeping your blood sugar levels and blood pressure levels within a target range. If you smoke, quit. All of this reduces the risk of damage to the retina. It can also help slow down how quickly your retinopathy gets worse and can prevent future vision loss.

If you have a dilated eye exam regularly, you and your doctor can find diabetic retinopathy before it has a chance to get worse. For most people, this will mean an eye exam every year. Finding retinopathy early gives you a better chance of avoiding vision loss and blindness.

How is it treated?

Surgery, laser treatment, or medicine may help slow the vision loss caused by diabetic retinopathy. You may need to be treated more than once as the disease gets worse.

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