Diabetes Treatment & Therapy

Diabetic Retinopathy: Causes, Symptoms, and Stages

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While many men and women are familiar with diabetes, only a very few are acquainted with Diabetic Retinopathy. Diabetic retinopathy refers to the diabetic complication responsible for causing changes in the blood vessels of the retina.

These blood vessels may swell, leak, or start growing on the retina surface, depending on your condition. Even though it may create only mild vision issues at the beginning, Diabetic Retinopathy can lead to blindness as well. The good news is that you can easily prevent this with routine checkups and diabetes management.

Diabetic Retinopathy
  • Diabetic Retinopathy is the number one reason responsible for causing preventable blindness in working-age adults.
  • 80% of diabetic patients (both type 1 and type 2) are likely to develop diabetic retinopathy.
  • Men and women suffering from diabetes must have their vision checked at least once in a year.
  • Symptoms of diabetic retinopathy often include blurred vision, floaters, difficulty seeing colors, loss of central vision, etc.
  • Even though retinal surgeries can help in getting relief from the symptoms, managing diabetes is the key to prevent diabetic retinopathy.

What is Diabetic Retinopathy?

Diabetic retinopathy is a diabetic complication that occurs as a result of damaged blood vessels of the retina. This condition is often observed in patients suffering from type 1 and type 2 diabetes. Patients having uncontrolled high blood sugar levels are more prone to developing this condition.


Diabetic retinopathy usually starts with mild vision issues and can cause blindness if not diagnosed and treated on time. However, it takes several years for diabetes patients to reach the stage where they would completely lose their vision.


The high amount of blood sugar blocks the blood vessels responsible for nourishing the eyes. Once the blood supply is cut off, eyes attempt to form new blood vessels. As these vessels don’t form properly and leak, you suffer from diabetic retinopathy.

Who Is At The Risk of Getting Diabetic Retinopathy?

Anyone with a prolonged history of uncontrolled high blood sugar is at the risk of developing diabetic retinopathy. This diabetic condition can happen to both type 1 and type 2 patients. However, you might be at a greater risk of developing this if you have:

  • High blood pressure
  • High cholesterol levels
  • Are pregnant
  • No control over blood sugar over time

Those who can keep their blood sugar level and cholesterol under control are less likely to develop diabetic retinopathy.  

What Is The Reason Behind Diabetic Retinopathy?

Human eyes have retina which changes images into nerve signals so that the brain can understand it at ease. When you have high blood sugar, the excess sugar damages the blood vessels supplying your retina with blood.

Once these blood vessels are damaged, your retina doesn’t get the usual blood supply. Other weak blood vessels start to grow because of this reason.

Chances are high that these new vessels will leak and therefore cause scar tissue. Patients having diabetes for more than 30 years are more likely to develop diabetic retinopathy. The only way to slow down the progression is to keep your diabetes under control and have your eyes checked at least once in a year.

What Are The Symptoms of Diabetic Retinopathy?

Most of the patients report that there is no significant symptom of diabetic retinopathy during the early stages. Symptoms become stronger when a major damage happens inside your eyes. Monitoring your eye health and keeping blood sugar levels down is the only way to prevent your eyes from being damaged. Some of the most common symptoms that appear in both eyes include:

  • Floaters and dark spots
  • Challenges in seeing at night
  • Loss of vision
  • Difficulty in distinguishing colors
  • Blurred vision
  • Eye pain or redness

What Are The Stages of Diabetic Retinopathy?

Diabetic retinopathy often has four stages i.e. Mild Nonproliferative Retinopathy, Moderate Proliferative Retinopathy, Severe Nonproliferative Retinopathy, and Proliferative Retinopathy. Nonproliferative retinopathy refers to the condition when the damaged blood vessels leak blood and fluid into the eye. Proliferative retinopathy happens when the new blood vessels start growing within your retina.

Mild Proliferative Retinopathy

Moderate Nonproliferative Retinopathy

Severe Nonproliferative Retinopathy

Proliferative Retinopathy

What Are The Complications Related to Diabetic Retinopathy?

Since diabetic retinopathy involves growth or blood vessels in your retina, it may lead to severe complications which may cause several vision problems. Some of these complications are:

Vitreous Hemorrhage

Vitreous Hemorrhage happens when the blood vessels bleed into the jelly-like substance located at the center of the eyes. You might be seeing floaters or dark spots if the amount of bleeding is little. However, more bleeding can fill the vitreous cavity and therefore block your vision. Vitreous Hemorrhage may not cause permanent vision loss unless the retina is damaged.

Detached Retina

Diabetic retinopathy often stimulates the growth of scar tissue because of which the retina can be pulled away from the back of your eyes. This may cause floating spots or flashes of light in your vision.

Glaucoma

Glaucoma happens when the blood vessels start growing in the front section of your eyes. These vessels often disturb the normal fluid flow and therefore cause pressure in your eyes. This pressure may damage your nerve responsible for carrying images from the eyes to the brain.

Diabetic Retinopathy

Diabetic retinopathy and healthy eye. The eye condition that affect people with diabetes.

How Can You Prevent Diabetic Retinopathy?

The easiest way to prevent diabetic retinopathy is to go for regular eye examination, keeping blood sugar levels under control, and treating vision problems at an early stage. Here are some of the things that you can do to control the diabetic retinopathy:

  • Diabetes Management: Managing diabetes is the key to preventing diabetic retinopathy. You must make sure that you follow a healthy eating plan along with regular physical activities including aerobic exercises and brisk walking. Also, don’t forget to take oral medications or insulin as prescribed by your doctor.
  • Monitoring Blood Sugar Levels: If you have been suffering from high blood sugar for some time, you should be monitoring it several times a day. Your doctor will be able to help you with these measurements.
  • Glycosylated Hemoglobin Test: The Hemoglobin A1C test can accurately tell you about the average blood sugar level before 2-3 months of the test. If the A1C is under 7%, you are safe.
  • Blood Pressure and Cholesterol: Another important thing to do is to keep blood pressure and cholesterol under control. Being on a healthy meal plan and regular exercise can help you to a significant extent.
  • Quit Smoking: If you have been a smoker for most of your life, this is the time to quit. Smoking often leads to numerous diabetic complications.
  • Vision Changes: You need to pay attention to even the slightest vision changes. If you experience sudden vision changes, please consult with your doctor immediately.

What Is The Treatment For Diabetic Retinopathy?

Depending on the condition of your eyes, your doctor will conduct a comprehensive dilated examination of your eyes. However, you will need treatment right away if your eyes are in serious condition.

If you have been experiencing blurred vision or changes in vision, immediate treatment will help your vision from getting to a worse state. Here are some of the common treatments used for patients suffering from diabetic retinopathy:

1

Anti-VEGF Injections

Anti-VEGF drugs are often used to slow down the diabetic retinopathy. It can also reverse the condition. Doctors often use another medicine named corticosteroids to treat diabetic retinopathy.

2

Photocoagulation Surgery

Photocoagulation surgery is one of the most effective treatments that prevent loss of vision. During this surgery, your doctor will be using a laser to stop or control the leakage by sealing the vessels. There are three types of photocoagulation surgery i.e. scatter photocoagulation, focal photocoagulation, and vitrectomy.


In Scatter photocoagulation, hundreds of little holes are burnt two or more times using the laser. Focal photocoagulation allows you to get rid of a specific leaky vessel which otherwise would have made the macular edema worse. In the vitrectomy method, all the scar tissues and cloudy fluid are removed.

Key Takeaways:

  • Keep blood sugar and cholesterol under control.
  • Visit the doctor for a comprehensive eye examination at least once in a year.
  • Follow healthy diet plans along with moderate physical activities.
  • Keep an eye on even the slightest change in vision and report the same to your doctor.

Dr. Shin Fen Chow is an American Board of internal medicine certified doctor and a dedicated and diligent internist serving the community of West Orange. Dr. Chow obtained her medical degree from the University of Columbia and then completed her residency in internal medicine at Mayo Clinic, Rochester. She is a part of BHMG- center for Asian health and received many awards and scholarships like Dr. Charles F. Hamilton award in pulmonary medicine and Mead university scholarship from Columbia University in 1991 and 1987 respectively.

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