People with diabetes can have an eye disease called diabetic retinopathy. This is when high blood sugar levels cause damage to blood vessels in the retina. These blood vessels can swell and leak. Or they can close, stopping blood from passing through. Sometimes abnormal, new blood vessels grow on the retina. All of these changes can steal your vision.

Video: What Is Diabetic Retinopathy?

The Two Stages of Diabetic Eye Disease

There are two main stages of diabetic eye disease.

NPDR (non-proliferative diabetic retinopathy)

This is the early stage of diabetic eye disease and is caused by leaky blood vessels. Many people with diabetes have it.

With NPDR, tiny blood vessels leak, making the retina swell. When the macula swells, it is called macular edema. This is the most common reason why people with diabetes lose their vision. Sometimes tiny particles called exudates can form in the retina. These can affect your vision too.

When blood vessels close off, this is called macular ischemia. When that happens, blood cannot reach the macula. 

If you have NPDR, your vision will be blurry.

PDR (proliferative diabetic retinopathy)

PDR is the more advanced stage of diabetic eye disease. It happens when the retina starts growing new blood vessels. This is called neovascularization. These fragile new vessels often bleed into the vitreous. If they only bleed a little, you might see a few dark floaters. If they bleed a lot, it might block all vision.

These new blood vessels can form scar tissue. Scar tissue can cause problems with the macula or lead to a detached retina.

PDR is very serious, and can steal both your central and peripheral (side) vision.

Video: Vitreous Hemorrhage

What Happens When You Have Diabetic Retinopathy?

You can have diabetic retinopathy and not know it. This is because it often has no symptoms in its early stages. As diabetic retinopathy gets worse, you will notice symptoms such as:

• more floaters
• blurry vision
• vision that changes sometimes from blurry to clear
• blank or dark areas in your field of vision
• poor night vision
• colors appearing faded or washed out
• loss of vision

Diabetic retinopathy symptoms can affect both eyes.

Diabetic Retinopathy Diagnosis

Drops will be put in your eye to dilate (widen) your pupil. This allows your ophthalmologist to look through a special lens to see the inside of your eye.

Your doctor may do optical coherence tomography (OCT) to look closely at the retina. A machine scans the retina and provides detailed images of its thickness. This helps your doctor find and measure swelling of your macula.

Fluorescein angiography or OCT angiography helps your doctor see what is happening with the blood vessels in your retina. Fluorescein angiography uses a yellow dye called fluorescein, which is injected into a vein (usually in your arm). The dye travels through your blood vessels. A special camera takes photos of the retina as the dye travels throughout its blood vessels. It shows if any blood vessels are blocked or leaking fluid. It also shows if any abnormal blood vessels are growing. OCT angiography is a newer technique and does not need dye to look at the blood vessels. But it does not provide as much information as fluorescein angiography.

Can Diabetic Retinopathy Go Away?

Your treatment is based on what your ophthalmologist sees in your eyes. Treatment options may include:

Medical control

Controlling your blood sugar and blood pressure can stop vision loss. Carefully follow the diet your nutritionist has recommended. Take the medicine your diabetes doctor prescribed for you. Sometimes, good sugar control can even bring some of your vision back. Controlling your blood pressure keeps your eye’s blood vessels healthy.

Medicine

One class of medication is called anti-VEGF. These include Avastin, Eylea, and Lucentis. They help reduce swelling of the macula, slowing vision loss and perhaps improving vision. These drugs are given by injections (shots) in the eye. Steroid medicine is another option to reduce macular swelling. This is also given as injections in the eye. Your doctor will recommend how many medication injections you will need based on your response to treatment.

Video: How Are Eye Injections Done?

Laser surgery

Laser surgery might be used to seal off leaking blood vessels. This can reduce swelling in the retina. Laser surgery can also help shrink blood vessels and prevent them from growing again. Often, more than one treatment is needed.

Video: How Is Laser Treatment for Macular Edema Done?

Vitrectomy

If you have advanced PDR, your ophthalmologist may recommend surgery called vitrectomy. Your ophthalmologist removes vitreous gel and blood in the back of your eye. This allows light rays to focus properly on the retina again. Scar tissue also might be removed from the retina and laser may be used at the time of surgery. 

5 Ways to Prevent Vision Loss from Diabetic Retinopathy

• If you have diabetes, talk with your primary care doctor about controlling your blood sugar. High blood sugar damages retinal blood vessels. That causes vision loss.
• Do you have high blood pressure or kidney problems? Ask your doctor about ways to manage and treat these problems.
• See your ophthalmologist regularly for dilated eye exams. Diabetic retinopathy may be found before you even notice any vision problems.
• If you notice vision changes in one or both eyes, call your ophthalmologist right away.
• Get treatment for diabetic retinopathy as soon as possible. This is the best way to prevent vision loss.

Do You Have Diabetes and Need an Eyeglasses Exam?

Changes in blood sugar levels can affect your vision. Make sure your blood sugar is under control for at least a week before an eye exam. Eyeglasses prescribed when your blood sugar levels are stable work best!