Diabetic retinopathy is a serious eye condition that develops as a complication of diabetes. It occurs when prolonged high blood sugar levels damage the tiny blood vessels in the retina—the light-sensitive tissue at the back of your eye responsible for visual clarity. Over time, this damage can lead to vision impairment or even blindness if left untreated.

This condition is one of the leading causes of vision loss among adults globally. Nearly one-third of people with diabetes develop some form of diabetic retinopathy. With diabetes rates rising worldwide, experts estimate that by 2040, approximately 224 million individuals will be affected by this eye disease.

Common Symptoms

Diabetic retinopathy typically develops slowly and may not cause noticeable symptoms during the early stages. As the disease progresses, symptoms begin to appear and may include:

  • Blurry vision

  • Difficulty seeing at night or in dim lighting

  • Seeing floaters (tiny spots or strings)

  • Blank or dark patches in your field of vision

  • Colors appearing faded

  • Gradual or sudden vision loss

These visual changes occur as damaged retinal blood vessels leak fluid or bleed, causing swelling and scarring.

What Causes It

Diabetic retinopathy is caused by prolonged periods of elevated blood glucose levels. In people with diabetes, the pancreas either doesn't produce enough insulin or the body cannot effectively use the insulin produced. This leads to excess sugar remaining in the bloodstream, which over time damages blood vessels throughout the body, including those in the eyes.

The small blood vessels in the retina are especially vulnerable. Damage may result in leakage, swelling, or abnormal growth of new, fragile blood vessels. These changes impair the retina’s ability to function correctly and threaten your vision.

Key Risk Factors

While anyone with type 1 or type 2 diabetes is at risk, several additional factors can increase the likelihood of developing diabetic retinopathy:

  • Duration of diabetes – The longer you’ve had diabetes, the higher the risk.

  • Poor blood sugar control – Uncontrolled glucose levels accelerate eye damage.

  • High blood pressure (hypertension)

  • High cholesterol levels

  • Kidney disease

  • Smoking

  • Pregnancy (in women with pre-existing diabetes)

  • Family history of diabetic eye disease

Certain ethnic groups, such as African Americans and Hispanics, are at greater risk due to higher incidences of diabetes and hypertension.

How It’s Diagnosed

Diagnosing diabetic retinopathy typically begins with a comprehensive annual eye exam performed by an ophthalmologist or optometrist. Tests include:

  • Dilated eye exam: Eye drops dilate the pupils, allowing the doctor to examine the retina for signs of damage.

  • Fluorescein angiography: A dye is injected into your arm, and special cameras track its movement through retinal blood vessels to detect leaks or abnormalities.

  • Optical coherence tomography (OCT): This imaging test uses light waves to capture detailed cross-sectional images of the retina, helping to assess fluid buildup and retinal thickness.

Early diagnosis is critical in preventing vision loss.

Stages of the Disease

Diabetic retinopathy progresses through two primary stages:

1. Non-Proliferative Diabetic Retinopathy (NPDR): This early stage involves swelling and leakage from weakened blood vessels. Microaneurysms form, and the macula (the center of the retina responsible for sharp vision) may swell, leading to blurred vision.

2. Proliferative Diabetic Retinopathy (PDR): This more advanced stage involves the growth of abnormal blood vessels on the surface of the retina. These fragile vessels may bleed into the vitreous (gel in the eye), cause scar tissue, and lead to retinal detachment, glaucoma, or permanent vision loss.

Available Treatment Options

Although there is no definitive cure for diabetic retinopathy, various treatments can prevent or slow down its progression. The right option depends on the stage and severity of the condition.

Blood Sugar and Blood Pressure Management: Managing diabetes through medication, diet, exercise, and lifestyle changes is the most important step. Keeping blood pressure and cholesterol in check is equally vital.

Anti-VEGF Injections: Anti-vascular endothelial growth factor (VEGF) medications are injected directly into the eye to reduce swelling and stop abnormal blood vessel growth. Common medications include:

  • Avastin (bevacizumab)

  • Lucentis (ranibizumab)

  • Vabysmo (faricimab)

These injections are typically given monthly but may be spaced out over time.

Laser Therapy (Photocoagulation): This treatment uses a laser to shrink abnormal blood vessels, seal leaks, and reduce swelling. It is often used in cases of macular edema or proliferative retinopathy.

Vitrectomy Surgery: In severe cases with significant bleeding or scar tissue, a vitrectomy may be necessary. This surgical procedure removes the vitreous gel and blood from the eye, allowing light to focus properly on the retina again.

Can It Be Prevented?

While diabetic retinopathy isn’t always preventable, you can significantly reduce your risk with proper diabetes management and eye care:

  • Control blood sugar levels

  • Monitor and manage blood pressure and cholesterol

  • Attend annual dilated eye exams

  • Quit smoking

  • Follow your healthcare provider’s recommendations

The earlier the condition is detected, the better your chances of preserving vision.

Other Related Eye Conditions

Diabetic retinopathy can contribute to or occur alongside several other serious eye conditions:

  • Diabetic macular edema (DME): Swelling in the macula that affects central vision

  • Retinal detachment: Scar tissue can pull the retina away from the back of the eye

  • Neovascular glaucoma: New blood vessel growth disrupts fluid drainage, raising eye pressure

Living With Diabetic Retinopathy

Being diagnosed with diabetic retinopathy doesn’t mean you’re destined to go blind. Many people live full, active lives with proper treatment and monitoring. Key tips include:

  • Adhere to your diabetes management plan

  • Keep regular eye appointments

  • Report any sudden vision changes immediately

  • Take medications as prescribed

Your eye health depends on consistency, early detection, and collaboration with your healthcare team.