Diabetic Retinopathy 

Diabetic retinopathy is an eye problem that can happen if you have diabetes. If left untreated, it can lead to severe vision loss or blindness.

At Banner Health, our eye specialists are experts in diagnosing and treating diabetic retinopathy. Learn more about this eye disease, your risk and how it is treated.

What is diabetic retinopathy?

Diabetic retinopathy is the most common eye issue related to diabetes and is the leading cause of vision loss in the United States. 

When you have diabetes, your blood sugar levels can get too high. Over time, high blood sugar can slowly damage the small blood vessels in your retina (the lining in the back of your eye that changes light into images). The blood vessels can swell and leak, or they can close entirely and cause a blockage that prevents blood from passing through.

A healthy retina is important for good vision. When it is damaged, it can lead to permanent vision loss and blindness.

What are the four stages of diabetic retinopathy?

Stage 1 - Mild non-proliferative diabetic retinopathy (NPDR): In the early stage of the disease, tiny areas of swelling called microaneurysms appear in the blood vessels. Small amounts of fluid may leak into the retina, causing swelling in the macula (an area near the retina).

Stage 2 - Moderate NPDR: Blood vessels in your eye swell more, causing a buildup of blood and other liquids in the macula.

Stage 3 - Severe NPDR: More blood vessels get blocked, slowing blood flow even more. When this happens, the body receives signals to grow new but weak vessels.

Stage 4 - Proliferative diabetic retinopathy (PDR): At this advanced stage, the body sends more signals to make new vessels. They grow on the retina and along the back part of the eye. These new vessels may leak and form scar tissue. This can lead to serious eye conditions, such as retinal detachment, glaucoma and permanent blindness.

What are the symptoms of diabetic retinopathy?

Many people don’t notice symptoms until the disease progresses to the PDR stage. Symptoms usually affect both eyes at the same time and may include:

• Blurry vision
• Dark floating spots or strings in your vision
• Reading problems
• Difficulty seeing at night
• Trouble seeing colors
• Loss of vision

Am I at risk for diabetic retinopathy?

Anyone with diabetes can get diabetic retinopathy. This includes people with type 1 diabetes, type 2 diabetes and gestational diabetes (a type of diabetes that develops during pregnancy). 

Your risk goes up based on these factors:

• How long you have had diabetes
• How well your blood sugar is controlled
• High blood pressure
• High cholesterol
• Smoking or using tobacco
• If you are Black, Hispanic or Native American

How is diabetic retinopathy diagnosed?

If you have diabetes, it’s important to get regular eye exams. Eye care specialists (ophthalmologists and optometrists) will check for diabetic retinopathy as part of these exams. 

Your eye care specialist will place drops in your eyes to make the pupils dilate (widen) to give them a better view of the inside of your eye. They will look for:

• Swelling in the retina that can mess with your vision (diabetic macular edema)
• Signs that blood isn’t flowing well in the retina
• Problems with the blood vessels 
• Any new blood vessels or scar tissue on the retina’s surface

In addition to this exam, they may also use other tests to diagnose diabetic retinopathy:

• Optical coherence tomography: This imaging technique provides detailed pictures of your retina that show its thickness and help determine if fluid has leaked.
• Fluorescein angiography: This test helps eye care specialists see changes in the structure and function of your blood vessels. A special dye is injected into your arm, and then photographs are taken of your retina as the dye outlines your blood vessels. 

What treatment is available for diabetic retinopathy?

When the condition is caught in its early stages, the first treatment is improving your blood sugar levels, cholesterol and blood pressure. You may also need to come in more often to have your eyes checked. 

In later stages, you’ll need care right away. Depending on the specific problem with your retina, treatment may include:

• Laser therapy: Laser treatments can reduce swelling in your retina, seal off leaking blood vessels and prevent new blood vessels from growing. This is often used to treat PDR and swelling.
• Injections: Medicines can be given to prevent new blood vessels from growing and treat any swelling.
• Vitrectomy: A surgeon makes a small cut in your eye and removes scar tissue, blood or fluid. 

What is the outlook for diabetic retinopathy?

Your eyes are unique and the outlook depends on how well you care for them. If diabetic retinopathy is caught early and managed well, you have a good chance of keeping your vision. 

Remember to follow your provider’s treatment plan closely, manage your diabetes, protect your eyes and watch for vision changes. These steps can slow down any problems and minimize your risk of vision loss.

Can I prevent diabetic retinopathy?

While prevention is not always guaranteed, you can take steps to lower your risk.

• Control your diabetes
• Live a healthy lifestyle
• Get annual eye exams
• Quit smoking
• Limit how much alcohol you drink

We’re here to help

At Banner Health, your vision is important to us. From routine eye exams to surgical treatments, we diagnose and treat diabetic retinopathy and other eye-related problems like cataracts and glaucoma.