Diabetic Retinopathy (DR)

Diabetic retinopathy is a complication of diabetes that damages blood vessels in the retina. If left untreated, it can impair vision and may lead to blindness.
Early stages often show no clear symptoms. As the condition progresses, patients may notice floaters, blurred vision, or flashes of light. Severe cases can cause partial or total vision loss.
Treatment depends on the disease stage and may include blood sugar control, medication, laser therapy, intravitreal injections, or retinal surgery to prevent permanent vision damage.

Vision is essential for daily life. However, for people with diabetes, eyesight can be threatened by a condition known as diabetic retinopathy. If early warning signs are overlooked or proper care is delayed, permanent vision loss may occur. This article explains the causes of diabetic retinopathy, warning symptoms that should not be ignored, and ways to protect your eyesight safely and effectively.

What Is Diabetic Retinopathy?

Diabetic retinopathy (DR) is an eye complication caused by diabetes. Persistently high blood sugar damages small blood vessels in the retina, leading to leakage, bleeding, or abnormal new vessel growth. These changes can result in blurred vision and, if untreated, blindness.

In early stages, symptoms may not be noticeable. As the disease becomes more severe, vision can deteriorate significantly. Therefore, people with diabetes should undergo comprehensive eye examinations at least once a year for early detection and timely treatment.

Stages of Diabetic Retinopathy

Diabetic retinopathy develops gradually due to progressive retinal blood vessel damage and can be divided into two main stages:

Early Stage (Non-Proliferative DR)

Retinal blood vessels weaken and form microaneurysms, leading to small hemorrhages, lipid leakage, nerve fiber ischemia, and possible retinal swelling. Without treatment, this stage may progress to a more severe form.

Advanced Stage (Proliferative DR)

Abnormal new blood vessels form and are fragile, causing bleeding into the vitreous. Scar tissue may pull on the retina, leading to retinal tears or detachment and severe vision loss or blindness. Immediate and close treatment is required.

If new vessels grow on the iris, fluid drainage can be blocked, increasing eye pressure and causing neovascular glaucoma, a difficult-to-treat condition that can also result in blindness.

Causes and Risk Factors of Diabetic Retinopathy

Diabetic retinopathy is closely related to blood sugar levels and vascular health. Risk factors include:

Chronic high blood sugar – weakens and damages retinal blood vessels
High blood pressure – accelerates vascular damage and bleeding risk
High cholesterol and abnormal blood lipids – causes vessel blockage and retinal deposits
Long duration of diabetes – risk increases after 5–10 years
Smoking – constricts blood vessels and worsens disease progression
Pregnancy or gestational diabetes – hormonal changes increase risk
Older age and genetics – natural vascular degeneration and family history raise susceptibility

Symptoms of Diabetic Retinopathy

Common and Early Symptoms

Blurred or fluctuating vision
Floating black spots or web-like lines (floaters)
Distorted images
Reduced visual clarity
Difficulty distinguishing colors

Severe Symptoms and Complications

Dark or shadowed areas in vision
Sudden increase in floaters due to vitreous bleeding
Flashes of light from retinal traction
Partial or sudden vision loss

These symptoms may indicate serious conditions such as vitreous hemorrhage or retinal detachment. Early treatment greatly reduces the risk of permanent vision loss.

Diagnosis of Diabetic Retinopathy

Eye examinations assess retinal and vascular health to detect abnormalities early:

Basic vision testing – visual acuity and screening
Dilated eye examination – detailed retinal assessment
Fundus photography – documents retinal changes
Fluorescein angiography – identifies leakage and abnormal vessels
OCT (Optical Coherence Tomography) – measures retinal thickness and swelling
Additional tests in severe cases, such as intraocular pressure measurement

People with diabetes should have a retinal exam at least once a year.

Treatment Options for Diabetic Retinopathy

1. Medication

Used in early stages or mild retinal swelling:

Eye drops or oral medication to reduce inflammation
Injectable medications to reduce vascular leakage
Always combined with blood sugar, blood pressure, and lipid control.

2. Laser Treatment

Recommended for retinal swelling or advanced disease:

Focal laser seals leaking vessels
Panretinal photocoagulation reduces abnormal vessel growth
Laser treatment slows vision loss but may slightly affect peripheral or night vision.

3. Intravitreal Injections

Anti-VEGF or steroid injections reduce swelling and abnormal vessel growth. Repeated injections may be required under ophthalmologist supervision.

4. Vitrectomy Surgery

Used in severe cases with vitreous bleeding or retinal detachment. Surgery removes blood-filled vitreous and repairs retinal damage. Close postoperative follow-up is essential.

How to Prevent Diabetic Retinopathy

Maintain good blood sugar control
Control blood pressure and cholesterol
Have regular eye examinations
Quit smoking and limit alcohol
Exercise regularly
Eat a balanced diet
Protect eye health and avoid eye injuries

Self-Care for Diabetic Patients to Prevent Blindness

Attend regular eye checkups
Maintain HbA1C below 7%
Control blood pressure and lipid levels
Quit smoking
Exercise regularly
Take medications as prescribed
Consult doctors to fully understand the condition

Diabetic Retinopathy Screening & Treatment at Vibhavadi Hospital

Vibhavadi Hospital provides comprehensive diabetic retinopathy screening and treatment using advanced diagnostic tools and expert ophthalmologists. Personalized treatment plans are tailored to disease severity, focusing on early detection, prevention of progression, and preservation of vision.

Summary

Diabetic retinopathy is a serious complication of diabetes that damages retinal blood vessels and may lead to blindness if untreated. Early stages may show no symptoms, but regular eye exams allow early detection and effective treatment. With proper care, blood sugar control, and timely medical intervention, long-term vision can be preserved.