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Diabetic Retinopathy

What is Diabetic Retinopathy?

If you have diabetes, you probably know that your body can’t use or store sugar properly. When your blood sugar gets too high, it can damage the blood vessels in your eyes. The damage to retinal vessels is referred to as diabetic retinopathy.

In later stages, the disease may lead to new blood vessel growth over the retina. The new blood vessels can cause scar tissue to develop, which can pull the retina away from the back of the eye. This is known as retinal detachment and can lead to blindness if untreated. In addition, abnormal blood vessels can grow on the iris, which can lead to glaucoma.

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Vision loss is largely preventable


You can significantly lower your risk of vision loss by maintaining strict control of your blood sugar and visiting us regularly.

When to schedule an examination




Rapid changes in the blood sugar can cause fluctuating vision in both eyes even if retinopathy is not present.


  • Affect either one or both eyes;
  • Last more than a few days;
  • Are not associated with a change in blood sugar.


  • Within five years of the diagnosis if you are 29 years old or younger;
  • Within a few months of the diagnosis if you are 30 years old or older.

Types of Diabetic Retinopathy

Types of Diabetic Retinopathy ChartThere are two types of diabetic retinopathy; nonproliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR).


Many people with diabetes have mild NPDR, which usually does not affect their vision. When vision is affected it is the result of macular edema (pronounced eh-DEEM-uh), macular ischemia (pronounced ih-SKEE-mee-uh), or both.

  • Macular ischemia occurs when small blood vessels (capillaries) close. Vision blurs because the macula no longer receives sufficient blood supply to work properly.




Proliferative diabetic retinopathy causes visual loss in the following ways:

Vitreous hemorrhage. The fragile new vessels may bleed into the vitreous, a clear gel-like substance that fills the center of the eye. If the vitreous hemorrhage is small, a person might see only a few new, dark floaters. A very large hemorrhage might block out all vision.

It may take days, months, or even years to reabsorb the blood, depending on the amount of blood present. If the eye does not clear the vitreous blood adequately within a reasonable time, vitrectomy surgery may be recommended.



Neovascular glaucoma. Occasionally, extensive retinal vessel closure will cause new, abnormal blood vessels to grow on the iris (colored part of the eye) and in the drainage channels in the front of the eye. This can block the normal flow of fluid out of the eye. The pressure in the eye builds up, resulting in neovascular glaucoma, a severe eye disease that causes damage to the optic nerve.

How is diabetic retinopathy treated?


Medical treatment: In certain cases, we may choose to treat your macular edema with injections of medicine in your eye. These special shots of medicine- called intravitreal injections-may be steroids or other medications. They are designed to shrink the swelling of the macula.


For macular edema, the laser is focused on the damaged retina near the macula to decrease the fluid leakage. The main goal of treatment is to prevent further loss of vision. It is uncommon for people who have blurred vision from macular edema to recover to normal vision, although some may experience partial improvement. A few people may see the laser spots near the center of their vision following treatment. The spots usually fade with time but may not disappear.

For PDR, the laser is focused on all parts of the retina except the macula. The panretinal photocoagulation treatment causes abnormal new vessels to shrink and often prevents them from growing in the future. It also decreases the chance that vitreous or retinal distortion will occur.

Multiple laser treatments over time are sometimes necessary. Laser surgery does not cure diabetic retinopathy and does not always prevent future vision loss.

Vitrectomy: In advanced PDR, your ophthalmologist may recommend a vitrectomy. During this microsurgical procedure, which is performed in the operating room, the blood-filled vitreous is removed and replaced with a clear solution. We may wait for several months to see if the blood clears on its own before performing a vitrectomy.


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