Diabetic retinopathy: How diabetes can lead to vision loss and what you can do about it

Diabetic retinopathy is a serious and potentially blinding complication of diabetes that affects the retina—the part of the eye responsible for processing light. Over time, high blood sugar levels can damage the small blood vessels in the retina, leading to vision problems and, in severe cases, complete blindness. This condition is one of the leading causes of vision impairment among adults worldwide, making early detection and management crucial.

Despite being a common complication of diabetes, many people remain unaware of how diabetic retinopathy progresses or how they can reduce their risk. With regular eye exams and effective blood sugar control, it is possible to slow down or even prevent vision loss caused by this condition. Understanding the symptoms, risk factors, and available treatments is essential for anyone living with diabetes.

What is Diabetic Retinopathy?

Diabetic retinopathy occurs when prolonged exposure to high blood sugar damages the delicate retinal blood vessels, leading to leakage, swelling, or abnormal new blood vessel growth. This disruption can gradually impair vision and, if left untreated, cause permanent blindness.

The condition progresses through different stages:

Non-Proliferative Diabetic Retinopathy (NPDR): In the early stage, weakened retinal blood vessels begin to leak fluid or blood, leading to retinal swelling. Vision may still be unaffected at this point, making early detection difficult.

Proliferative Diabetic Retinopathy (PDR): In the advanced stage, the retina starts developing fragile new blood vessels that can rupture, causing severe bleeding into the vitreous humor, the gel-like substance inside the eye. This can result in sudden vision loss and an increased risk of retinal detachment.

Symptoms of Diabetic Retinopathy

In its early stages, diabetic eye disease often develops without noticeable symptoms. Many individuals may not realise they have the condition until significant vision loss occurs. As the disease progresses, symptoms may include:

• Blurred or fluctuating vision
• Dark spots or floating shapes in the field of vision
• Impaired colour perception
• Sudden vision loss due to retinal bleeding

Because symptoms appear only in later stages, routine eye examinations are essential for individuals with diabetes. Regular screening can help detect diabetic eye disease before it leads to irreversible damage.

Who is at Risk of Diabetic Retinopathy?

Anyone with diabetes—whether type 1 or type 2—is at risk of developing diabetic eye disease, but certain factors increase the likelihood of progression. Individuals with poorly managed blood sugar levels are particularly vulnerable, as high glucose concentrations weaken retinal blood vessels over time.

Additional risk factors include:

• Long-standing diabetes, as the risk increases with the duration of the disease
• High blood pressure and cholesterol, which can worsen retinal blood vessel damage
• Pregnancy, as hormonal changes can accelerate the progression of diabetic eye disease
• Smoking, which contributes to vascular problems and reduces oxygen supply to the retina

Understanding these risk factors and taking preventive measures can significantly reduce the chances of developing severe vision loss diabetes complications.

How is Diabetic Retinopathy Diagnosed?

Early detection plays a crucial role in preventing diabetic eye disease from leading to severe vision impairment. Ophthalmologists use specialised tests to assess the condition of the retina and identify any damage caused by diabetic eye disease.

• Dilated Eye Examination: This is a routine screening method where eye drops are used to enlarge the pupils, allowing a detailed view of the retinal blood vessels.
• Optical Coherence Tomography (OCT): This imaging technique provides a cross-sectional view of the retina, helping to detect swelling and fluid buildup.
• Fluorescein Angiography: This test involves injecting a fluorescent dye into the bloodstream, which highlights abnormalities in the retinal blood vessels when viewed under a special camera.

These diagnostic methods allow doctors to determine the stage of the disease and recommend appropriate treatment strategies.

Treatment Options for Diabetic Retinopathy

Advancements in medical technology have made it possible to slow or even halt the progression of diabetic eye disease. The choice of treatment depends on the severity of the condition.

• Laser Therapy (Photocoagulation): A precise laser is used to seal leaking retinal blood vessels, reducing swelling and preventing further damage. This procedure is particularly effective for early-stage diabetic macular edema.
• Anti-VEGF Injections: These injections help block the growth of abnormal blood vessels and reduce fluid leakage, improving vision in some cases.
• Vitrectomy Surgery: In advanced cases where significant bleeding or retinal detachment occurs, a surgical procedure called vitrectomy may be required. This involves removing the blood-filled vitreous humor and replacing it with a clear fluid to restore vision.

Early intervention is crucial, as these treatments are most effective before extensive retinal damage occurs.

Preventing Diabetic Retinopathy

While not all cases of diabetic eye disease can be prevented, adopting a proactive approach to diabetes management significantly lowers the risk.

• Blood Sugar Control: Maintaining stable glucose levels reduces stress on retinal blood vessels and slows disease progression.
• Regular Eye Exams: Annual screenings enable early detection and timely treatment, preventing irreversible vision loss diabetes complications.
• Healthy Lifestyle Choices: A balanced diet, regular exercise, and smoking cessation contribute to overall vascular health, benefiting the eyes.

Preventive measures empower individuals with diabetes to take control of their eye health and minimise the impact of diabetic eye disease.

Diabetic retinopathy remains one of the most preventable causes of blindness, yet many people remain unaware of its risks. Regular eye examinations, strict blood sugar management, and timely intervention can make a significant difference in preserving vision. For individuals living with diabetes, prioritising eye health is not just a recommendation—it is a necessity.