Diabetic Retinopathy

Diabetes often causes damage quietly over time. High blood sugar levels can harm small blood vessels throughout the body — including those in the retina, the light-sensitive tissue at the back of the eye that allows us to see.

Diabetic retinopathy occurs when these delicate retinal blood vessels become weakened. They may leak fluid or blood, swell, close off, or grow abnormally. As this damage progresses, vision can become blurred or permanently lost.

Diabetic retinopathy is one of the leading causes of vision loss in adults. According to the Centers for Disease Control and Prevention (CDC), nearly one-third of adults over age 40 with diabetes show signs of this condition, with higher rates among African American and Hispanic populations.

If you have diabetes, regular eye exams are essential for protecting your vision.

Diabetic retinopathy typically develops gradually and progresses through four stages:

Mild nonproliferative retinopathy

Tiny areas of swelling form in the retinal blood vessels. These weakened areas may begin to leak fluid into the retina.

Moderate nonproliferative retinopathy

As the disease advances, blood vessels become more damaged. Swelling increases, and some vessels may start to close off, reducing blood flow to parts of the retina.

Severe nonproliferative retinopathy

Many blood vessels are blocked, preventing oxygen-rich blood from reaching areas of the retina. In response, the retina releases signals that stimulate new blood vessel growth.

Proliferative diabetic retinopathy

New blood vessels begin to grow, but they are fragile and abnormal. These vessels can bleed into the eye, causing vision loss. Scar tissue may form, leading to retinal detachment. In some cases, abnormal vessel growth can also increase eye pressure and cause painful glaucoma.

Anyone with type 1 or type 2 diabetes can develop diabetic retinopathy. Risk increases if:

• Blood sugar levels are poorly controlled
• You have had diabetes for many years
• You have high blood pressure or high cholesterol
• You are pregnant
• You smoke or use tobacco
• You are Black, Hispanic, or Native American

Early diabetic retinopathy often causes no noticeable symptoms. As the condition progresses, you may experience:

• Floating spots or dark strings in your vision
• Blurred or fluctuating vision
• Difficulty seeing colors clearly
• Blind spots
• Partial or complete vision loss

A comprehensive eye exam to evaluate diabetic retinopathy may include:

• Visual acuity testing – Measures how clearly you see at various distances
• Dilated eye exam – Allows your doctor to examine the retina and optic nerve for signs of damage
• Eye pressure testing (tonometry) – Checks for elevated eye pressure
• Advanced imaging or diagnostic testing – Used to confirm the diagnosis and monitor changes over time

The goal of treatment is to slow or stop disease progression and preserve vision.

Early-stage management may include:

• Tight blood sugar control
• Managing blood pressure and cholesterol
• Maintaining a healthy diet
• Staying physically active
• Following your eye doctor’s recommended treatment plan

Advanced treatments may include:

• Laser therapy – Seals leaking blood vessels and reduces abnormal vessel growth
• Intravitreal injections – Medications placed inside the eye to reduce swelling, inflammation, and abnormal blood vessel growth

If you have diabetes, the National Eye Institute recommends staying on TRACK to help reduce vision loss:

• Take medications as prescribed
• Reach and maintain a healthy weight
• Add physical activity to your daily routine
• Control your ABCs: A1C (blood sugar), Blood pressure, and Cholesterol
• Kick the smoking habit

Diabetes also increases the risk of other serious eye diseases:

• Cataracts – Clouding of the eye’s natural lens; people with diabetes are up to five times more likely to develop cataracts
• Glaucoma – Damage to the optic nerve; diabetes roughly doubles the risk

If you have diabetes, you should have a diabetic eye exam at least once a year, even if your vision seems normal. Contact your eye doctor immediately if you notice sudden changes in your sight.

Early detection and prompt treatment can help prevent diabetes from stealing your vision.

At Northeastern Washington Eyecare, we are committed to helping our patients protect their vision at every stage of life. Call us today or schedule an appointment online to learn more about diabetic retinopathy and how we can help.