Understanding Diabetic Retinopathy

If you have diabetes, you should see an eye doctor for a comprehensive dilated eye exam at least once a year. However, you may need to see a retina specialist if:

• Your eye doctor detects signs of diabetic retinopathy or macular edema.
• You experience sudden changes in vision, such as blurriness, dark spots, or floaters.
• You are diagnosed with moderate or severe diabetic retinopathy, which requires specialized care.
• You have a high risk of progression to proliferative diabetic retinopathy (PDR).

Early intervention by a retina specialist can help prevent vision loss by offering advanced treatments such as laser therapy or anti-VEGF injections.

Not necessarily. While diabetes increases the risk of vision loss, most people with diabetes do not go blind, especially if the condition is detected early and managed properly. You can protect your vision by:

• Keeping your blood sugar levels stable.
• Managing blood pressure and cholesterol to protect blood vessels.
• Getting annual eye exams to catch problems early.
• Seeking prompt treatment if you develop diabetic retinopathy.

If diabetic retinopathy progresses to an advanced stage without treatment, it can lead to permanent vision impairment or blindness.

Some symptoms indicate that diabetic retinopathy may be progressing rapidly and requires urgent care. You should see a retina specialist immediately if you experience:

• Sudden vision loss in one or both eyes.
• New or worsening floaters (dark spots or cobweb-like lines in your vision).
• Flashes of light, which may indicate retinal detachment.
• Severe blurriness that does not improve with blinking.
• A dark curtain or shadow in your vision, which may signal a retinal detachment.
• Pain or redness in the eye, which could indicate neovascular glaucoma.

These symptoms can be signs of vitreous hemorrhage, macular edema, or retinal detachment—all of which require immediate treatment to prevent permanent vision loss.

Yes, while anyone with diabetes can develop diabetic retinopathy, certain factors increase the risk, including:

• Having diabetes for a long time—after 20 years, nearly 99% of type 1 and 60% of type 2 diabetics have some degree of retinopathy.
• Poor blood sugar control (high hemoglobin A1C levels).
• High blood pressure (hypertension).
• High cholesterol levels.
• Pregnancy—diabetic retinopathy can worsen during pregnancy.
• Smoking, which accelerates blood vessel damage.
• Ethnicity—studies show that African American, Hispanic, and Native American populations have a higher risk of developing severe diabetic eye disease.

In the early stages (nonproliferative diabetic retinopathy or NPDR), controlling diabetes can sometimes slow or even partially reverse some of the damage. However, once the disease progresses to the proliferative stage (PDR) or causes diabetic macular edema (DME), vision loss becomes more difficult to reverse.

Available treatments—such as anti-VEGF injections, laser therapy, and vitrectomy surgery—can slow progression, prevent further damage, and, in some cases, improve vision. However, the best way to protect your sight is to prevent diabetic retinopathy from worsening through early detection and diabetes management.

While there is no guaranteed way to avoid diabetic retinopathy, you can significantly lower your risk by:

• Keeping blood sugar levels within a healthy range (A1C below 7%).
• Monitoring and controlling blood pressure and cholesterol.
• Getting annual dilated eye exams to catch changes early.
• Eating a healthy diet and staying physically active.
• Avoiding smoking and excessive alcohol consumption.
• Following your doctor’s recommendations for diabetes management.