Diabetic Retinopathy: Frequently Asked Questions

What is diabetic retinopathy?

Diabetic retinopathy is a condition in which high blood sugar causes retinal blood vessels to swell and leak blood.

Who’s at the most risk for diabetic retinopathy?

Fluctuating blood sugar levels increase risk for this disease, as does long-term diabetes.

Most people don’t develop diabetic retinopathy until they’ve had diabetes for at least 10 years.

However, adult onset (type 2) diabetics should be evaluated at the time of diagnosis and every year thereafter, whereas juvenile onset (type 1) diabetics should be evaluated five years after diagnosis and every year thereafter, at a minimum.

Can diabetic retinopathy be prevented?

Not totally, but your risk can be greatly reduced. The Diabetes Control and Complications Trial (DCCT) showed that better control of blood sugar level slows the onset and progression of retinopathy and lessens the need for laser surgery for severe retinopathy. Keeping your blood sugar at an even level can help prevent diabetic retinopathy. If you have high blood pressure, keeping that under control is helpful as well.

Even controlled diabetes can lead to diabetic retinopathy, so you should have your eyes examined once a year; that way, your doctor can begin treating any retinal damage as soon as possible.

What are the signs and symptoms of diabetic retinopathy?

In the early stages of diabetic retinopathy, you might have no symptoms at all, or you might have blurred vision.

In the later stages, you develop cloudy vision, blind spots or floaters. But never assume that good vision means all is well in the retina! This can be a setup for disaster.

What are the different types of diabetic retinopathy?

Diabetic retinopathy is classified as either nonproliferative or proliferative.

Nonproliferative retinopathy is the early stage, where small retinal blood vessels break and leak.

In proliferative retinopathy, new blood vessels grow abnormally within the retina. This new growth can cause scarring or a retinal detachment, which can lead to vision loss. The new blood vessels may also grow or bleed into the vitreous humour, the transparent gel filling the back of the eye in front of the retina.

Is diabetic retinopathy curable?

No. Early treatment can slow the progression of diabetic retinopathy, but is not likely to reverse any vision loss.

What diabetic retinopathy treatments are currently available?

The best treatment is to keep your diabetes under control; blood pressure control also helps.

Your doctor may decide on laser photocoagulation to cause regression of leaking blood vessels and prevent new blood vessel growth. If blood gets into the vitreous humour, your doctor might want to perform a procedure called a vitrectomy.

Can diabetic retinopathy be treated?

Yes. Your eye care professional may suggest laser surgery in which a strong light beam is aimed onto the retina. Laser surgery and appropriate follow-up care can reduce the risk of blindness by 90 percent. However, laser surgery often cannot restore vision that has already been lost, which is why finding diabetic retinopathy early is the best way to prevent vision loss.

How common are the other diabetic eye diseases?

If you have diabetes, you are also at risk for other diabetic eye diseases, such as cataract and glaucoma. People with diabetes develop cataract at an earlier age than people without diabetes. Cataract can usually be treated by surgery.

A person with diabetes is nearly twice as likely to get glaucoma as other adults. And, as with diabetic retinopathy, the longer you have had diabetes, the greater your risk of getting glaucoma. Glaucoma may be treated with medications, laser surgery, or conventional surgery.

What research is being done?

Much research is being done to learn more about diabetic eye disease. For instance, the National Eye Institute is supporting a number of research studies in the laboratory and with patients to learn what causes diabetic retinopathy and how it can be better treated. This research should provide better ways to detect and treat diabetic eye disease and prevent blindness in more people with diabetes.

What can you do to protect your vision?

Finding and treating the disease early, before it causes vision loss or blindness, is the best way to control diabetic eye disease. So, if you have diabetes, make sure you get a comprehensive dilated eye examination at least once a year.

Remember…

Diabetes is a disease that can cause very serious health problems. If you have diabetes:

1. Know your ABCs: A1C (blood glucose), blood pressure (BP), and cholesterol numbers.
2. Take your medicines as prescribed by your doctor.
3. Monitor your blood sugar daily.
4. Reach and stay at a healthy weight.
5. Get regular physical activity.
6. Quit smoking.