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DIABETIC RETINOPATHY

DEFINITION OF DIABETIC RETINOPATHY

Diabetic Retinopathy (DR) is a serious diabetes-related eye complication caused by damage to the tiny blood vessels in the retina. If left untreated, it can lead to vision loss or blindness. High blood sugar levels weaken the blood vessels, causing leakage, swelling, and abnormal growth of new blood vessels, leading to retinal damage.

RISK FACTORS OF DIABETIC RETINOPATHY

  • Poor Blood Sugar Control (Hyperglycemia)
  • Duration of Diabetes
  • High Blood Pressure (Hypertension)
  • High Cholesterol or Lipid Levels
  • Smoking

SYMPTOMS

 

High blood sugar levels cause fluid to leak into the lens of the eye or retina, leading to swelling—especially in the macula, which is responsible for sharp, central vision.

Damage to the retina, especially in low light conditions, reduces contrast sensitivity and the eye’s ability to adapt to darkness.

Tiny spots of blood or debris from leaking blood vessels enter the vitreous humor (the gel-like fluid in the center of the eye).

Blocked or burst blood vessels deprive parts of the retina of oxygen, causing areas of retinal damage or death.

Swelling in the macula (macular edema) distorts the surface of the retina, bending how light is focused.

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TREATMENT TYPES

    • Tight blood sugar control

      • Target HbA1c: <7%

      • Slows progression of eye damage

    • Control blood pressure

      • Goal: <130/80 mmHg

    • Manage cholesterol and lipids

      • Statins may reduce risk of retinal complications

    • Regular eye exams

      • Every 6–12 months depending on severity

Anti-VEGF injections (first-line therapy)

        • Reduce swelling and stabilize/improve vision

      • Steroid injections or implants (e.g., dexamethasone)

        • Used when anti-VEGF is not effective or tolerated

      • Focal/grid laser photocoagulation

        • Targets leaking areas to reduce fluid buildup

  • Pan-retinal photocoagulation (PRP) laser

    • Destroys peripheral retina to stop growth of abnormal vessels

    • Reduces risk of severe vision loss

  • Anti-VEGF intravitreal injections

    • Now often used alone or in combination with laser

    • May delay or replace need for PRP in some patients

  • Vitrectomy surgery

    • Required if:

      • There is a vitreous hemorrhage

      • Retinal detachment or scar tissue forms

    • Removes blood and scar tissue from inside the eye

 

  • For patients with reduced vision from irreversible damage

  • Includes magnifiers, high-contrast screens, or vision rehabilitation services

 

        • Work with endocrinologist and nutritionist to:

          • Improve A1c

          • Maintain healthy diet and exercise routine

          • Quit smoking

    • Vitrectomy surgery

      • Removes blood and scar tissue from the eye

      • May include laser or anti-VEGF therapy during surgery

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FAQS

Diabetic retinopathy is a complication of diabetes that damages the tiny blood vessels in the retina (the light-sensitive tissue at the back of the eye). Over time, high blood sugar levels can cause these vessels to leak, swell, or close off, leading to vision problems and even blindness if untreated.

The main cause is chronic high blood sugar from diabetes. Additional risk factors include high blood pressure, high cholesterol, long duration of diabetes, smoking, and poor diabetes management.

      • Blurred or fluctuating vision

      • Floaters (spots or cobwebs)

      • Difficulty seeing at night

      • Distorted vision (straight lines appear wavy)

      • Dark or empty areas in vision

      • Sudden vision loss (in advanced stages)

      ⚠️ In early stages, you may have no symptoms at all, which is why regular eye exams are so important.

  • Through a dilated eye exam by an optometrist or ophthalmologist. Specialized imaging tests like OCT (Optical Coherence Tomography) and retinal photography can detect fluid, bleeding, or changes in the retina before you notice any vision loss.

  • Treatment depends on the stage:

    • Early stages: Blood sugar, blood pressure, and cholesterol control

    • Diabetic macular edema (DME): Anti-VEGF injections, steroid injections, or laser treatment

    • Proliferative diabetic retinopathy (PDR): Laser therapy (PRP), anti-VEGF injections, or vitrectomy surgery

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