Eyes and diabetes (diabetic retinopathy)
Diabetes can damage the delicate blood vessels of the retina and at first may cause no symptoms. This page explains why a yearly examination matters and what treatment does.
What is diabetic eye disease?
High blood sugar damages the tiny blood vessels of the retina. The retina is the light-sensitive tissue at the back of the eye. This damage is called “diabetic retinopathy”. Retinopathy is the most common cause of vision loss in people with diabetes. Diabetes also raises the risk of cataract and glaucoma.
The most important point: this disease can be silent. The early stages usually have no symptoms. Some people may sometimes have trouble reading or seeing at a distance, but these changes come and go.
Signs of the advanced stages:
- Dark spots or cobweb-like strands floating in the vision, which may be due to bleeding inside the eye
- Blurred central vision, which goes with swelling of the macula
- Sudden loss or blurring of vision
These do not necessarily mean retinopathy. But they must be checked.
Who is it for?
Anyone with diabetes: type 1, type 2 or gestational diabetes. The risk rises the longer you have diabetes. High blood pressure and high blood fats also raise the risk.
If you have diabetes, an eye doctor should examine you whether or not your vision is good. If you have never had an eye examination, book one now.
How is it checked and treated?
The main check is a full eye examination with the pupil dilated so the doctor can see the retina. Photographs or other tests may also be needed.
Treatment depends on the stage:
- Early stages. Immediate treatment is usually not needed, only regular follow-up.
- More advanced stages. The sources name these treatments: injections into the eye, laser on the retina, and surgery for severe bleeding or scar tissue.
The most important part of treatment happens outside the eye: controlling blood sugar with diet, exercise and prescribed medicines, controlling blood pressure and blood fats, and stopping smoking. Your own doctor should set your sugar target with you.
After treatment
- Eye treatments can stop things getting worse, but they do not restore vision that has been lost.
- Go to follow-up visits, even when your vision has improved.
- Healing time, driving and returning to work depend on the type of treatment and differ from patient to patient. Your doctor will tell you.
- The pages “Care after eye surgery” and “Putting in eye drops correctly” give general advice on care.
Risks
If diabetes is not controlled and you are not examined, it can lead to:
- Swelling of the macula and blurred central vision
- Bleeding inside the eye
- Retinal detachment with pulling by scar tissue
- Glaucoma caused by abnormal blood vessels
These do not always happen. Regular examination and good diabetes control lower the chance. The treatments carry their own risks, which the doctor explains before any treatment.
When to call
If you have diabetes and suddenly:
- Your vision gets worse or blurred
- A dark curtain comes over your vision
- You see new flashes or many new floaters
contact an eye doctor or the emergency department the same day. Do not wait for your yearly visit.
If your vision has slowly got worse or you see poorly at night, book a visit as soon as you can. The full list of urgent signs is in the guide “When should I get urgent help?”.
Frequently asked questions
My vision is good. Do I still need to be examined?
Yes. Diabetic eye disease usually has no symptoms in the early stages. By the time vision changes, the disease may be advanced. Regular examination is for finding the problem before there are symptoms.
How often should I be examined?
According to the source, people with diabetes need a full dilated eye examination at least once a year. If retinopathy has been diagnosed, the doctor may want to see you more often. The eye doctor decides the interval.
What if I have diabetes and I am pregnant?
According to the source, you should have a full eye examination as soon as possible and ask your doctor how often you need to be examined from then on. Also tell your obstetrician and your diabetes specialist.
Does treatment bring back vision that has been lost?
Treatment can stop things getting worse, but it does not bring back vision that has been lost. That is why early detection matters.
Is retinopathy treated with injections?
Injections into the eye, laser and surgery are among the treatments named in the sources. Which one you need depends on the stage of the disease, and the doctor decides after examining you. In the early stages, follow-up alone is usually enough.