Diabetic retinopathy screenings are essential. Screening can tell you if you need treatment to slow the progression of vision loss.
Read more about what diabetic retinopathy is, how screenings work, and the diagnostic and treatment process.
What Is Diabetic Retinopathy?
Diabetic retinopathy can occur when there is damage to the small blood vessels in a part of the eye called the retina. High blood sugar levels cause this damage in people with diabetes.
Over time, high blood sugar levels cause leaking and swelling of the tiny blood vessels. Vision loss results from a lack of oxygenated blood flow to the back of the eye, as well as leaking blood vessels into the retina.
The two main types of diabetic retinopathy are:
Nonproliferative diabetics retinopathy (NPDR): In this early-stage blood vessel damage, the blood vessels begin leaking in the retina, causing poor blood flow. Over time, less oxygenated blood can flow through these vessels, depriving the retina of the oxygen it needs to function. Proliferative diabetics retinopathy (PDR): In the later stage of blood vessel damage in the eye, abnormal blood vessels grow in response to a lack of oxygenated blood flow to the retina. When the retina does not receive oxygenated blood and new, weak blood vessels begin to form, they leak and bleed into the retina. This continual leaking moves into the fluid surrounding the retina, causing it to detach and cause severe and permanent vision loss.
Damage in both phases is observable during an eye examination with your ophthalmologist (a medical specialist in eye and vision care) or optometrist (a doctor who provides primary vision care).
Causes
The number one cause of diabetic retinopathy is diabetes. Having chronic, uncontrolled high blood sugar damages the blood vessels throughout the body, but it has a particularly damaging effect on smaller blood vessels, such as those in the eye.
The retina is a part of the eye that helps you see. It detects light and communicates with the brain through the optic nerve. But if the eye isn’t receiving sufficient blood to work properly, the retina cannot complete that job. The eye may try to compensate for the lack of oxygenated blood by growing new vessels that do not work as well.
Signs and Symptoms
In the earlier phases of diabetic retinopathy, there may not be any signs or symptoms. Many people with the disease don’t begin to lose vision until the disease has progressed into its later stages. Sometimes people may experience symptoms intermittently.
Symptoms may include:
Blurry visionTrouble readingDifficulty seeing objects from far awayPoor vision at nightEye floatersColor blindness that was not there beforeSeeing a dark or empty spot in the center of your vision
Risk Factors
Everyone who has type 1 or type 2 diabetes should receive diabetic retinopathy screenings.
There are additional risk factors that may put you at a higher risk for developing the disease. These include:
Uncontrolled diabetes (type 1 or type 2) Long duration of diabetes Older age Presence of additional health issues, such as high blood pressure or high cholesterol Nephropathy (deterioration of kidney function)
Preventing any risk factors that you have control over may delay or prevent diabetic retinopathy.
The Process of a Diabetic Retinopathy Screening
A diagnosis of diabetic retinopathy requires an appointment with your ophthalmologist or optometrist. Most exams begin with an acuity test to determine how well you can see.
To screen the vessels in the eye, the ophthalmologist or optometrist will need to take a picture of your retina. The photo requires that the pupils of your eyes be dilated, or widened, for your provider to see as much of the eye as possible. Patients receive dilating eye drops, which usually take up to 20 minutes to dilate the eyes thoroughly. The eye drops may sting for a moment.
Once the eyes are dilated enough, a camera takes photos of the backs of the eyes. You will sit down in front of a machine that takes pictures of the retina in each eye. Upon getting a clear image, the ophthalmologist or optometrist can assess the condition of the eyes, the retina, and the blood vessels that serve it.
Treatment
Treatment for diabetic retinopathy will depend on what your ophthalmologist or optometrist sees when looking at your eyes. Some treatments may include:
Controlling blood sugar and eating a healthy diet: You will need to start by getting your blood sugar and blood pressure within acceptable ranges. This can be achieved through a healthy diet and with medications prescribed to manage these conditions. In some cases, maintaining good blood sugar levels can help with vision loss. Medication: Some medications can help treat diabetic retinopathy, which can reduce swelling of the macula of the eye (the center portion of the eye that processes sharp and clear vision). Steroids are another type of medication injected into the eye to help with the swelling of the macula. Laser surgery: Lasers can stop leaking blood vessels, reduce swelling in the retina, and decrease the demand for oxygen to the retina. In some cases, more than one laser treatment may be needed. Vitrectomy: Advanced diabetic retinopathy treatment may require a surgical procedure called a vitrectomy. This surgery removes the vitreous gel and blood that has leaked into your eye and in some cases, scar tissue. This procedure can help the retina work properly again.
Summary
Diabetic retinopathy is a condition resulting from damage to blood vessels in the eye. The best way to diagnose or even prevent diabetic retinopathy from occurring is through regular screenings. People with diabetes should reach out to their healthcare provider, ophthalmologist, or optometrist to get screened.
A Word From Verywell
Receiving a diagnosis of diabetic retinopathy can be frightening. However, it is usually much easier to prevent vision loss caused by diabetic retinopathy than to reverse it once it has caused significant damage. Regular screenings can help prevent its development or progression. If you have diabetes, see your ophthalmologist or optometrist for routine exams. Follow their recommendations for controlling high blood sugar that can damage your eyes over time.
