Diabetic retinopathy is a complication of diabetes and a leading cause of blindness. It occurs when diabetes damages the tiny blood vessels inside the retina in the back of the eye. Although changes may be subtle at first, vision deteriorates over time, and can eventually lead to complete loss of sight.
Deeper dive
The disease has four stages:
- Mild nonproliferative retinopathy.
- Moderate nonproliferative retinopathy.
- Severe nonproliferative retinopathy.
- Proliferative retinopathy.
They correspond to the deterioration of blood supply to the retina, and in the final stage, growth of new, abnormal, fragile blood vessels. If these thin-walled vessels leak blood, severe vision loss or blindness can occur.
According to the National Eye Institute, the early stages of diabetic retinopathy usually don’t have any symptoms. Some people notice changes in their vision, like trouble reading or seeing faraway objects. These changes may come and go. In later stages of the disease, blood vessels in the retina start to bleed into the vitreous (gel-like fluid that fills the eye). If this happens, a person may see dark, floating spots or streaks that look like cobwebs. Sometimes, the spots clear up on their own — but it’s imperative to get a vision exam as soon as possible. Without treatment, scars can form in the back of the eye. Blood vessels may also start to bleed again, or the bleeding may get worse.
Prompt treatment can stop someone’s vision from worsening, although it won’t undo any existing vision damage. Options include:
- Injections. Anti-VEGF drugs can slow down or reverse diabetic retinopathy. Corticosteroids can also help.
- Laser treatment. To reduce swelling in the retina, ophthalmologists can use lasers to make the blood vessels shrink and stop leaking.
- Surgery. If the retina is bleeding a lot or if there are numerous scars in the eye, an ophthalmologist may recommend vitrectomy, a procedure which involves making very small openings in the eye wall and removing most of the vitreous from the eye with a suction tool.