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Diabetic retinopathy is damage to the eye that can happen in people with diabetes. Too much sugar in the blood can, over time, cause blood vessels in the eye to bulge and bleed, leading to vision changes.

Those who have had diabetes for many years, and have poorly controlled diabetes, are most at risk. You can take steps to improve your health and stop diabetic retinopathy from developing or worsening.

What Are the Symptoms of Diabetic Retinopathy?

People who have diabetic retinopathy may have one or more of the following:

• Blurry vision.
• Distorted vision.
• Issues reading or doing close-up work.
• Problems seeing at night.
• Floaters, which are small dark spots or lines that ‘float’ across your vision.
• Not seeing colors well. Colors may appear faded rather than vibrant.
• Vision that worsens over time.

The Stages of Diabetic Retinopathy

In the first stage, people might not have symptoms. But the damage to the small blood vessels in the retina causes swelling and bleeding. A doctor can pick up on these early signs during an eye exam.

Retinopathy can cause blurry vision as it gets worse. The blurriness may come and go. If swelling happens in the macula (a part of the retina most important for vision), vision loss can be serious.

In the later stage of the disease, the body makes new blood vessels. These new blood vessels are fragile and prone to leaking and bleeding. At this stage, blood can leak into the vitreous, the gel-like fluid in the eye, and cause it to swell.

Untreated diabetic retinopathy can lead to blindness.

Many wonder, ‘Can diabetic retinopathy be reversed?’ While it cannot be completely reversed, diabetic retinopathy treatment and better control of blood sugars can improve vision. It can also stop symptoms from getting worse.

Preventing and Managing Diabetic Retinopathy

Keeping your blood sugars within a healthy range can help prevent eye damage from diabetic retinopathy. If you have retinopathy, controlling your blood sugar can help stop it from worsening.

You can improve your blood sugar levels by:

• Eating healthy, based on your dietician’s advice.
• Exercising often.
• Taking insulin and other diabetes medicines your doctor prescribes.
• Keeping a close eye on your blood sugar level.
• Regular doctor visits to keep blood sugar levels healthy. They may need to adjust your diabetes medicines.

If you have diabetes, you should also get an eye exam each year. That’s because your eye doctor can see the signs of diabetic retinopathy before you notice symptoms. Managing diabetic retinopathy early with treatments and lifestyle changes can prevent vision loss.

If you have diabetic retinopathy, you may need to see the eye doctor more than once a year. This way, the doctor can see if the disease gets worse. They’ll also adjust your diabetic retinopathy treatment plan as needed.

Pay attention to blood pressure and cholesterol levels, too

On top of watching your blood sugars, watch your cholesterol levels and blood pressure. High cholesterol and high blood pressure further stress the eye’s blood vessels. This can make them more prone to leaking.

See your doctor regularly for blood pressure and cholesterol checks. Lower your blood pressure by eating healthy and reducing salt and alcohol intake.

You can lower your cholesterol by avoiding saturated fats. Saturated fats are in fried foods, dairy, and meat. Your diet should be rich in fiber, found in fruits, vegetables, and whole grains.

Your doctor may suggest you take medicine to lower your blood pressure or cholesterol.

Diabetic Retinopathy Treatment

Diabetic retinopathy treatment may include:

• Doctors inject medicines into the eye with local anesthesia (“freezing”) so you don’t feel anything.
• An implant in the eye that slowly releases a steroid medicine over many months before dissolving.
• Laser treatments seal leaking blood vessels and reduce swelling in the retina.
• Surgery, where the surgeon removes blood and other fluid from the back of the eye to reduce pressure on the retina.

Medicines for diabetic retinopathy include steroids and antivascular endothelial growth factor drugs (anti-VEGF medicine).

Steroids reduce swelling in the eye. Anti-VEGF medicines slow the growth of new blood vessels. This reduces the risk of fragile new blood vessels growing and leaking into the eye.

Doctors only suggest surgery in the advanced stage of the disease. It can help people with a lot of blood or scar tissue at the back of the eye. But surgery is riskier than other treatments.

The Importance of Early Diabetic Retinopathy Treatment

Treatments and better blood sugar control can help improve vision in people with diabetic retinopathy. The earlier people seek diabetic retinopathy treatment, the less likely they are to have serious vision loss. Without treatment, diabetic retinopathy worsens over time.

If left untreated, diabetic retinopathy can lead to:

• Retinal detachment. The retina pulls away from its usual place. This can lead to blindness.
• Glaucoma. Abnormal blood vessels cause a build-up of fluid that damages the optic nerve. As the optic nerve sends messages from the eye to the brain, glaucoma can also lead to blindness.

Who’s Most at Risk of Getting Diabetic Retinopathy?

People can get diabetic retinopathy if they have any type of diabetes. This includes type I and type II diabetes and gestational diabetes.

People are most at risk of getting diabetes if they have high A1C levels for a long time. Most people don’t get symptoms of diabetic retinopathy until they’ve had diabetes for many years.

An A1C test shows your average blood sugar level over the past three months. If your A1C levels are high, talk to your care team about what changes you can make to reduce them.

Other risk factors for diabetic retinopathy include:

• A family history of diabetic retinopathy.
• Being of Hispanic or African American descent.
• Being pregnant. Pregnancy can put more pressure on the blood vessels. Hormone changes can cause or worsen diabetes.
• Having high blood pressure.
• Having high cholesterol.

If you have diabetes, see your doctor as soon as possible if you notice any vision changes or loss.