Often there are no early signs and some people might have 20/20 vision while others might have difficulty reading or seeing faraway objects - symptoms that could easily be attributed to “regular” and less dangerous problems of the eye.

This stage is called non-proliferative diabetic retinopathy (NDPR) and while the damage is not fully reversible it is manageable with proper treatment, preventing any significant loss of vision. 

Until recently, the only way to detect NDPR before any noticeable symptoms was through retinal examination by a trained ophthalmologist or optometrist.

The second stage, called proliferative diabetic retinopathy (NPR), is when damage to the blood vessels is significant enough to cause blurriness of vision, which can progress to only being able to tell light from dark. Management through treatment is, again, possible, but in most cases full vision can not be restored.

General symptoms to watch out for:

Diabetic retinopathy can lead to other serious eye conditions: 

Diabetic macular edema (DME)
Over time, about 1 in 15 people with diabetes will develop DME. DME happens when blood vessels in the retina leak fluid into the macula (a part of the retina needed for sharp, central vision). This causes blurry vision.

Neovascular glaucoma
Diabetic retinopathy can cause abnormal blood vessels to grow out of the retina and block fluid from draining out of the eye. This causes a type of glaucoma (a group of eye diseases that can cause vision loss and blindness).

Retinal detachment
Diabetic retinopathy can cause scars to form in the back of your eye which can pull the retina away from the back of the eye.

Who is at risk?

Anyone with any kind of diabetes, including gestational diabetes (which can occur during pregnancy) can get diabetic retinopathy.

Risk factors:

• Having diabetes for a long time

• Poor control blood sugar level

• High blood pressure

• High cholesterol

• Pregnancy

• Tobacco use

• Black, Hispanic or Native Americans are at higher risk

Prevention and treatment

Diabetes causes high blood sugar which damages all blood vessels, including ones in the retina, so good management of diabetes can lower the overall risk of diabetic retinopathy. This means regular physical activity, eating healthy, monitoring blood sugar levels and regularly taking medication as prescribed. 

In case of early detection and if there had not yet been any signs of vision degradation, regular dilated eye exams (every 2 to 4 months) are all that might be necessary. In later stages, and especially if vision degradation had already occured, treatment should start right away in order to halt further damage. Treatment can consist of:

Anti-VEGF drugs
Damage to small blood vessels of the retina is partly caused by overproduction of a protein called vascular endothelial growth factor (VEGF). Anti-VEGF drugs are injected into the eye to block the harmful effects of this protein.

Corticosteroids
Corticosteroids also combat VEGF by reducing its production as well as reduce occurrence of Diabetic macular edema (DME)

Laser treatment
Scatter laser surgery is used to reduce growth of new abnormal blood vessels as well as treat existing damaged ones

Eye surgery
Vitrectomy can be used to remove accumulated blood in the middle of the eye as well as deal with scar tissue in more advanced stages of diabetic retinopathy

There is however currently no cure or ways to fully reverse existing damage. The only path to preventing diabetic retinopathy complication is through early detection by regular screening, ideally at least once a year. This is easier said than done as often the biggest hurdle is lack of awareness among diabetics. In some parts of the world, this is compounded by lack of equipment as well as personnel able to conduct screening in sufficient numbers.