For People with Diabetes

Diabetic Eye Disease FAQ

Diabetes is a very serious disease that can cause problems such as blindness, heart disease, kidney failure, and amputations. But by taking good care of yourself through diet, exercise, and special medications, you can control diabetes. And there is more good news. Diabetic eye disease, a complication of diabetes, can be treated before vision loss occurs.

All people with diabetes need to get a comprehensive dilated eye exam at least once a year.

What is diabetic eye disease?

Diabetic eye disease refers to a group of eye problems that people with diabetes may face as a complication of this disease. All can cause severe vision loss or even blindness.

Diabetic eye disease includes:

Diabetic retinopathy: Damage to the blood vessels in the retina.
Cataract: Clouding of the lens of the eye.
Glaucoma: Increase in fluid pressure inside the eye that leads to optic nerve damage and loss of vision.

What is the most common diabetic eye disease?

Diabetic retinopathy. This disease is a leading cause of blindness in American adults. It is caused by changes in the blood vessels of the retina. In some people with diabetic retinopathy, retinal blood vessels may swell and leak fluid. In other people, abnormal new blood vessels grow on the surface of the retina. These changes may result in vision loss or blindness.

What are its symptoms?

There are often no symptoms in the early stages of diabetic retinopathy. There is no pain and vision may not change until the disease becomes severe. Blurred vision may occur when the macula (the part of the retina that provides sharp, central vision) swells from the leaking fluid. This condition is called macular edema. If new vessels have grown on the surface of the retina, they can bleed into the eye, blocking vision. Even in more advanced cases, the disease may progress a long way without symptoms. This symptomless progression is why regular eye examinations for people with diabetes are so important.

Diagram of the eye.

Who is most likely to get diabetic retinopathy?

Anyone with diabetes. The longer someone has diabetes, the more likely he or she will get diabetic retinopathy. Between 40?45 percent of those with diagnosed diabetes have some degree of diabetic retinopathy.

How is diabetic retinopathy detected?

If you have diabetes, you should have your eyes examined at least once a year. Your eyes should be dilated during the exam, which means eyedrops are used to enlarge your pupils. This dilation allows the eye care professional to see more of the inside of your eyes to check for signs of the disease.

What You Should Know

What is diabetic retinopathy?

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, the light-sensitive tissue at the back of the eye. A healthy retina is necessary for good vision.

If you have diabetic retinopathy, at first you may notice no changes to your vision. But over time, diabetic retinopathy can get worse and cause vision loss. Diabetic retinopathy usually affects both eyes.

Diagram of the human eye.

What are the stages of diabetic retinopathy?

Diabetic retinopathy has four stages:

Mild nonproliferative retinopathy: At this earliest stage, microaneurysms occur. They are small areas of balloon-like swelling in the tiny blood vessels of the retina.
Moderate nonproliferative retinopathy: As the disease progresses, some blood vessels that nourish the retina are blocked.
Severe nonproliferative retinopathy: Many more blood vessels are blocked, depriving several areas of the retina of their blood supply. These areas of the retina send signals to the body to grow new blood vessels for nourishment.
Proliferative retinopathy: At this advanced stage, the signals sent by the retina for nourishment trigger the growth of new blood vessels. This condition is called proliferative retinopathy. These new blood vessels are abnormal and fragile. They grow along the retina and along the surface of the clear, vitreous gel that fills the inside of the eye. (See diagram above.)

By themselves, these blood vessels do not cause symptoms or vision loss. However, they have thin, fragile walls. If they leak blood, severe vision loss and even blindness can occur.

Who is at risk for diabetic retinopathy?

All people with diabetes, both type 1 and type 2, are at risk, which is why everyone with diabetes should get a comprehensive dilated eye exam at least once a year. Between 40 to 45 percent of Americans diagnosed with diabetes have some stage of diabetic retinopathy. If you have diabetic retinopathy, your eye care professional can recommend treatment to help prevent its progression.

During pregnancy, diabetic retinopathy may be a problem for women with diabetes. To protect vision, every pregnant woman with diabetes should have a comprehensive dilated eye exam as soon as possible. Your eye care professional may recommend additional exams during your pregnancy.