Diabetic Retinopathy: Symptoms, Stages, Diagnosis & Treatment

Diabetic retinopathy is an eye condition caused by diabetes that damages blood vessels in the retina, the light-sensitive tissue at the back of the eye. It can develop without noticeable symptoms and, if it progresses, may lead to serious vision loss.

Regular diabetic eye examinations help detect changes early, when monitoring or treatment may help protect your vision. At Massachusetts Eye Research & Surgery Institution (MERSI), our ophthalmologists evaluate and treat diabetic retinal disease at our Waltham, Massachusetts office.

What Are the Symptoms of Diabetic Retinopathy?

Diabetic retinopathy often causes no symptoms in its early stages. As the condition progresses, you may experience:

• • Blurry or fluctuating vision

  • Dark spots or floating shapes in your vision

  • Difficulty reading or seeing fine details

  • Distorted or reduced central vision

  • Sudden vision loss in more advanced cases

Seek urgent eye care if you experience sudden vision loss, a sudden increase in floaters, or a dark shadow across your vision. These symptoms may indicate bleeding or another serious retinal problem.

Learn more about the symptoms of diabetic retinopathy.

What Are the Stages of Diabetic Retinopathy?

Diabetic retinopathy is generally classified into two main types: nonproliferative and proliferative diabetic retinopathy.

Nonproliferative Diabetic Retinopathy (NPDR)

NPDR is the earlier form of the disease. Damaged retinal blood vessels may develop small bulges, leak fluid, or bleed. Eye doctors classify NPDR as mild, moderate, or severe based on the extent of the retinal changes. Vision may remain normal even as the condition progresses, making regular examinations important.

Proliferative Diabetic Retinopathy (PDR)

PDR is a more advanced form of diabetic retinopathy. Reduced blood flow can trigger the growth of fragile, abnormal blood vessels on the retina. These vessels may bleed into the eye or contribute to scar tissue that pulls on the retina. Without appropriate treatment, PDR can cause severe vision loss.

What Is Diabetic Macular Edema?

Diabetic macular edema (DME) occurs when fluid accumulates in the macula, the central part of the retina responsible for detailed vision. DME can develop at different stages of diabetic retinopathy and may cause blurry or distorted central vision.

Who Is at Risk for Diabetic Retinopathy?

Anyone with type 1 or type 2 diabetes can develop diabetic retinopathy. Risk generally increases with the duration of diabetes and with factors such as:

• • Blood sugar levels that remain above individualized treatment goals

  • High blood pressure

  • Abnormal cholesterol levels

  • Kidney disease associated with diabetes

  • Pregnancy in people with preexisting diabetes

Managing blood sugar, blood pressure, and cholesterol with your healthcare team can help reduce the risk of developing or worsening diabetic retinopathy.

How Is Diabetic Retinopathy Diagnosed?

Diabetic retinopathy is diagnosed through a comprehensive eye examination, usually including dilation so the eye doctor can examine the retina. Depending on the findings, your ophthalmologist may recommend additional testing:

• • Retinal photography: Documents visible changes in retinal blood vessels.

  • Optical coherence tomography (OCT): Produces detailed cross-sectional images that can identify retinal swelling and help monitor treatment.

  • Fluorescein angiography: Uses a special dye and photography to evaluate retinal circulation and blood vessel leakage when clinically indicated.

These tests help determine the severity of the disease and whether treatment is needed.

How Often Should You Have a Diabetic Eye Exam?

Adults with type 2 diabetes should generally have an initial comprehensive dilated eye examination when diabetes is diagnosed. Adults with type 1 diabetes should generally have their initial examination within five years of diagnosis.

Follow-up intervals depend on the examination findings and individual risk. Some people with consistently normal examinations may qualify for screening every one to two years, while those with diabetic retinopathy may require annual or more frequent evaluations. Your eye care professional will recommend the appropriate schedule.

What Are the Treatment Options for Diabetic Retinopathy?

Treatment depends on the stage of diabetic retinopathy, whether macular edema is present, and how vision is affected.

Monitoring and Diabetes Management

Early diabetic retinopathy may be managed with regular retinal examinations and attention to blood sugar, blood pressure, and cholesterol.

Anti-VEGF Injections

Anti-VEGF medications are injected into the eye to reduce abnormal blood vessel activity and retinal swelling. They are commonly used for vision-impairing diabetic macular edema and may also be recommended for certain cases of proliferative diabetic retinopathy.

Laser Treatment

Laser procedures may be recommended to reduce the risk of vision loss from certain forms of advanced diabetic retinopathy. The type of laser treatment depends on the retinal findings.

Vitrectomy Surgery

In advanced cases involving persistent bleeding or retinal traction, a retina specialist may recommend vitrectomy surgery to address complications inside the eye. Your ophthalmologist will explain the benefits, limitations, and risks of the options appropriate for your condition.

When Should You See a Retina Specialist?

A retina specialist may be recommended when diabetic retinopathy is progressing, retinal swelling develops, or treatment is being considered.

People with moderate or more advanced nonproliferative diabetic retinopathy, proliferative diabetic retinopathy, or diabetic macular edema should receive prompt evaluation by an ophthalmologist experienced in managing diabetic retinal disease.

Learn more about what type of doctor treats diabetic retinopathy.

Diabetic Retinopathy Care at MERSI

At MERSI, our ophthalmologists provide specialized evaluation and management of diabetic retinal conditions, including retinal imaging, ongoing monitoring, and individualized treatment planning.

Our physicians include Peter Y. Chang, MD, FACS, Partner and Co-President, whose specialties include vitreoretinal surgery, and Carl S. Wilkins, MD, whose clinical interests include diabetic retinopathy and vitreoretinal surgery. We work with patients and referring eye care professionals to evaluate retinal changes and determine appropriate next steps.

Schedule a Diabetic Retinopathy Evaluation at MERSI

Have you been diagnosed with diabetic retinopathy, noticed changes in your vision, or been referred to a retina specialist? The ophthalmologists at MERSI provide specialized retinal evaluations and individualized treatment recommendations.

Take the next step toward protecting your vision. Call 781-891-6377 to request an appointment at our Waltham, Massachusetts office.

Location: 1440 Main Street, Suite 201, Waltham, MA 02451

 

Frequently Asked Questions About Diabetic Retinopathy

Can You Have Diabetic Retinopathy Without Symptoms?

Yes. Early diabetic retinopathy often causes no noticeable vision changes. A dilated eye examination can identify retinal abnormalities before symptoms develop.

Can Diabetic Retinopathy Be Reversed?

Some retinal changes may improve with treatment and better management of diabetes, but existing damage is not always reversible. Early detection and appropriate treatment can help preserve vision.

Does Everyone With Diabetic Retinopathy Need Eye Injections?

No. Some patients need monitoring rather than immediate treatment. Injections may be recommended for certain forms of diabetic macular edema or more advanced retinal disease.

Can Diabetic Retinopathy Cause Permanent Vision Loss?

Yes. Advanced diabetic retinopathy can cause permanent vision loss, particularly when complications are not identified and treated promptly.

 

Medically reviewed by:

Stephen D. Anesi, MD, FACS, Partner & Co-President

Specializes in: Ocular inflammatory diseases, cornea, glaucoma (medical, surgical & MIGS), cataract, and medical retina

Peter Y. Chang, MD, FACS, Partner & Co-President

Specializes in: Ocular inflammatory diseases, vitreoretinal surgery, and cataract

Carl S. Wilkins, MD

Specializes in: Ocular inflammatory diseases, vitreoretinal surgery, and cataract

Reviewed: