People with diabetes can have an eye disease called diabetic retinopathy. This is when high blood sugar levels cause damage to blood vessels in the retina. These blood vessels can swell and leak. Or they can close, stopping blood from passing through. Sometimes abnormal new blood vessels grow on the retina. All of these changes can steal your vision.

The Two Stages of Diabetic Eye Disease

There are two main stages of diabetic eye disease.

NPDR (non-proliferative diabetic retinopathy)

This is the early stage of diabetic eye disease. Many people with diabetes have it.

With NPDR, tiny blood vessels leak, making the retina swell. When the macula swells, it is called macular edema. This is the most common reason why people with diabetes lose their central vision.

Also with NPDR, blood vessels in the retina can close off. This is called macular ischemia. When that happens, blood cannot reach the macula. Sometimes tiny particles called exudates can form in the retina. These can affect your vision too.

If you have NPDR, your vision will be blurry.

PDR (proliferative diabetic retinopathy)

PDR is the more advanced stage of diabetic eye disease. It happens when the retina starts growing new blood vessels. This is called neovascularization. These fragile new vessels often bleed into the vitreous. If they only bleed a little, you might see a few dark floaters. If they bleed a lot, it might block all vision.

These new blood vessels can form scar tissue. Scar tissue can cause problems with the macula or lead to a detached retina.

PDR is very serious, and can steal both your central and peripheral (side) vision.

What Happens When You Have Diabetic Retinopathy?

You can have diabetic retinopathy and not know it. This is because it often has no symptoms in its early stages. As diabetic retinopathy gets worse, you will notice symptoms such as:

• seeing an increasing number of floaters,
• having blurry vision,
• having vision that changes sometimes from blurry to clear,
• seeing blank or dark areas in your field of vision,
• losing vision.

Diabetic retinopathy symptoms usually affect both eyes.

Diabetic Retinopathy Diagnosis

Drops will be put in your eye to dilate (widen) your pupil. This allows your ophthalmologist to look through a special lens to see the inside of your eye.

Your doctor may do optical coherence tomography (OCT) to look closely at the retina. A machine scans the retina and provides detailed images of its thickness. This helps your doctor find and measure swelling of your macula.

Fluorescein angiography or OCT angiography helps your doctor see what is happening with the blood vessels in your retina. Fluorescein angiography uses a yellow dye called fluorescein, which is injected into a vein (usually in your arm). The dye travels through your blood vessels. A special camera takes photos of the retina as the dye travels throughout its blood vessels. This shows if any blood vessels are blocked or leaking fluid. It also shows if any abnormal blood vessels are growing. OCT angiography is a newer technique and does not need dye to look at the blood vessels.

Can Diabetic Retinopathy Go Away?

Your treatment is based on what your ophthalmologist sees in your eyes. Treatment options may include:

Medical control

Controlling your blood sugar and blood pressure can stop vision loss. Carefully follow the diet your nutritionist has recommended. Take the medicine your diabetologist prescribed for you. Sometimes, good sugar control can even bring some of your vision back. Controlling your blood pressure keeps your eye’s blood vessels healthy.

Medicine

One type of medication is called anti-VEGF medication. These include Avastin, Eylea, Lucentis and Pagenax Anti-VEGF medication helps to reduce swelling of the macula, slowing vision loss and perhaps improving vision. This drug is given by injections (shots) in the eye into the vitreous cavity.

Steroid medicine is another option to reduce macular swelling. This is also given as injections in the eye. Your doctor will recommend how many medication injections you will need over time.

Laser surgery

Laser surgery might be used to help seal off leaking blood vessels. This can reduce swelling of the retina. Laser surgery can also help shrink blood vessels and prevent them from growing again. Sometimes more than one treatment is needed.

Vitrectomy

If you have advanced PDR, your ophthalmologist may recommend surgery called vitrectomy. Your ophthalmologist removes vitreous gel and blood from leaking vessels in the back of your eye. This allows light rays to focus properly on the retina again. Scar tissue also might be removed from the retina.

5 Ways to Prevent Vision Loss from Diabetic Retinopathy

• If you have diabetes, talk with your primary care doctor about controlling your blood sugar. High blood sugar damages retinal blood vessels. That causes vision loss.
• Do you have high blood pressure or kidney problems? Ask your doctor about ways to manage and treat these problems.
• See your ophthalmologist regularly for dilated eye exams. Diabetic retinopathy may be found before you even notice any vision problems.
• If you notice vision changes in one or both eyes, call your ophthalmologist right away.
• Get treatment for diabetic retinopathy as soon as possible. This is the best way to prevent vision loss.

Do You Have Diabetes and Need an Eyeglasses test to change your spectacles?

Changes in blood sugar levels can affect your vision. Make sure your blood sugar is under control for at least a week before an eye exam. Eyeglasses prescribed when your blood sugar levels are stable work best!

Why do I have blurry vision as a diabetic?

Many conditions cause temporary blurred vision, including elevated blood sugar levels. Without performing a full exam, it is difficult to pinpoint the exact cause. But with elevated blood sugar levels, the lens in the eye can swell and cause blurred vision that improves when blood sugar levels normalize. Follow up with your ophthalmologist to better understand the cause of your blurred vision, and find ways to manage your blood sugar with physical activity, glucose monitoring (device that checks your blood sugar), and the right meal plan.

What is the importance of fundoscopy?

Fundoscopy, especially when the pupils are dilated for a more complete view of the entire retina, allows for examination of the retina to help diagnose conditions and identify risk factors for potential vision loss associated with the retina. For example, patients with diabetes should have an annual dilated fundus examination to check the retina for signs of diabetic retinopathy that could lead to permanent or difficult-to-treat vision loss. Signs of diabetic retinopathy, which is often a sign also of systemic disease associated with diabetes, include bleeding, inflammation, lack of oxygen, and other problems with the retina that can lead to permanent vision loss. Fundoscopy can also help diagnose other diseases such as infection or inflammation in the eye that requires treatment to preserve vision.

Is it possible to reverse mild diabetic retinopathy?

Diabetic retinopathy is when high blood sugars damage blood vessels in the retina. When blood sugars and other conditions like blood pressure are
well-controlled, diabetic retinopathy can improve and even resolve over time

How long before vision normalizes after glucose has stabilized?

Assuming you have not developed diabetic eye disease, it can take as long as three months for vision to normalize after blood glucose levels stabilize. To prevent eye damage from diabetes, take steps to control your blood sugar with eye healthy foods, exercise and regular eye exams as recommended by your ophthalmologist.

Is a multifocal IOL safe for use if you have uncomplicated diabetes?

Yes, as long as you have no diabetic retinopathy. Be sure to confirm with your ophthalmologist after you have had a complete dilated eye exam that the diabetes has not affected your vision.