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Condition

Diabetic retinopathy

Diabetic retinopathy is damage to the blood vessels in the retina caused by diabetes. It often has no early signs, so a yearly dilated eye exam and good diabetes care are the best ways to protect your sight.

Key points

Common signs
Often none at first. Later, blurry or changing vision, floaters, or dark or empty spots in your vision.
Who’s at risk
Anyone with diabetes. Risk is higher the longer you have it, and when blood sugar or blood pressure runs high.
How it’s found
A dilated eye exam, with retinal photos or an OCT scan, can find damage before you notice any change.
Treatment
Injections, laser treatment or surgery can slow or stop vision loss. Managing your diabetes helps protect your eyes.
A blood sugar meter, an insulin pen and tablets, the daily tools for managing diabetes

Diabetic retinopathy is an eye disease caused by diabetes. It affects the retina, the thin layer at the back of your eye that senses light and sends pictures to your brain.

Over time, high blood sugar can damage the tiny blood vessels in the retina. They can swell, leak fluid or blood, or close off so that parts of the retina don’t get enough blood. This early stage often causes no symptoms at all.

In a more advanced stage, the eye tries to fix the problem by growing new blood vessels. These new vessels are weak. They can bleed into the clear gel that fills the eye, and they can form scar tissue that pulls on the retina. In the worst cases, the retina can pull loose from the back of the eye.

Diabetic macular edema

The macula is the small center of the retina that gives you sharp, straight-ahead vision for reading, driving and seeing faces. When leaking fluid builds up there, it is called diabetic macular edema. It can happen at any stage of diabetic retinopathy, and it is one of the most common reasons people with diabetes lose vision.

Diabetes also raises your risk of other eye problems, such as cataracts and glaucoma. The good news is that finding diabetic eye disease early, and keeping your diabetes well managed, gives you the best chance of keeping your sight.

Two boys holding balls, with dark blotches covering parts of the scene
How diabetic retinopathy can leave dark or missing patches in what you see. Image: National Eye Institute, National Institutes of Health.

Diabetic retinopathy usually has no symptoms in its early stages. You can see well and still have damage that needs treatment. That is why a regular dilated eye exam matters so much.

As it gets worse, you may notice:

  • Blurry vision
  • Vision that changes from day to day, or comes and goes
  • Spots, dark strings or cobwebs floating in your vision (floaters)
  • Dark or empty areas in your vision
  • Colors that look faded or washed out
  • Trouble seeing at night

Very high blood sugar can also blur your vision for a while by making the lens inside your eye swell. This often clears once your blood sugar settles. Any change in your vision is still worth having checked.

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