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Diabetic Retinopathy

Diabetic Retinopathy

Diabetic Retinopathy Explained 

Diabetes affects more than just your blood sugar. Over time, high blood sugar can weaken or damage the small blood vessels in the retina — the light-sensitive layer at the back of your eye. This damage is called diabetic retinopathy, and it is one of the leading causes of vision loss among adults. 

The challenge is that it often develops silently. You may not notice any symptoms until significant damage has already occurred. That’s why regular, comprehensive eye exams with your optometrist are essential if you have diabetes. 

What Is Diabetic Retinopathy (DR)? 

Diabetic retinopathy happens when the tiny blood vessels in the retina weaken, leak, or become blocked. In later stages, the retina may grow new, fragile blood vessels that are prone to bleeding and scarring. These changes interfere with the retina’s ability to process light clearly, which can gradually impair your vision. 

What Is Diabetic Macular Edema (DME)? 

Diabetic macular edema is a complication of diabetic retinopathy. It happens when fluid leaks into the macula (the central part of the retina responsible for sharp vision), causing swelling. This swelling will blur or distort your central vision. 

Early Symptoms to Watch For 

In the early stages, diabetic retinopathy may cause no symptoms at all. As the condition progresses, you might notice: 

  • Blurry or fluctuating vision 
  • Dark spots or floaters in your vision 
  • Poor night vision 
  • Difficulty seeing colours 
  • Sudden vision loss in one or both eyes 

These signs mean the retina is already being affected and need immediate attention. 

Who Is at Risk? 

Anyone with type 1 or type 2 diabetes can develop diabetic retinopathy. The longer you have diabetes, the higher the risk. Other factors increase the chances, including: 

  • Poor blood sugar control 
  • High blood pressure 
  • High cholesterol 
  • Pregnancy 
  • Smoking 

How Optometrists Detect It 

During a comprehensive eye exam, your optometrist will use special drops to dilate your pupils and look directly at the retina. Advanced imaging tools can also detect subtle changes in the retinal blood vessels long before you notice vision problems. 

Treatment Options 

Diabetic retinopathy (DR) is treated based on the stage and severity of the disease, and the main goal is to prevent further vision loss rather than restore vision already lost. Here are the main treatment options: 

  • Monitoring 
  • In mild cases of early diabetic retinopathy (Non-Proliferative Diabetic Retinopathy - NPDR), no treatment is required, and your optometrist will continue to monitor you every 6 to 12 months for changes that do require treatment. 
  • Medical Management 
  • Anti-VEGF injections (e.g., ranibizumab, aflibercept, bevacizumab): Medication is injected directly into the eye to reduce abnormal blood vessel growth and the swelling from diabetic macular edema. 
  • Laser Treatment  
  •  Focal/grid laser photocoagulation: Laser is used for diabetic macular edema (DME) by sealing leaking microaneurysms near the macula. 
  • Panretinal photocoagulation (PRP): Laser is used for advanced or proliferative diabetic retinopathy (PDR). By making small laser burns in your peripheral retina, fewer dangerous and abnormal, leaky blood vessels will develop, and the existing ones will shrink. 
  • Surgical Treatment  
  • Vitrectomy: A surgery to remove the vitreous gel inside the eye is performed in very advanced cases of diabetic retinopathy where there is significant bleeding internally in the eye or the beginning of a retinal detachment. It involves clearing the blood and relieving the traction that is causing the retina to detach. 

Prevention and Daily Care 

You can reduce your risk of diabetic retinopathy by: 

  • Keeping your blood sugar, blood pressure, and cholesterol under control 
  • Attending annual eye exams — more often if recommended by your optometrist 
  • Staying active, eating a healthy diet, and avoiding smoking 

The Bottom Line 

Diabetic retinopathy is common, but it doesn’t have to lead to vision loss. Regular eye exams with your optometrist, paired with good diabetes management, are your best defence. 

OHIP covers an annual eye exam for all people who have diabetes.  

If you have diabetes and it’s been more than a year since your last exam, don’t wait. Book today at FindAnEyeDoctor.ca.