The short answer
Diabetic retinopathy is an eye disease that can happen to anyone with diabetes. High blood sugar slowly damages the tiny blood vessels in the retina (the thin layer at the back of your eye that senses light). In the early stages, there are usually no symptoms at all. That’s why people with diabetes need a dilated eye exam at least once a year. Found early, treatment can often slow it down and help protect your vision.
If you have diabetes, your eyes can be changing even when your vision seems fine. Diabetic retinopathy usually starts quietly. There’s no pain, and your eyesight may not change for years. By the time you notice blurry vision or dark spots, the disease may already be further along.
The good news is that an eye doctor can spot it long before you can. A yearly diabetic eye exam is one of the best things you can do to protect your sight.
This guide explains what diabetic retinopathy is, the signs to watch for, how it’s found, how it’s treated, and what you can do to lower your risk.
Key Takeaways
- Diabetic retinopathy damages the blood vessels in the retina. It can affect anyone with type 1, type 2 or gestational diabetes (diabetes during pregnancy).
- Early on, it usually causes no symptoms. Later signs include blurry vision and dark spots or streaks.
- It has two main stages: an early stage (nonproliferative) and a more advanced stage (proliferative).
- A dilated eye exam at least once a year is how it’s found.
- Treatments include eye injections and laser treatment. Keeping blood sugar, blood pressure and cholesterol in a healthy range helps lower your risk.
What Is Diabetic Retinopathy?
Think of the retina as the film in a camera. It catches the light that comes into your eye and sends the picture to your brain. To work well, it needs a steady supply of blood through very small blood vessels.
Over time, high blood sugar can weaken those tiny vessels. They can swell, leak fluid or blood, or close off. In some people, the eye tries to fix the problem by growing new blood vessels. But these new vessels are weak and can bleed easily.
When this damage happens in the retina, it’s called diabetic retinopathy. Left untreated, it can cause vision loss and blindness, according to the National Eye Institute (NEI).
What Are the First Signs of Diabetic Retinopathy?
Most of the time, there are no early signs. NEI says the early stages “usually don’t have any symptoms.” Your vision can be clear while the blood vessels in your retina are already changing. Only an eye exam can find it at this point.
As the disease gets worse, you may notice:
- Blurry vision, or vision that changes from day to day
- Dark spots or streaks floating in your vision (some people say they look like cobwebs)
- Dark or empty areas in your vision
- Trouble seeing colors
- Trouble seeing at night
These signs don’t always mean diabetic retinopathy. But if you have diabetes and notice any of them, see your eye doctor soon.
Call your eye doctor right away if you notice:
- A sudden shower of new floaters (dark spots) in your vision
- A shadow or curtain blocking part of your vision
- Sudden blurry vision or vision loss in one or both eyes
These can be signs of bleeding in the eye or another urgent problem. Don’t wait for your next routine visit.
What Does Diabetic Retinopathy Look Like?
To you, it might not look like anything at first. As it gets worse, things may look blurry, as if you’re looking through a smudged window. You may see dark specks or strings drifting across your view. If there’s a lot of bleeding inside the eye, part of your vision can be blocked.
To your eye doctor, it looks different. During a dilated exam, the doctor can see tiny bulges in the blood vessels, small spots of bleeding, leaking fluid, or new blood vessels that shouldn’t be there. Special pictures of the retina help show the changes even more clearly.
The Stages of Diabetic Retinopathy
Eye doctors usually describe diabetic retinopathy in two main stages.
Early stage: nonproliferative diabetic retinopathy (NPDR)
This is the early stage, and many people with diabetes have it. The walls of the tiny blood vessels weaken. They can bulge, leak, or get blocked. This stage can be mild, moderate or severe. Most people have no symptoms until it becomes more serious.
Advanced stage: proliferative diabetic retinopathy (PDR)
In this stage, the retina starts growing new blood vessels. “Proliferative” just means growing. These new vessels are fragile and can bleed into the vitreous (the clear gel that fills the middle of your eye). They can also cause scar tissue that pulls on the retina. This stage can lead to serious vision loss if it isn’t treated.
Diabetic macular edema (DME)
DME can happen at any stage. It’s when fluid leaks into the macula (the small center of the retina that gives you sharp, straight-ahead vision for reading and seeing faces). The macula swells, and your central vision gets blurry. The American Academy of Ophthalmology calls this the most common reason people with diabetes lose vision.
Want to understand the parts of the eye better? Read our guide: Parts of the eye and how they work.
Who Is at Risk?
Anyone with diabetes can get diabetic retinopathy. That includes type 1, type 2 and gestational diabetes. Your risk goes up if:
- You’ve had diabetes for a long time
- Your blood sugar is often higher than your target
- You have high blood pressure
- You have high cholesterol
- You’re pregnant and have diabetes
NEI says women with diabetes who become pregnant are at high risk and should have a full dilated eye exam as soon as possible.
How Is Diabetic Retinopathy Found?
It’s found with a dilated eye exam. The doctor puts drops in your eyes to widen your pupils (the black circles in the middle of your eyes). This lets the doctor see the whole retina and its blood vessels. NEI calls the exam “simple and painless.”
Your eye doctor may also take special pictures of the back of your eye. One common test is an OCT scan (a quick, painless scan that shows the layers of the retina, a little like an ultrasound uses sound). It can show swelling in the macula before you notice any change.
How often should you get a diabetic eye exam?
NEI recommends a dilated eye exam at least once a year if you have diabetes. If you already have diabetic retinopathy, your eye doctor may want to see you more often, sometimes every 2 to 4 months.
Medicare Part B covers an eye exam for diabetic retinopathy once a year if you’re eligible. You may still pay part of the cost, like the Part B deductible and coinsurance. Every plan is different, so check your own plan. Our team can help check your coverage before your visit.
Tip for your visit
Bring someone to drive you home. The dilating drops can make your vision blurry and bright light uncomfortable for a few hours.
How Is Diabetic Retinopathy Treated?
Treatment depends on the stage and on whether the macula is swollen. In the early stage, your eye doctor may just watch your eyes closely with regular exams. When treatment is needed, the options include:
Eye injections
Medicines called anti-VEGF drugs are given as a small shot in the eye. They help stop new blood vessels from growing and reduce swelling in the macula. Your eye is numbed first. NEI says these medicines “can slow down or reverse diabetic retinopathy.” Many people need a series of injections over time.
Laser treatment
A laser can help shrink weak blood vessels and stop them from leaking. It’s done in the office, and your eye is numbed first.
Surgery
If there’s a lot of bleeding or scar tissue in the eye, surgery called a vitrectomy may be needed. The doctor removes the cloudy gel and blood from inside the eye. Your eye doctor will explain whether you need it and who performs it.
Everyone’s eyes are different. Your eye doctor will explain which treatment fits your eyes and what to expect.
Have diabetes and haven’t had a dilated eye exam this year?
Can Diabetic Retinopathy Be Reversed?
Sometimes, partly. Treatment can often slow the disease, and in some people it can help vision get better, especially when swelling in the macula goes down. But some damage can’t be undone, and vision that’s already lost may not come back.
That’s why finding it early matters so much. The earlier it’s caught, the more vision there is to protect.
How to Lower Your Risk
You can’t control everything, but these steps help protect your eyes:
- Keep your blood sugar in your target range. Work with your doctor on your plan.
- Keep your blood pressure and cholesterol in a healthy range.
- Stay active and eat healthy foods.
- Take your medicines the way your doctor tells you.
- Don’t smoke. If you do, ask your doctor about help quitting.
- Get a dilated eye exam at least once a year, even if you see fine.
Diabetes can also raise your risk of other eye problems, like glaucoma. Learn more in our glaucoma guide.
Frequently Asked Questions
Is diabetic retinopathy painful?
Usually not. Most people feel nothing, even as the disease gets worse. That’s why a yearly eye exam is so important.
Can you go blind from diabetic retinopathy?
It can cause vision loss and blindness if it isn’t found and treated. Regular exams and early treatment can often help protect your vision.
Can diabetic retinopathy be cured?
There’s no cure, but it can be managed. Treatment can slow it down, and keeping your diabetes under control helps.
Does diabetic retinopathy affect both eyes?
It usually affects both eyes, but one eye can be worse than the other.
I see fine. Do I still need a diabetic eye exam?
Yes. Early diabetic retinopathy usually has no symptoms. Clear vision doesn’t mean your retina is healthy.
Is diabetic retinopathy the same as macular degeneration?
No. Both affect the retina, but macular degeneration is linked to aging, not diabetes. Read our macular degeneration guide to learn the difference.
Get a Diabetic Eye Exam Close to Home
Diabetic retinopathy works quietly, so the exam matters more than how your eyes feel. Dr. James Powers and our team check for diabetic retinopathy at our St. Petersburg, Clearwater and New Port Richey offices, and we can check your insurance before your visit.
Ready to schedule your diabetic eye exam?
- New Port Richey — 5413 US Highway 19, New Port Richey, FL 34652
- Clearwater — 2565 Enterprise Rd, Clearwater, FL 33763
- St. Petersburg — 603 7th St S, St. Petersburg, FL 33701
More guides: Glaucoma · Macular degeneration · Dry eye · Parts of the eye
Sources: National Eye Institute, “Diabetic Retinopathy” (nei.nih.gov); American Academy of Ophthalmology, “What Is Diabetic Retinopathy?” (aao.org); Medicare.gov, “Eye exams (for diabetes).”
This article is general information, not medical advice for your eyes. For advice about your own eyes, call us or see your eye doctor.