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Understanding Diabetic Retinopathy

Diabetic retinopathy is an eye condition that affects people with diabetes and can result in vision loss and potentially blindness. Diabetic retinopathy is a complication of diabetes that affects the blood vessels in the retina (the back of the eye). It can affect people who have either type I or type II diabetes.

There are misconceptions, at times, that diabetic retinopathy is only a result of uncontrolled type II diabetes. Diabetic retinopathy may not present initial symptoms. Therefore, early detection is key to ongoing management to protect remaining vision.

What Causes Diabetic Retinopathy?

High blood sugar levels cause diabetic retinopathy in people with diabetes. Over time, having an increased sugar level can damage your retina, the part of your eye that detects light and sends signals to your optic nerve. Diabetes damages blood vessels throughout the body. The damage within the eye happens when sugar blocks the blood vessels that go to your retina, causing them to bleed. As a result, the eye creates new blood vessels. However, these new vessels are often ineffective and easily leak or bleed.

Risk Factors

Anyone with diabetes can develop diabetic retinopathy, including those with gestational diabetes. The longer you have diabetes, the higher your risk. You can manage your diabetes well with proper diet, exercise, and managing your A1C level. In addition, high blood pressure and cholesterol can increase the risk of developing the disease, so adequate management is critical. Pregnant women are at higher risk. People who smoke are also at higher risk. Additionally, African American, Hispanic, and Indigenous populations are at higher risk of developing diabetic retinopathy.

Symptoms

Diabetic retinopathy may not show initial symptoms. 

  • Spots or floaters in your vision
  • Blurred vision
  • Fluctuations or changes in vision
  • Dark spots or missing areas of vision
  • Vision Loss (acuity or clarity) 

Additional Considerations

People with diabetes and those with diabetic retinopathy are also at an increased risk for other eye conditions caused in part because of new blood vessel development. These conditions include diabetic macular edema, glaucoma, retinal detachment, vitreous hemorrhage, and blindness.

Eye Care

If you have diabetes, it is vital to ensure you receive at least an annual comprehensive eye exam. During the exam, your eye doctor will dilate your eyes to check your retina and surrounding blood vessels. They will also look for signs of other eye conditions. If you are diagnosed with diabetic retinopathy, early treatment is imperative. Additional tests may follow to determine the current stage and proper treatments.

Treatment

Treatment can vary based on the stage of the condition and early detection. In the early stages, your doctor may choose to monitor your vision, including more frequent eye exams. In later stages, treatments to reduce the potential for further vision loss include injections, laser treatments, or surgery to repair bleeding or scarring.

If you or someone you know has diabetes or is pre-diabetic, seek comprehensive eye care. Schedule an appointment with your eye care provider to monitor your vision and ongoing eye health annually. If you do not have an ophthalmologist, speak with your primary care provider about changes that you are experiencing with your vision. Seek eye care immediately. Early treatment can reduce the potential for ongoing vision loss.

To learn more about diabetic retinopathy, visit:
https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/diabetic-retinopathy

Resources:

TRICARE vision care: https://www.tricare.mil/CoveredServices/Vision

VA vision care: https://www.va.gov/health-care/about-va-health-benefits/vision-care/

VA Low vision care: https://www.va.gov/OPTOMETRY/Low_Vision_Rehabilitation.asp

VA MyhealtheVet: https://www.myhealth.va.gov/mhv-portal-web/home