Diabetic Retinopathy

If you have diabetes, it’s important to take care of your eyes. Diabetic retinopathy is a common eye disease caused by high blood sugar. It can lead to vision loss, but with early care and the right treatment, you can protect your sight.

At UVA Health, we understand how important your vision is. Our eye specialists work closely with your diabetes care team to catch problems early and provide the best treatment.

What Is Diabetic Retinopathy?

Diabetic retinopathy happens when high blood sugar damages the blood vessels in the back of your eye (called the retina). Over time, these blood vessels can leak, swell, or grow incorrectly, which causes vision problems.

You may be at risk if you:

• Have had diabetes for many years
• Struggle to control your blood sugar
• Have high blood pressure or high cholesterol
• Are pregnant and have diabetes
• Smoke

Diabetic Retinopathy Stages

This disease develops in stages:

• Mild nonproliferative diabetic retinopathy – small changes in the blood vessels lead to weak spots in the blood vessel walls (called microaneurysms).
• Moderate to severe nonproliferative diabetic retinopathy – more damage leads to blockage of some blood vessels. You may develop swelling (edema) or bleeding in the retina that may need treatment.
• Proliferative diabetic retinopathy – new, weak blood vessels grow and can bleed or cause scars, leading to serious vision loss if not treated quickly.

Complications of Diabetic Retinopathy

If left untreated, diabetic retinopathy can lead to:

• Vitreous hemorrhage: bleeding into the gel in the back of the eye
• Retinal detachment
• Glaucoma: damage to the optic nerve, which is the cable that connects the eye to the brain

All of these complications can result in permanent vision loss or blindness.

Symptoms of Diabetic Retinopathy

You might not notice any symptoms at first. That’s why regular eye exams are so important. As the disease gets worse, you may have:

• Blurry or wavy vision
• Dark spots, floaters, or cobwebs in your vision
• Trouble seeing at night
• Vision that comes and goes

If you notice any of these signs, don’t wait. Early treatment can help save your sight.

Screening & Diagnosis

A simple eye exam can detect diabetic retinopathy early, even before you have symptoms. During the exam, your eye doctor looks closely at the blood vessels in your retina. You may also need special photos or scans to check for damage.

At UVA Health, we use advanced tools to find problems early and track changes over time.

Prevention

There are steps you can take to prevent your diabetes from affecting your eyes or causing serious damage:

• Blood sugar monitoring: Talk to your doctor about how to monitor your blood sugar at home.
• Hemoglobin A1C: This is a blood test that your doctor performs. The goal value is less than 7 for most people with diabetes to limit damage to their eyes. Talk to your doctor about how often you should have this checked.
• Blood pressure: Check your blood pressure at home. The goal is to keep your blood pressure in a normal range (less than 120/80). Talk to your doctor about whether you need medications to control your blood pressure.
• Avoid smoking: Smoking can damage your eyes, and this risk is higher in people with diabetes.
• Get regular check-ups: See your primary care or diabetes doctor and eye doctor regularly.

Diabetic Retinopathy Treatment

The right diabetic retinopathy treatment depends on your stage of disease. Options include:

• Careful monitoring if the damage and your symptoms are mild
• Injections to reduce swelling and slow disease progression
• Laser treatment to stop leaking blood vessels
• Surgery if bleeding or scars threaten your vision

Our eye care team will create a personalized plan that fits your needs, and work with your diabetes doctor to keep your eyes as healthy as possible.