Diabetic Retinopathy: Symptoms, Screening & Treatment

Overview

The retina is the light-sensitive layer at the back of the eye that depends on a fine network of blood vessels for its blood supply. Persistently high blood sugar levels damage these small vessels, causing them to leak, become blocked, or trigger abnormal new vessel growth — this is diabetic retinopathy.

Diabetic retinopathy typically progresses in stages, from mild non-proliferative changes to more advanced proliferative disease, and can also cause diabetic macular oedema, where fluid accumulates in the central part of the retina responsible for sharp vision.

Because early retinal changes usually cause no symptoms, screening is recommended for every person with diabetes regardless of how their vision feels.

Symptoms

Diabetic retinopathy often has no symptoms in its early stages. As it progresses, patients may notice:

• Blurred or fluctuating vision
• Dark spots or floaters in the field of vision
• Difficulty seeing at night
• Colours appearing washed out
• Sudden vision loss, which can occur with bleeding inside the eye or retinal detachment in advanced disease

Causes

Diabetic retinopathy is caused directly by prolonged exposure of the retinal blood vessels to high blood glucose levels, which weakens vessel walls and disrupts normal blood flow to the retina.

Risk Factors

• Long duration of diabetes
• Poor blood sugar control (high HbA1c)
• Coexisting high blood pressure or high cholesterol
• Pregnancy in a woman with diabetes
• Kidney disease related to diabetes
• Smoking

When to See a Doctor

Every person with diabetes should have a dilated retina examination at diagnosis and at least once a year afterwards, even with normal vision.

Seek prompt evaluation for any sudden blurring, new floaters, flashes of light, or a curtain-like shadow in vision, as these can indicate bleeding or retinal detachment needing urgent attention.

Diagnosis

Diabetic retinopathy is diagnosed through a comprehensive dilated retinal examination, supported by retinal imaging to document and grade the extent of the disease.

Tests

• Visual acuity assessment
• Dilated fundus examination to inspect the retina directly
• Fundus photography with the Remidio fundus camera to document and monitor retinal changes over time
• Optical coherence tomography (OCT), available on a rental basis, to assess for macular oedema
• Referral to a visiting retina consultant for advanced disease requiring specialised retina-specific procedures

Treatment Options

Treatment depends on the stage of retinopathy and whether the macula is affected. Strict blood sugar, blood pressure and cholesterol control are essential at every stage and reduce the risk of progression.

• Regular monitoring alone for mild, early-stage changes
• Laser photocoagulation to stabilise abnormal or leaking blood vessels
• Anti-VEGF or steroid injections into the eye for diabetic macular oedema, performed by the retina consultant
• Vitreoretinal surgery for advanced disease with bleeding or retinal detachment
• Close coordination with your diabetologist/physician for overall diabetes management

Expected Outcomes

With timely screening and treatment, most vision loss from diabetic retinopathy is preventable. Outcomes are best when the condition is caught at an early stage and when blood sugar and blood pressure are well controlled alongside eye-specific treatment.

Why Choose Dr. Murkute's O2 Bone & Eye Care

• Comprehensive diabetic eye screening with dilated examination and fundus photography
• Access to a visiting retina consultant for advanced diagnosis and retina-specific treatment
• Clear explanation of retinopathy stage and personalised follow-up schedule
• Coordinated approach with your physician for overall diabetes control
• Convenient Kharadi location for patients across East Pune