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Treating Diabetic Macular Edema

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Signs of Diabetic Retinopathy: Symptoms, Diagnosis, and More

Medically Reviewed By William C. Lloyd III, MD, FACS

Diabetic retinopathy is a complication of diabetes that can lead to vision loss. Symptoms of diabetic retinopathy can include difficulty seeing color and fluctuating vision. Diabetes can cause high blood sugar levels. Blood sugar levels that are not treated effectively can damage the blood vessels in the retina over time.

Without proper treatment, diabetic retinopathy may lead to vision loss. However, early treatment and monitoring can help reduce the risks or stop the condition from worsening.

This article explains the signs of diabetic retinopathy, including at different stages of progression. It also discusses when to contact a doctor for signs of diabetic retinopathy, the diagnostic process, and some frequently asked questions.

Signs of diabetic retinopathy

A woman sits while an optometrist uses equipment to examine her eye.
Photography by PeopleImages/Getty Images

Symptoms of diabetic retinopathy can include:

  • Blurry vision: This can appear as hazy or fuzzy vision and an inability to see detail.
  • Eye floaters: These are floating shadows that move across the eye and impair vision. At later stages, eye floaters may appear dark.
  • Patchy vision: Diabetic retinopathy may cause dark patches in your vision or empty patches where you cannot see anything.
  • Fluctuating vision: This refers to when the quality and clarity of your vision changes from time to time, such as hazy vision that comes and goes.
  • Difficulty seeing in the dark: Trouble seeing in dark or dim lighting could be a symptom of diabetic retinopathy.
  • Difficulty distinguishing colors: This can present Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source as difficulty distinguishing or identifying shades or colors.
  • Vision loss: You may notice a reduction in the quality of your vision or your ability to see in some ways. For example, you may experience a decrease in your peripheral vision. This vision loss may be gradual or sudden.
  • Eye pain or redness: Diabetic retinopathy can cause higher pressure inside the eye, known as glaucoma. This may lead to pain or visible redness.

Symptoms of diabetic retinopathy can vary, and not everyone will experience the same symptoms in the same way. Diabetic retinopathy symptoms can develop gradually, come and go, or appear suddenly.

Some people may experience mild or minimal symptoms. Others may experience severe symptoms that impact daily life.

Diabetic retinopathy stages

There are different stages of diabetic retinopathy. These types include:

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  • Early diabetic retinopathy or non-proliferative diabetic retinopathy (NPDR): Damaged or swollen blood vessels may leak blood into the retina. Many people do not experience symptoms at this stage. Others may experience mild symptoms.
  • Advanced diabetic retinopathy or proliferative diabetic retinopathy (PDR): The blood vessels in the eye may narrow, meaning that the retina may not receive enough oxygen. This can cause new, atypical blood vessels to grow and leak blood. PDR can also lead to inflammation and retinal detachment. PDR may cause more noticeable or severe symptoms.

According to the National Institutes of Health (NIH), the longer a person has diabetes, the higher the risk Trusted Source National Eye Institute Governmental authority Go to source of developing an eye disease as a complication of diabetes.

This means that you may be more likely to experience symptoms of diabetic retinopathy after having diabetes for a while. However, some people may still develop diabetic eye conditions earlier.

When to see a doctor

Contact an optometrist or ophthalmologist immediately after noticing vision or eye symptoms, including if:

  • You have symptoms that you feel are mild, come and go, or do not appear to be worsening.
  • You have diabetes or a family history of diabetes or vision conditions.
  • You have prediabetes or diabetes, and you have questions about your eye health.
  • You have difficulty following your diabetes treatment plan or have questions about your treatment.

Only a qualified eye doctor will be able to check your eye health. Also, some factors may make it hard to identify or interpret your condition alone, for example:

  • Some people may otherwise have good or 20/20 vision, so may believe they do not have an eye condition.
  • Some symptoms can be general and may be shared with other conditions. For example, some people may misidentify blurry vision as myopia, or shortsightedness.
  • Some early signs of diabetic retinopathy, such as microaneurysms, may not be visible or noticeable to you. However, an eye doctor may be able to see them during exams of the inner eye.

In addition, if you have diabetes, it is vital to get regular eye health checks with an eye doctor even if you do not have symptoms. Early treatment can improve your outlook and protect you from vision loss.

The NIH recommends that people with diabetes get an eye exam at least once a year Trusted Source National Institutes of Health Governmental authority Go to source . A 2017 review also suggests that people with moderate to severe retinal damage get an eye exam as often as every 3–6 months Trusted Source The New England Journal of Medicine Highly respected journal, Expert written journal, Peer reviewed journal Go to source . However, your eye doctor may recommend a personalized checkup routine based on your condition.

Diagnosis

The diagnostic process may start with your eye doctor asking about your symptoms and medical history, including your treatment for diabetes.

An eye doctor can then use several tools and tests to check your eye health, such as:

  • Comprehensive eye examination: This exam can test vision changes, any prescription glasses, and the structure and pressure of the eye.
  • Eye drops: Drops dilate the pupils so that the doctor can examine the retina.
  • Optical coherence tomography: This exam uses sound waves to measure your retina.
  • Fluorescein angiogram: This uses a dye to help your doctor check for changes to the retina. The dye may be injected in another body area, such as your arm, and travel up to the eye.

These tests can also help identify conditions and signs of diabetic retinopathy that you may not be able to notice alone.

Following diagnosis, your eye doctor will create a treatment plan.

Summary

Symptoms of diabetic retinopathy can include vision loss, difficulty seeing colors or seeing in the dark, and eye floaters. These symptoms can vary. For example, symptoms may come and go, develop gradually or suddenly, and range from mild to severe.

Contact an eye doctor immediately if you have any symptoms of diabetic retinopathy or vision changes.

Early diabetic retinopathy may not always cause noticeable symptoms for the person with the condition. As a result, if you have diabetes, contact your eye doctor to discuss regular monitoring, as they may be able to spot early signs of diabetic retinopathy.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2023 Mar 14
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