If you have type 1 or type 2 diabetes, you probably already know that you have a greater chance of developing eye problems. One of the most common ones is diabetic retinopathy. This is a condition that affects the blood vessels in your retina, the light-sensitive tissue in the back of your eye. If you have too much sugar in your blood, there’s damage to the tiny blood vessels that provide oxygen and other nutrients to the retina. As a result, your eyes can’t work properly, and you get blurry vision.
You may not have symptoms at first. But over time, if left untreated, diabetic retinopathy can cause these other serious, potentially sight-stealing eye complications:
Diabetic macular edema (DME). Over time, about half of people with diabetic retinopathy will develop DME. When you have diabetic retinopathy, the walls of the blood vessels in your retina weaken. They can leak fluid and blood into the central part of your retina, known as your macula. This is the part of the retina responsible for sharp, detailed central vision. The macula swells and causes symptoms like blurriness, double vision, and a sudden increase in eye floaters.
The standard treatment is anti-VEGF medication. These medicines help to lessen swelling of the macula by blocking a substance called vascular endothelial growth factor (VEGF), which promotes blood vessel growth. This can slow the progress of DME.
Vitreous hemorrhage. The new blood vessels may bleed into the clear, jelly-like substance that fills the center of your eye. The blood blocks light from reaching your retina. If the amount of bleeding is small, you might see only a few dark spots (floaters). In more serious cases, the blood can fill the vitreous cavity and completely block your vision.
Diabetes isn’t always the cause of a vitreous hemorrhage, but it’s still important to see your doctor right away to prevent bleeding. The blood sometimes clears from your eye within a few weeks or months, but your eye doctor will need to watch you closely during this time. If it doesn’t clear, you’ll need a vitrectomy surgery, which removes the vitreous, or other treatments.
Neovascular glaucoma. If you have abnormal blood vessels that grow out of your iris (the colored part of your eye), they can block fluid from draining. This causes a type of glaucoma. The fluid can build up quickly, causing a sudden increase in eye pressure. If it’s not treated, this type of glaucoma can cause blindness in just a few days.
A doctor can use laser treatment and give you medicine to help the fluid drain. This can lower eye pressure and protect your vision.
Retinal detachment. Diabetic retinopathy can progress to a more serious form known as proliferative retinopathy. The blood vessels become completely blocked, and your body responds by growing new blood vessels in your retina. These vessels are weak, so they can leak blood and cause scar tissue to grow. This tissue may ultimately pull your retina away from the back of your eye. Symptoms include:
- A lot of new floaters
- Flashes of light in one or both eyes
- A dark shadow or “curtain” on the sides or in the middle of your field of vision
A retinal detachment is a medical emergency. If you have symptoms, see your eye doctor immediately, or go to the ER. Doctors can treat a small hole or tear with a freezing probe or a medical laser to seal it shut. If a large part of your retina is detached, you’ll need surgery. The good news is it has about a 90% success rate, especially if you catch it early.
There are things you can do to prevent complications from diabetic retinopathy. They include:
Manage your diabetes. The better control you have over your blood sugar, the better chance your diabetic retinopathy won’t progress. The sugar itself damages the tiny blood vessels that go to your retina, which causes them to leak fluid or bleed.
Watch your blood pressure. If it’s elevated, it can also damage your blood vessels, including the ones in your eyes.
Ask your doctor about treatments. Research suggests that if treatments are done in the early stages of disease, they may slow down the progression of diabetic retinopathy. This will lessen complications that can threaten your vision.
National Eye Institute: “Diabetic Retinopathy,” “Retinal Detachment,” “Macular Edema.”
Mayo Clinic: “Diabetic Retinopathy.”
Prevent Blindness: “Diabetes-related Macular Edema.”
National Institutes of Health: “Preventive treatment reduces diabetic retinopathy complications.”
Kellogg Eye Center, University of Michigan: “Vitreous Hemorrhage.”
Glaucoma Research Foundation: “Diabetes and your Eyesight.”
American Academy of Ophthalmology: “Causes of Glaucoma.”
American Diabetes Association: “Eye Complications.”