The Risk of Untreated Diabetic Retinopathy

Medically Reviewed By William C. Lloyd III, MD, FACS
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If you have diabetes, you have to pay careful attention to more than just your blood sugar levels. Your eyes are vulnerable, too. In fact, people with diabetes are at increased risk for certain kinds of eye disease, including diabetic retinopathy. Diabetic retinopathy is the result of damage to the tiny blood vessels that feed the retina, which is the light-sensitive area at the back of the eye. If you don’t seek treatment for your diabetic retinopathy, you could be putting your eyesight at risk, and even lose it completely.

How Diabetic Retinopathy Can Cause Vision Loss

Why do people with diabetes develop diabetic retinopathy? People who have trouble controlling their blood sugar levels seem to be at the greatest risk. High blood sugar levels damage the small, delicate blood vessels that nourish the retina. When damaged, those vessels tend to leak fluids or bleed, which can affect your vision. The leaking causes swelling in the macula, which is the central part of your retina and the part of your eye that helps you focus on details.

In the early, or nonproliferative, stage of the disease, you might not notice anything wrong for quite a while. That’s common. But eventually, you might notice your vision seems blurred or cloudy. You might start noticing little spots or floaters in your vision. As the disease progresses, the damage worsens and your vision will get worse, too. Those blood vessels may shrink and even lose their capacity to transport blood to the retina. And other blood vessels may get blocked.

At some point, if untreated, the disease progresses to the stage known as proliferative diabetic retinopathy, or PDR. At this advanced stage, the retina is starving for fresh oxygen and serious damage can occur. In response, the retina stimulates the growth of abnormal blood vessels that leak. Scar tissue can develop and cause your retina to pull away from the tissue underneath. This retinal detachment can cause permanent vision loss.

Another possible complication of diabetic retinopathy is glaucoma. The pressure that can build up when new blood vessels grow and obstruct the usual flow of fluid in and out of the eye can permanently damage the optic nerve. You can experience vision loss as a result of glaucoma, too.

How to Intervene

Vision loss is a scary prospect. Fortunately, there’s a way to detect the progression of the disease before it’s too late: get your eyes examined. In fact, the National Eye Institute reports that early detection and treatment can reduce your chances of developing blindness as a result of diabetic retinopathy by a whopping 95%.

Experts strongly recommend everyone with diabetes get a comprehensive dilated eye examination once a year. During this type of exam, an ophthalmologist puts dilating drops in your eye and examines your retina and optic nerve. The doctor will be checking for any changes to your blood vessels, including leaks, as well as swelling of the macula. Your doctor might also perform an optical coherence tomography (OCT) test, which is similar to an ultrasound, to get more detailed images of your eye.

That way, if there are signs of developing diabetic retinopathy, the doctor will see them and can discuss the best way to proceed with you. Even if you don’t notice any signs of impending trouble with your vision, you should make an annual appointment for the exam. The signs may be too subtle for you to detect, but that doesn’t mean they aren’t occurring.

How Treatment Can Help

Once you know what you’re dealing with, you can take steps to preserve your vision. Your treatment options depend on how advanced your case of diabetic retinopathy is. If it’s in the early stages, your doctor may advise you to watch and wait–and keep your blood sugar levels under tight control. You’ll also need to commit to regular follow-up visits to monitor the progression.

Other diabetic retinopathy treatment options to ward off vision loss include:

  • Laser treatment. During scatter laser surgery or laser photocoagulation, your ophthalmologist will focus a laser on your retina to create hundreds of tiny laser burns. The goal is to stop the formation of new blood vessels and shrink any existing ones.

  • Intravitreal injections. Your doctor can inject a biologic medication into your eye to stop the release of a chemical called vascular endothelial growth factor (VEGF), which promotes blood vessel growth and leakage.

  • Vitrectomy surgery. This procedure is recommended for people who’ve had bleeding into the vitreous gel in the center of the eye. A surgeon will remove the vitreous gel and replace it with a sterile It should help restore your vision.

In case you need another reason to maintain good control of your blood sugar levels, here it is! You can’t completely eliminate your chances of developing diabetic retinopathy, but your actions can prevent serious vision loss. Pay attention to any changes in your vision, too, and don’t hesitate to contact your doctor if you notice any problems.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jul 2
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