Retina
Diabetic retinopathy: checking in time is what saves sight
Diabetic retinopathy is one of the leading causes of sight loss in working-age adults. The most important thing to know is that early on it causes no symptoms.
By Dr Idaira Sánchez Santos, ophthalmologist · Nº 390905425
Last reviewed: · Patient information. It does not replace a medical consultation.
What diabetes does to the retina
Over the years, high blood sugar damages the tiny vessels of the retina. Microaneurysms, small haemorrhages and poorly perfused areas appear. In advanced stages (proliferative retinopathy) fragile new vessels grow that can bleed or pull on the retina.
At any stage diabetic macular oedema can develop: fluid in the macula, which is the most common cause of vision loss.
Why you need check-ups even if you see well
You can have significant retinopathy and still see well. That is why regular retinal screening is recommended, usually every year or as often as your ophthalmologist advises. Good control of blood sugar, blood pressure and cholesterol greatly reduces the risk of progression.
How it is treated
- Intravitreal injections of anti-VEGF drugs or steroid implants for macular oedema.
- Laser (photocoagulation) at certain stages, especially proliferative retinopathy.
- Vitrectomy when there is bleeding that does not clear or traction on the retina.
The choice depends on the stage, the OCT and your general health.
When an online consultation helps
- You have been told you have retinopathy or macular oedema and want to understand your stage.
- You want a second opinion on starting or continuing injections or laser.
- Your check-ups are delayed and you want a specialist to review your retinal photos and OCT.
- You need a clear follow-up plan and to know what to watch for.
Which tests to send the doctor
- Retinal photographs of both eyes
- Macular OCT (and its progression if you have several)
- Latest HbA1c and blood pressure
- Reports of previous treatment (injections, laser, surgery)
Sudden loss of vision, a "shower" of black spots or a shadow over part of your sight may mean a bleed or a detachment. Go to an eye emergency department.
Frequently asked questions
If I see well, do I still need check-ups?
Yes. Diabetic retinopathy usually progresses without symptoms until late. Regular screening is the best protection.
Is good blood sugar control enough?
It is the most important way to prevent and slow retinopathy, together with blood pressure and cholesterol. But once there is macular oedema or proliferative retinopathy, eye treatment is also needed.
Is a screening photo from my GP or diabetes clinic useful?
Yes, screening photographs are very useful. Send them together with an OCT if you have one.