Diabetic retinopathy

Diabetic retinopathy is an eye disease linked to type 1 and type 2 diabetes. It can develop when high blood sugar levels damage the small blood vessels in the retina, which is the tissue lining the back of your eyes. This can affect your vision, but you can protect your eye health by managing your blood sugar, seeing your provider for regular eye exams, and getting treatments when needed.

Comprehensive eye care specialists at Penn Medicine are experts at detecting diabetic retinopathy and other diabetes-related eye diseases. Our providers can diagnose the disease before symptoms appear and provide advanced therapies that help prevent further damage to your retinas. Diabetes can affect your eyesight, but we can help lower your risk of vision loss.

In the early stages of diabetic retinopathy, you may not have any eye symptoms. As the disease gets worse, symptoms can appear in one or both eyes. You might experience:

• Blurred vision
• Spots or shapes in your vision, known as floaters
• Shadows or dark areas in your field of vision
• Vision loss

Diabetic retinopathy is caused by high blood sugar levels from type 1 diabetes or type 2 diabetes. When light hits your retinas, they send signals to your brain that allow you to see colors and fine detail. Your retinas also give you peripheral vision and help you see in low light. But if high blood sugar damages the small blood vessels that keep your retinas healthy, your vision can go from clear to blurry or distorted over time.

Diabetic retinopathy develops in two stages. In the early stage of the disease, called nonproliferative diabetic retinopathy, small blood vessels in your retinas can become damaged. Sometimes they leak blood or fluid. Some patients experience vision loss during this stage of the disease, while others may not notice much vision change. As the disease gets worse, new, irregular blood vessels form in the retina that can leak blood into the gel-like fluid called vitreous that fills the center of your eye, causing floaters or blocking your vision. This later stage is known as proliferative diabetic retinopathy, and it can lead to vision loss.

Your doctor can diagnose the disease with an eye exam that dilates your pupils. You’ll be given eye drops that widen your pupils and allow your doctor to examine the backs of your eyes. Imaging tests of your retinas can also help diagnose the disease, including optical coherence tomography and fluorescein angiography.

If your eye disease is mild, your eye specialist may monitor you before starting treatment. Controlling your blood sugar and blood pressure through lifestyle and medication can help prevent the disease from worsening. If you have more advanced diabetic retinopathy, your eye specialist may recommend laser treatment or eye injections. Your doctor might also recommend eye surgery to remove scar tissue or blood.

Diabetic retinopathy can’t always be prevented, but you can take steps to lower your risk of developing it or of serious symptoms, like vision loss. Managing your diabetes, blood pressure, and cholesterol can protect blood vessels in your eyes. It’s also important to see your eye specialist for regular eye exams. If you notice any changes in your vision, see your health care provider.

Penn Medicine is home to top specialists in ophthalmology who deliver personalized care for diabetic retinopathy and other eye diseases. With a high level of expertise, we provide an accurate diagnosis and the most effective treatments to help preserve your vision by slowing or stopping the progression of diabetic retinopathy. We also coordinate your care with your other providers as you manage your blood sugar and take other measures that can improve diabetes eye problems.

Our ongoing research drives continual improvements in treatments for diabetic eye disease, earning Penn Medicine’s researchers recognition for advancing patient care. Our work in understanding diabetic retinopathy allows us to bring you the latest treatment options to preserve healthy vision.