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What is diabetic retinopathy (DR)?
What is diabetic retinopathy (DR)?
Diabetic retinopathy is an eye condition that can develop in people with diabetes. It happens when long-term high blood sugar damages the tiny blood vessels at the back of the eye, called the retina, which is responsible for sharp, detailed vision.
Over time, these weakened blood vessels can leak fluid or blood, or become blocked. In more advanced stages, abnormal new blood vessels may grow on the retina, which are fragile and can bleed easily. This can lead to severe loss of sight if left untreated.
The condition often has no early symptoms, which is why regular eye checks are very important for anyone with diabetes. The good news is that early detection and treatment—along with good control of blood sugar, blood pressure, and cholesterol—can significantly reduce the risk of permanent vision loss.
How does diabetes affect the eyes?
How does diabetes affect the eyes?
Diabetes can affect the eyes in several ways, mainly because high blood sugar damages small blood vessels and nerves that are essential for healthy vision.
How diabetes affects the eyes
How diabetes affects the eyes
1. Diabetic retinopathy
High blood sugar damages the tiny blood vessels in the retina. These vessels can leak fluid or blood, become blocked, or grow abnormally. This is the most common diabetes-related eye condition and a leading cause of vision loss.
2. Diabetic macular oedema (DMO)
Fluid can leak into the macula (the central part of the retina responsible for detailed vision), causing swelling and blurred or distorted central vision.
3. Cataracts
People with diabetes tend to develop cataracts earlier and more quickly. High sugar levels cause the natural lens of the eye to become cloudy, leading to blurred or faded vision.
What are the symptoms of diabetic retinopathy (DR)?
What are the symptoms of diabetic retinopathy (DR)?
Blurred or fluctuating vision
Dark spots, floaters, or cobweb-like shadows
Difficulty reading or seeing fine details
Patchy or missing areas of vision
Poor night vision
Distorted or wavy vision
Sudden vision loss (in advanced stages or with bleeding)
What is diabetic macular oedema (DMO)?
What is diabetic macular oedema (DMO)?
Diabetic macular oedema (DMO) is a complication of diabetes that affects the macula, the central part of the retina responsible for sharp, detailed vision (such as reading and recognising faces).
It occurs when diabetes damages small blood vessels in the retina, causing them to leak fluid and proteins into the macula. This leakage leads to swelling (oedema), which blurs and distorts central vision.
DMO is diagnosed with retinal assessment and specialised scan known as optical coherence tomography (OCT)
What is the treatment?
What is the treatment?
Diabetic Retinopathy
Diabetic Retinopathy
1. Mild to moderate non-proliferative DR
1. Mild to moderate non-proliferative DR
Observation and monitoring
No immediate eye treatment may be needed
Regular retinal photography / OCT scans
2. Severe non-proliferative or proliferative DR
2. Severe non-proliferative or proliferative DR
a. Retinal laser treatment (pan-retinal photocoagulation, PRP)
Laser reduces oxygen demand of the retina
Causes abnormal blood vessels to shrink
Proven to reduce risk of severe vision loss
b. Anti-VEGF injections
Medications injected into the eye to reduce abnormal vessel growth
Often used if there is associated macular oedema or high-risk proliferative disease
c. Vitrectomy surgery
Used when there is:
Persistent vitreous haemorrhage
Retinal detachment
Scar tissue causing traction
This is an eye operation to remove blood and scar tissue and stabilise the retina.
Diabetic Macular Oedema
Diabetic Macular Oedema
1. Anti-VEGF eye injections (first-line treatment)
1. Anti-VEGF eye injections (first-line treatment)
These medications reduce leakage and swelling:
Given as a series of injections
Often results in improved or stabilised vision
Requires ongoing monitoring and sometimes long-term treatment
2. Steroid eye injections or implants
2. Steroid eye injections or implants
Used if anti-VEGF is insufficient or not suitable
Reduce inflammation and leakage
May increase eye pressure or cataract risk, so careful monitoring is needed
3. Focal or grid laser treatment
3. Focal or grid laser treatment
Used in selected cases
Helps seal leaking blood vessels
Less commonly used now but still valuable in specific situations
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