Nuffield Health Bournemouth Hospital, Lansdowne Road, Bournemouth, UK
For inquiries about cataract surgery, macular degeneration, or retinal disorders, please call 01202 702841.
About Diabetic retinopathy
What is Diabetic Retinopathy?
Diabetic retinopathy is an eye condition that can occur in people with diabetes. It is caused by damage to the small blood vessels in the retina, the light-sensitive layer at the back of the eye that is essential for vision.
Over time, high blood sugar levels can weaken and damage these blood vessels, leading to leakage, bleeding, or blockage. Diabetic retinopathy can affect both eyes and is one of the most common causes of sight loss in working-age adults in the UK. Early detection and treatment can significantly reduce the risk of serious vision loss.
Who is at Risk?
Anyone with type 1 or type 2 diabetes can develop diabetic retinopathy. The risk increases with:
- Longer duration of diabetes
- Poor blood sugar control
- High blood pressure
- High cholesterol
- Kidney disease
- Smoking
- Pregnancy (in women with diabetes)
Stages of Diabetic Retinopathy
Diabetic retinopathy usually develops gradually and may progress through several stages:
Background (Mild) Diabetic Retinopathy
Small areas of blood vessel damage
Often causes no symptoms
Usually does not affect vision
Pre-proliferative (Moderate to Severe) Diabetic Retinopathy
More widespread blood vessel damage
Increased risk of vision problems
Requires closer monitoring
Proliferative Diabetic Retinopathy
New, fragile blood vessels grow on the retina
These can bleed or cause scarring
Can lead to serious and permanent vision loss if untreated
Diabetic Maculopathy (Macular Oedema)
At any stage, diabetes can cause swelling of the macula (the central part of the retina), known as diabetic maculopathy or macular oedema. This is a common cause of reduced vision in diabetes.
Symptoms
In the early stages, diabetic retinopathy often causes no symptoms. As the condition progresses, symptoms may include:
- Blurred or fluctuating vision
- Difficulty reading or recognising faces
- Dark spots or floaters
- Patches of missing vision
- Sudden vision loss (in advanced cases)
Because symptoms may appear late, regular screening is essential.
Diabetic Eye Screening (UK)
In the UK, everyone aged 12 and over with diabetes is invited to attend annual diabetic eye screening through the NHS.
Screening involves:
- Eye drops to dilate the pupils
- Retinal photographs
- Assessment for signs of diabetic retinopathy
Screening can detect problems before vision is affected and is a key part of preventing sight loss.
When to Seek Urgent Help
Seek urgent medical advice if you notice:
- Sudden loss or worsening of vision
- New floaters or dark patches
- Distortion or blurring that does not improve
Contact your optician, GP, diabetes team, or local eye casualty department.
How is Diabetic Retinopathy Diagnosed?
If changes are detected at screening or if symptoms develop, you may be referred to an ophthalmologist. Tests may include:
- Detailed retinal examination
- Retinal scans (Optical Coherence Tomography, OCT)
- Retinal photographs
- Dye tests (fluorescein angiography) in some cases
Treatment Options
Treatment depends on the stage and whether the macula is affected.
Diabetic Macular Oedema
Anti-VEGF injections into the eye
Sometimes steroid injections or implants
Aimed at reducing swelling and improving or stabilising vision
Proliferative Diabetic Retinopathy
Laser treatment (pan-retinal photocoagulation) to reduce the risk of severe vision loss
Occasionally surgery may be required for advanced bleeding or scarring
Treatment is usually provided through NHS hospital eye services, but also can be provided privately
What to Expect
Early stages may only require monitoring
Treatment may involve multiple visits and ongoing follow-up
Vision outcomes vary, but early treatment greatly improves the chance of preserving sight
Your eye specialist will explain the likely outcome for your individual situation.
Looking After Your Eyes
You can reduce the risk of progression by:
- Keeping blood sugar levels within target range
- Controlling blood pressure and cholesterol
- Attending all diabetic eye screening appointments
- Not smoking
- Taking prescribed medications as advised
Good overall diabetes control is the most important factor in protecting your vision.
Living with Diabetic Retinopathy
Many people continue to live full and independent lives. Support may include:
- Good lighting and magnification aids
- Referral to low vision services
- Advice from occupational therapy
If vision is significantly affected, registration as sight impaired may give access to additional support and benefits.
Driving and Diabetic Retinopathy
Driving depends on your level of vision. You must meet DVLA visual standards and inform the DVLA if required. Your eye care professional can advise you.
Further Information and Support
The Macular Society (UK) – information, helpline, and local support groups
RNIB – information and visual support
Diabetes UK – advice on managing diabetes and complications
