By Reena Mukamal for the American Academy of Ophthalmology Oct. 12, 2023
Learning that you have diabetic retinopathy can be nerve-wracking. You might worry about losing your vision or feel overwhelmed by the treatment plan.
The first step to protecting your vision is to understand the condition. Read about diabetic retinopathy on EyeSmart, watch these short educational videos and decide whether lifestyle changes are needed. You may be surprised at how diabetes affects your routine eye care. Be sure to write down any questions that occur to you so that you can ask your doctor at your next appointment.
In the meantime, here’s some of the most common answers and advice that retina specialist and Academy member Rahul Khurana, MD, gives to newly diagnosed patients.
Why do I need to return so often for follow-up appointments?
Early treatment can prevent severe vision loss in 90% of people with diabetic retinopathy. But early treatment is only possible if you are vigilant about having your eyes checked routinely, Dr. Khurana says.
Patients with diabetic retinopathy who attend regular check-ups and report changes in vision to their doctor as soon as possible are likely to get prompt treatment, which can prevent blindness.
The longer you’ve had diabetes, the more risk there is for vision problems. That’s why it’s important to follow the schedule your eye doctor recommends for check-up appointments. But if you notice any changes in your vision, like seeing more floaters, having blurriness, seeing dark spots or faded colors, don’t wait for your next appointment. Call your eye doctor right away.
My vision seems fine. How can I have such a serious condition?
You can have diabetic retinopathy even if you haven’t noticed changes in your vision. This condition develops when blood sugar remains high for a long time and begins to damage the cells in the back of your eye, known as your retina.
Diabetic retinopathy can start damaging your retina even before you notice changes in vision, which is why you need to see an eye doctor regularly. Sometimes, you might not realize that your vision is getting worse because your healthier eye is helping you see, Dr. Khurana explains.
Can I get back vision I’ve lost to diabetic retinopathy?
The best way to prevent vision loss is to control your blood sugar, blood pressure and cholesterol levels. That means eating a healthy diet, maintaining a healthy weight, exercising regularly, quitting smoking and taking your diabetes medicine as prescribed.
Lasting improvements in blood sugar, blood pressure and cholesterol can potentially even restore some of the vision you’ve lost to the disease.
“These lifestyle changes are not just good for your eyes but also for your heart, brain, kidneys and overall health,” says Dr. Khurana.
How does diabetic retinopathy damage the eye?
Diabetic retinopathy can harm your eyes in different ways, depending on how advanced it is. In the early stages, tiny blood vessels in your retina may leak blood or other fluids and begin to swell (macular edema).
In more advanced stages of the disease, new and fragile blood vessels can grow in the retina and bleed into the clear gel between the lens and retina (vitreous). This can make you see floaters or, if there’s a lot of bleeding, it might block your vision completely.
In the most advanced stage of diabetic retinopathy, abnormal blood vessels can cause scar tissue to develop, which can pull your retina away from the back of your eye (detached retina).
How effective are treatments for diabetic retinopathy?
Today’s treatments for diabetic retinopathy are more effective than ever. Treatments are available to slow or even reverse vision loss, and your eye doctor will suggest the best treatment for your specific needs.
For macular edema, anti-VEGF medication can reduce swelling in the retina and help preserve or improve your vision. This treatment is given as an eye injection. Another option is steroid medicine, also given as an eye injection, to reduce retinal swelling. Your doctor will tell you how many injections you need over time.
Abnormal blood vessel growth can also be treated with Anti-VEGF shots or laser surgery to close off leaking vessels. In more serious cases, you might need a surgery called vitrectomy to remove blood and scar tissue from the back of your eye, so that light can focus properly on your retina again.
Eye injections sound terrifying. How is anyone brave enough to go through with them?
The idea of a needle going into your eye might sound terrifying, but it’s not as bad as you might think. The shots are usually quick and almost painless, and they do a great job at protecting your vision. Your eye is numbed first, and you typically won’t see the needle. The injection itself only takes a few seconds. You might feel a little sore afterward or have a slight, temporary burning feeling.
How will my life change if I lose vision due to diabetic retinopathy?
Even if you lose some vision because of diabetic retinopathy, you can still have a fulfilling life. Your eye doctor can connect you with a low vision specialist who can help you find tools and strategies to make the most of your remaining vision. Magnifiers, electronic devices, talking glucose monitors, and even smartphone apps can assist you with your daily tasks. Plus, a specialist can help you set up your home in the safest way possible.