6 Things to Know about Diabetic Eye Diseases


6 Things to Know about Diabetic Eye Diseases
People with diabetes stand at an increased risk of a group of eye diseases (categorised as diabetic eye diseases) including Diabetic Retinopathy, Diabetic Macular Edema, and Glaucoma.

If you have diabetes, you need to take special care in order to lower the risks of diabetic eye diseases. Know more about diabetic eye diseases here to take proper care.

1) How does Diabetes affect eye health?

High levels of blood sugar can cause the tissues in your eyes to swell and lead to temporary blurred vision. You may risk causing damage to the tiny blood vessels in the back of your eyes if you do not manage blood sugar levels. The damaged blood vessels, in turn, can leak fluids, lead to the growth of new weak blood vessels, increase the pressure inside the eyes, and/or cause swelling.

2) Protecting the eyes when you have diabetes:-

Managing your blood sugar levels is the best way to lower the risk of onset of diabetes eye complications mentioned above. You can talk with your eye doctor regarding the measures you need to take to manage your health condition and maintain a good eye health.

Our expert eye doctors at Disha Eye Hospital, a reputed eye hospital in West Bengal, can help you get a precise diagnosis and plan your treatment.

3)The most common diabetic eye disease:-

Diabetic Retinopathy is one of the most common diabetic eye complications. The serious eye complication involves damages to the blood vessels of the retina’s light-sensitive tissue. Diabetic Retinopathy, at early stages, may not cause any symptom or involve mild vision changes. However, the eye complication can lead to permanent blindness if not properly managed.

4) Symptoms and treatment options of  Diabetic Retinopathy:-

As the eye disease progresses, it may cause certain symptoms, including vision loss, vision blurriness, poor colour vision, and seeing floaters/dark spots in your vision. Major risk factors of the eye disease include the duration of Diabetes, tobacco use, pregnancy, and high cholesterol. Treatment options for Diabetic Retinopathy include medication, laser surgery, vitrectomy, and diet changes.

5) Diabetes and Glaucoma:-

People suffering from Diabetes are at an increased risk of developing glaucoma as compared to non-diabetics. A rare type of Glaucoma called Neovascular Glaucoma can occur when the damaged blood vessels on the retina lead to the growth of new, abnormal blood vessels on the iris and increase pressure in the eyes.

One of the treatment options for Neovascular Glaucoma is laser surgery, which is done to reduce the number of abnormal blood vessels on the surface of the retina and on the iris.

6) Diagnosing diabetic eye problems:-

Eye doctors conduct a dilated eye exam to diagnose eye problems caused by Diabetes. Prior to conducting the tests, the doctor may ask for medical history. During the eye exam, the eye specialist will widen the pupils using eye dilating drops. By doing so, the doctor will easily be able to examine the back portion of the eyes. The doctor may measure the pressure in the eyes and test visual acuity.

Get a proper consultation for Diabetic Retinopathy and other diabetic eye problems from our eye specialists in Kolkata

If you have Diabetes and are worried about your eye health, you can book an appointment at http://www.dishaeye.org/appointment and talk with our eye specialists.

Facts on Diabetic Eye Diseases

glaucoma treatment in Kolkata

Do you have diabetes? If yes, then take care of your eyes. It’s because vision problems are one of the most significant complications caused by diabetes and is a common cause of blindness.

Poorly managed diabetes can affect the lens, macula, retina, and optic nerve in your eyes and may cause permanent blindness. This is why it’s important to understand how this condition may affect your eyes.
The most common and serious eye condition caused by diabetes is diabetic retinopathy. However, diabetes causes a number of other eye conditions as well.

How diabetes affects your vision?

Diabetes may affect your vision (in severe cases) and may not, but in any case, it will affect your eyes and the way it functions. This is especially when your blood sugar levels are uncontrollably high. Here’s how it affect your eyes:

  1. Any changes in your blood sugar levels have an impact on your lens. This may blur your vision and as such, you may face difficulty in your day-to-day activities, depending on the blood sugar levels. It’s not necessary that people with diabetes will develop an eye condition. It all depends on your sugar level.
  2. Diabetes also makes your eye lens cloudy. This condition is called cataract. This happens when your eye lens swells due to high levels of blood glucose in the fluid around your eye lens. As a result, the area around the lens has more water than usual and it cannot focus the light properly on the retina. People with diabetes stand at a higher risk of developing cataract at an earlier age than non-diabetic people.
  3. Diabetic people may also develop glaucoma, an eye condition that damages the optic nerve. Elevated blood sugar levels may raise the ocular pressure (pressure inside your eyes) and result in glaucoma.
  4. Diabetes can also affect the flow of blood in your eyes. It may cause blockage in the vessels obstructing the flow of blood to your retina. This blockage can also cause leakage or cause unnatural growth in the vessels. All these conditions cause different types of retinopathy. This condition can turn worse, depending on the severity of the changes in the eye blood vessels.

Eye condition caused by diabetes

The World Health Organisation identifies diabetes as a major cause of blindness all over the globe. It is estimated that by 2030, the number of people suffering from diabetic retinopathy (DR) will rise to 191.0 million and the number of people suffering from vision-threatening diabetic retinopathy including Proliferative and Non-proliferative DR, and Diabetic Macular Edema (DME) may rise to 56.3 million.

Source: http://onlinelibrary.wiley.com/doi/10.1111/ceo.12696/pdf

Here’s a brief overview of eye conditions caused by diabetes:

5. Diabetic Retinopathy

Diabetic Retinopathy is of several types, depending on the level at which the blood vessels in your eyes are affected. This includes:

  • Background Diabetic Retinopathy

This type of retinopathy does not usually affect your eyesight. Your eyes develop this condition when there is a blockage in your capillaries in the retina. This causes the capillaries to swell which is known as microaneurisms.

A microaneurism may also leak blood or a fluid known as exudate. These changes in the eyes don’t affect the vision immediately but the eye doctor needs to monitor it regularly so that the condition doesn’t get worse.

  • Proliferative diabetic retinopathy

The blood vessels in the retina help in delivering oxygen to your retina for its proper functioning. If background retinopathy gets worse, these blood vessels may get completely damaged. As a result, a large section of your retina is affected and the blood supply to the retina is reduced.

This condition is known as ischaemia where particular areas in your retina are deprived of the oxygen they require. Your body then tries to fix this issue by growing new blood vessels on the surface of the retina or the vitreous gel. However, these blood vessels are extremely weak and as such, they bleed causing haemorrhages.

Such haemorrhages can completely block your vision as your retinopathy enters a proliferative stage. In many cases, with time, the blood might get reabsorbed into your body and there is a chance for your vision to improve. But chances are high that these haemorrhages will keep resurfacing and the blood may not be absorbed completely.

This may lead to permanent vision loss. If the haemorrhages are large, it can also scar the tissue. As the retina shrinks, the scar tissues may distort the retina or pull it on. As a result, the retina may get detached and cause serious vision loss.

  • Diabetic maculopathy and diabetic macular edema

When the retinopathy affects your macula, it causes Diabetic Maculopathy. This condition affects your central vision which is important for seeing colours and other fine detail.

As a result,  it becomes difficult for you to carry on precision tasks such as writing, reading and seeing other detail. If the fluid leakage is near the macula, the accumulation of fluid can result in macular swelling. This condition is known as diabetic macular edema. This makes your eyesight blurred and distorted. Even the colours may appear washed out.

6. Cataract

It’s through the lens that your eyes focus on an image and see. This lens is usually clear and free of any debris. Now, when you have a cataract, the lens becomes cloudy. Anyone can develop this condition but diabetic people tend to get them earlier compared to non-diabetic.

Also, cataract in a diabetic eye worsens faster. If your eye lens is cloudy, it cannot focus on images as it should. Common symptoms of cataract include blurry vision and light sensitivity. Cataract can be removed by surgery. The doctor will remove the cloudy lens and replace it with an artificial lens.

If you are diabetic the odds of developing the eye condition depends completely on your blood glucose levels.  The lens of your eyes derives nutrients from the aqueous humour. This is the front part of your eye which is filled with fluid. Aqueous humour supplies oxygen and glucose to your eyes. Glucose is essential for proper functioning of the cells.

However, if the glucose levels are uncontrolled, the sugar content in your aqueous humour also increases causing it to swell and affects the clarity of your vision. The lens also has an enzyme that helps in converting glucose into sorbitol. When sorbitol accumulates in the lens, it affects the lens cells and other naturally-occurring proteins. As a result, the lens becomes more opaque. This condition eventually results in cataract formation.

7. Glaucoma

The relationship between diabetes and open-angle glaucoma is subject to research. Diabetic people are more likely to develop glaucoma compared to non-diabetics. Diabetes is also associated with a rare type of glaucoma known as neovascular glaucoma.

In some cases of diabetic retinopathy, the blood vessels in the retina are destroyed and as a result, the retina develops abnormal blood vessels. Neovascular glaucoma develops when new blood vessels grow on your iris. This obstructs the flow of fluid in your eyes, raising the eye pressure. This condition is difficult to treat; however, laser surgery can help in reducing the proliferation of abnormal blood vessels on the iris and your retina.

The doctor may prescribe medication for treating open-angle glaucoma. This is the most common form of glaucoma. Medicines can be used to lower eye pressure, reduce the amount of fluid in your eyes, and speed up the drainage process. Open-angle glaucoma usually doesn’t cause any symptom unless it has progressed to an advanced stage. A comprehensive eye examination is the only way to determine whether you have open-angle glaucoma or not.

You may notice these symptoms:

•    Headaches
•    Halos around lights
•    Blurred vision
•    Eye aches or pain
•    Vision loss
•    Watery eyes

How to prevent diabetic eye condition?

If your blood sugar levels are under control, you won’t have any problems in your vision. Even if you have, they won’t be severe. And that is why visiting an eye specialist from time to time is essential. This is the only way to find out whether your eyes are affected or not. The doctor may do the following tests and screening:

8. Diabetic Eye Screening

With early intervention, most of the diabetes-related eye conditions can be treated. And a thorough eye screening is the best way to detect any abnormality caused by diabetes. A comprehensive screening is essential during early stages of diabetic eye conditions as they don’t have any primary symptoms (except cataract). By the time the symptoms become noticeable, the condition becomes worse and difficult to treat.

During diabetic eye screening, the doctor will put an eye drop for enlarging the pupils. It takes 15-20 minutes and during that time, your vision is temporarily blurred. After that, the doctor takes photographs of your retina. The camera won’t touch your eyes and there will be several flashes each time a photograph is taken.

The light is pretty bright and the eye drops may make your eyes a bit stingy. Depending on the type of eye drops used, the haziness of your vision may last from two to six hours. After the screening procedure, everything around you may feel a bit bright. Do not worry, your vision will get normal soon after some time.

9. Photocoagulation (Scatter and Focal) and Vitrectomy

Scatter and Focal photocoagulation and vitrectomy help in preventing blindness in most of the cases. The sooner your condition is diagnosed, higher the chances that the treatment will be successful. In photocoagulation, the eye doctor will use a laser beam for making small burns on your retina. These burns seal the blood vessels, preventing further growth and leakage.

In scatter photocoagulation, which is also known as pan-retinal photocoagulation, the eye specialist will make hundreds of such burns in dotted patterns. This procedure reduces your chances and risk of blindness caused by vitreous haemorrhage or retinal detachment. However, this procedure will only work if the detachment hasn’t progressed much and before bleeding has occurred. Scatter Photocoagulation is also used for treating certain kinds of glaucoma.

Focal photocoagulation is where the eye care specialist aims the laser exactly on the leaking blood vessels in the macula.  This procedure won’t cure blurry vision caused by macular oedema but it can prevent the condition from getting worse.

In case the retina has already detached or excessive amount of blood has leaked into the eye, this procedure is of no help.  The next option that you have is vitrectomy. This is a surgery for removing scar tissue and cloudy fluid from your eyes. In this case too, the earlier you opt for the operation, the more likely it is to be successful.

For treating macular edema, the doctor either goes for Focal Laser Therapy or using medications. Focal laser therapy slows the leakage of fluid whereas medications can be injected into the eye to slow the growth of new blood vessels and for reducing the leakage of fluid into the macula.

Who are at the risk of developing diabetic eye disease?

Your chances of retinopathy are high if you have diabetes for a longer period. This means, almost everyone with type 1 diabetes may eventually suffer from non-proliferative retinopathy.

And most of the people with type 2 diabetes are also at the risk of developing it. If you are diabetic and you have good control over your blood sugar levels and if they are close to normal then you are less likely to develop retinopathy.

Most people with non-proliferative retinopathy usually do not show any symptoms. And that’s the reason why you should have your eyes examined regularly by an eye care expert.

Get your eye health diagnosed at a leading eye hospital in Kolkata

Get in touch with experts for thorough eye check-up or for glaucoma treatment in Kolkata. Visit http://www.dishaeye.org appointment to book an appointment.

Protect your Vision When you have Diabetes

Disha Eye Hospital

Our eyes are sensitive and delicate by nature, and diabetes can cause damage to them. Diabetes can impose great harm to eye health by causing vision impairment and even vision loss.

According to WebMD, diabetes is a primary cause of blindness in adults aged from 20 to 74. There are several types of eye diseases associated with diabetes including Diabetic Macular Edema, Diabetic Retinopathy, cataract, and glaucoma. NIH also states that all forms of diabetic eye disease can cause severe vision loss and blindness.

Here are some of the ways how you should protect your vision when you have diabetes.

1) Practice good diabetes management
diabetes management
Diabetes increases the sugar levels in the blood which can cause the tiny blood vessels in your eyes to suffer from serious damage. In most cases, it’s often unmanaged diabetes that triggers the onset of eye complications such as diabetic retinopathy which causes the blood vessels in the retina to leak blood.

So, one of the best ways for protecting your vision is to keep your blood sugar level in check. Maintain a strict routine for checking your blood sugar as high blood sugar can alter the shape of the eyes’ lens which can cause blurry vision. Also, you need to make sure that you maintain a healthy blood pressure and cholesterol levels.

You should also consult with your doctor. When your doctor knows that you have diabetes, he/she can be prepared to offer appropriate screenings to monitor eye health. Doing so can eventually lower the risk of developing eye complications.

2) Have regular dilated eye examination

According to American Academy of Ophthalmology, Diabetic Retinopathy doesn’t have any symptoms during the early stages. So, you may never know that you have Diabetic Retinopathy unless severity such as vision impairment starts to appear.

So, the best way to prevent the onset of Diabetic Retinopathy is to do timely dilated eye exam. During a dilated eye exam, your doctor conducts a thorough examination of the retina and optic nerve – mainly for checking signs of damage before it worsens. When you have your eye health under scrutiny, your doctor can arrange treatment for treating the disease when it’s not reached the advanced stage.

3) Boost eye health with proper diet
Boost eye health
Apart from managing your blood sugar levels and undergoing regular dilated eye exam, you should also eat healthy food. Maintaining a well-balanced diet that is rich in nutrients can boost eye health which, in turn, can significantly reduce the risk of diabetic eye diseases.

According to Healthline, our eyes require several antioxidants to stay healthy. These include Zinc, Vitamin A, C, E, zeaxanthin, lutein, omega-3 fatty acids, and beta-carotene. Foods that boost eye health include fish (particularly salmon), kale, carrots, eggs, oranges and almonds.

In general, you have to include leafy vegetables, lean meat, and colourful fruits in your diet for boosting your eye health.

4) Exercise regularly
Eye protection
Exercise is the ultimate answer to maintaining good health and managing diabetes. Interestingly, exercise is good for your eye health as well – according to American Academy of Ophthalmology.

Although exercise might not benefit eye health directly, it can help in lowering blood sugar levels (in case of diabetes) which, in turn, improves your eye health. So, make sure that you exercise regularly. You can set a routine as to when you can manage your time and exercise for at least 30 minutes a day.

Your exercise regime doesn’t necessarily have to include heavy workouts. Light to moderate-intensity workouts including brisk walking, jogging, running, cycling and swimming are good for eye health. Moderate intensity exercise such as running and jogging can help in reducing eye pressure in young adults.

5) Eye protection
Eye protection
As discussed above, our eyes are delicate and therefore need great care, especially in case of diabetic patients. Apart from maintaining a good eye health, you have to be concerned about protecting your eyes as well, and the best way to do such is to wear sunglasses.

Sunglasses are more than a fashion accessory as they play a key role in protecting your eyes from harmful UV rays. According to NIH, a study funded in part by NEI (National Eye Institute) found out that chronic exposure to sunlight can increase the risk of cataract. What’s more surprising is that people with diabetes stand at a greater risk of triggering eye complication with exposure to the UV rays.

So, it is important that you wear sunglasses whenever you go outside, even if it’s cloudy as UV rays can pass through thin clouds and haze. It is even better if you are able to get your hands on frames that come with a close-fitting wraparound style as UV rays can even affect the sensitive skin surrounding the eyelid which can cause skin cancer.

6) Quit smoking
Quit smoking
Quitting smoking should be one of the first priorities in the prospect of preventing diabetic eye disease. Apart from imposing a serious threat to overall health, smoking also deteriorates eye health, especially in case of diabetic patients.

According to Healthline, smoking can potentially accelerate the development of diabetic retinopathy and worsen the disease. Over time, worsening of diabetic retinopathy can eventually lead to blindness. So, it is a must that you quit smoking and other tobacco-related products.

If you are one of those who finds it impossible to quit smoking, you can undergo therapies that help you get over with it. You can even take over-the-counter aids and nicotine gums for extra help. But you need to be aware of the fact that nicotine raises blood sugar. So, you need to cut off your consumption on nicotine-related aids once you quit smoking.

Get your eyes regularly checked at Disha Eye Hospital even though you feel your vision is normal.

FAQs for Diabetic Patients

eye hospital in Kolkata

Diabetes is a condition where the blood glucose levels are too high. This is mainly because either your body isn’t producing enough insulin or your body cells aren’t responding to the insulin. Diabetes affects multiple organs of your body, including your eyes. A study by the World Health Organisation says that all patients with Type 1 diabetes develop Diabetic Retinopathy; while 77% of people with Type 2 Diabetes who are living with Diabetes for over 20 years develop this eye condition. The report by WHO further mentions that Diabetic Retinopathy is responsible for 4.8% of the total 37 million cases of blindness all over the world.

Source: http://www.who.int/blindness/Prevention%20of%20Blindness%20from%20Diabetes%20Mellitus-with-cover-small.pdf

Apart from Diabetic Retinopathy, Diabetes also contributes to the development of a number of eye conditions.

Here are a few Frequently Asked Questions on Diabetes

How Diabetes affect the eyes?

Diabetes causes:

1. Blurry Vision

If you have diabetes, you may often find that your vision has become blurry. This is because the high blood glucose levels make your lens swell, thus affecting your vision. For normalising your vision, you need to get your blood sugar levels down. It might take maximum three long months before your get back your normal vision.

2. Glaucoma

If you have diabetes, then you might get a rare form of glaucoma known as Neovascular Glaucoma. This is a condition where new blood vessels grow in your iris, blocking the flow of fluid and raising your eye pressure. Moreover, people having Type 2 diabetes are most likely to have Open-Angle Glaucoma. Medications help in treating Open-Angle Glaucoma. This helps in reducing the eye pressure and facilitates the drainage of fluid. On the other hand, Neovascular Glaucoma is a bit complicated condition and might require surgery. There are many options for glaucoma treatment in Kolkata. If you have diabetes, then it’s a must to get your eyes checked thoroughly in a good eye hospital in Kolkata. It’s because it’s impossible to diagnose glaucoma without thorough eye check-up.

3. Diabetic Retinopathy

The high blood sugar levels can cause severe damage to the blood vessels in your retina causing Diabetic Retinopathy. Controlling your blood sugar levels, cholesterol, and blood pressure is essential for preventing this condition. You may develop Background Retinopathy (your blood vessels are damaged, but it doesn’t affect your vision); Maculopathy (a damaged macula), and Proliferative Retinopathy, a condition where the cells in the back of your eyes do not get enough oxygen and new blood vessels start growing. These blood vessels often bleed, thus scarring the retina.

Source: http://www.webmd.com/eye-health/eye-problems#1

What are Type 1 and Type 2 Diabetes?

Type 1 Diabetes is when the body doesn’t produce insulin because the insulin producing pancreatic cells are damaged by the body’s immune system. Type 2 Diabetes is the most common form of diabetes. This is caused when either the pancreas isn’t producing enough insulin or the body couldn’t use the available insulin. This condition is common in people who are obese.

Source: http://www.webmd.com/diabetes/diabetes-faq#1

What is Prediabetes?

Prediabetes is the condition when the blood glucose levels are higher than normal, but it isn’t high enough to be diagnosed with diabetes. People who have prediabetes are likely to suffer from cardiovascular diseases. Early screening is essential for avoiding any further risks.

Source: http://www.diabetes.co.uk/pre-diabetes.html

What is Gestational Diabetes?

This is a type of diabetes that women usually develop during pregnancy. This is a temporary type of diabetes. If you develop this type of diabetes in one pregnancy, you are likely to develop this during your other pregnancies. Gestational diabetes increases the risk of developing Type 2 diabetes in future. So, timely screening is important.

Who can develop Type 2 Diabetes?

These factors can increase your risk of developing this condition:

  • Family history: The family history of type 2 diabetes increases your risk of getting diabetes increases.
  • Age: with age, your risk of developing type 2 diabetes increases. This may be due to decreased physical activity and loss of muscle mass
  • Obesity: Obesity increases your risk factor for type 2 diabetes. With more fatty tissues, your cells become more resistant to insulin.
  • Inadequate physical activity: if you are less active then you are more likely to develop type 2 diabetes.
  • Unhealthy diet: a diet rich in saturated fats, sugar, and calories increase your body weight thus increasing your risk of getting type 2 diabetes.
  • What are the complications caused by Diabetes?
  • High blood glucose levels can damage your kidneys, eyes, nerves, and cause cardiovascular disease. You become susceptible to foot infection (that may lead to gangrene), stroke, heart attack, and sexual dysfunction.

Why it’s important to take special care of the feet?

People with diabetes are prone to foot problems. The blood circulation in your feet becomes poor thus damaging the nerves and reducing sensation. Check for various foot conditions such as cracked skin, swelling, ingrown toenail, blisters, bleeding corns. Proper foot care ensures that no wounds become so severe that the leg needs amputation.

Do Diabetic people need special diet?

Not really. Just ensure that the diet you are following is healthy and contains complex carbohydrates (whole grain cereals), is low in fats, and includes plenty of vegetables. If you plan your diet accordingly, you can still eat all kind of food and stay healthy.

What is Hypoglycaemia?

Hypoglycaemia or low blood sugar level is the most common complication faced by diabetic people. Due to several conditions such as not eating properly or eating too late, doing vigorous physical activity may drop your blood sugar levels below normal range. Patients usually feel weakness, sweating, and giddiness. At that time, the patient must be given fruit juice or some sugary drink. In case the patient is unconscious, he or she must be given intravenous glucose. Adjusting the dosage of antidiabetic medicine can help avoid this condition.

Source: http://www.searo.who.int/entity/world_health_day/2016/faqs-diabetes.pdf?ua=1

Glaucoma Treatment in Kolkata

Looking for the best eye hospital in Kolkata? Why not get your eyes tested by the experts at Disha Eye Hospital? We provide comprehensive glaucoma treatment in Kolkata. Book an appointment with us today at http://www.dishaeye.org/appointment.

Diabetic Retinopathy Guide

Diabetic Retinopathy, as the word implies, is a medical condition which causes progressive damage to the retina; mainly to the patients who have diabetes. When left untreated, the severity of Diabetic Retinopathy can eventually lead to blindness.

Diabetic patients have sugar (glucose) imbalance in their body as the metabolic disease interferes with insulin production. Later stages of diabetes cause damage to major organs of the body and eye is one of the first organs to get affected.

Analysts predict that the number of Americans affected by Diabetic Retinopathy is going to double up over the course of time. Hispanic Americans getting affected by this case are expected to reach up to 5.3 million by 2050.


Much like Macular Edema, self-diagnosis of Diabetic Retinopathy is very rare as you never know the onset of this eye complication. In most cases, patients are left clueless until severity and significant damages start to occur. Some of the common symptoms of Diabetic Retinopathy include:

  • Loss of central vision – You can diagnose Diabetic Retinopathy if you start losing sight or suffer poor vision while doing activities like reading and driving.
  • Colour Blindness – It is very common for a person to suffer from colour blindness when Diabetic Retinopathy prevails.
  • Night Blindness – If you start developing the inability to see during night-time, you might as well consider it to be the first effects of Diabetic Retinopathy.
  • Black Spots & Holes – One of the most dreadful initial effects of Diabetic Retinopathy is developing black structures that interfere with vision. To see it from the sufferer’s perspective, it would look something like –

diabetic vision


Diabetic Retinopathy is classified into 2 stages; NPDR (Non-proliferative Diabetic Retinopathy) and PDR (Proliferative Diabetic Retinopathy).

  • Stage 1 (NPDR)

During the early stages of Diabetic Retinopathy, the effects are indeed mild. In the 1st stage, blood vessels in the retina start to weaken and bulge out from their walls. This effect is also known as microaneurysm. These weakened blood vessels then release fluid into the retina which causes the macula to swell. NPDR is barely noticeable and doctors use fundus photography to confirm the onset of stage 1.

non-proliferative diabetic retinopathy

With time, the discharged fluid can fill up the macular region which leads to distorted vision which is not the same in both eyes. During NPDR, 10% of patients stand a high chance of developing vision loss.

  • Stage 2 (PDR)

When Diabetic Retinopathy enters stage 2, the disease gets more advanced. The early-on changes in PDR include growing of fragile blood vessels in the retina and vitreous. This phenomenon is also called neovascularization.

diabetic retinopathy

Then there are micro-disruptions in these fragile blood vessels which cause them to leak blood at the back of the eye which eventually interferes with vision. The retina eventually detaches due to the formation of scar tissue and development of glaucoma. This episode is followed by an extreme pain in the eye which eventually leads to blindness.


Although Diabetic Retinopathy usually occurs in patients who are already suffering from diabetes, other factors also contribute to the risk of developing this disease. Such factors include:

  • Pregnancy – As pregnant women are prone to develop gestational diabetics, therefore there’s a high chance that diabetes might cause Diabetic Retinopathy.
  • Race – Although researchers haven’t come up with specific reasons as to why certain groups of races get affected by Diabetic Retinopathy the most, White, African and Hispanic Americans hold the highest rate of the severity of this medical condition.
  • Other Medical Conditions –Apart from diabetes, other medical conditions such as high cholesterol and high blood pressure also trigger the risk of Diabetic Retinopathy.


Doctors usually diagnose Diabetic Retinopathy through a comprehensive eye examination. To diagnose the retina and macula, doctors go through a rigorous set of evaluations including:

-Patient History

Before starting with all the diagnosis, doctors generally go through the patient’s medical history to determine the cause of vision difficulties. In this step, the doctor determines whether it’s actually diabetes or other medical condition that is hampering eye health.

-Measurement of Visual acuity

Doctors also perform measurement of visual acuity to determine the loss of central vision. In case of minor central vision loss, the doctor might even prescribe eyeglasses for refraction of the eye lenses.

-Retinal Photography

To get a clearer picture of the status of retina, doctors conduct retinal photography for severely affected patients.

-Evaluating Ocular Structures

Further diagnosis of Diabetic Retinopathy involves the doctor evaluating the retina by dilating the pupil. The doctor might even conduct measurements for eye pressure to determine the severity of Diabetic Retinopathy.


Fundoscopic imaging and analyses

Fundoscopic imaging is one of the most favoured tools (diagnostics) by doctors to sort out Diabetic Retinopathy. Doctors take images of the retina to figure out abnormalities that are triggered by Diabetic Retinopathy. Doctors also use colour fundus photography to stage Diabetic Retinopathy.

To develop the further treatment plan, doctors access Fluorescein Angiography to take note of the abnormal growth of blood vessels. Now, computer-aided diagnosis has taken a massive leap of progress which involves the analysis of fundoscopic images to be automated. This computer automated diagnosis has several benefits including accuracy and time efficiency.

Blood Pressure Control

Controlling blood pressure is one rare measure that doctors take to cater prevention of Diabetic Retinopathy. According to a Cochrane study http://www.cochrane.org/CD006127/EYES_blood-pressure-control-for-diabetic-retinopathy, controlling or reducing blood pressure has helped prevent Diabetic Retinopathy up to 5 years for patients who already have diabetes.

However, there is no evidence of blood pressure control slowing down the progression of Diabetic Retinopathy or preservation of the clarity of the vision.

Stem Cell Therapy

Stem cell therapy for Diabetic Retinopathy is under clinical trials as of now. According to the analogy of clinical trials, doctors can use the patient’s bone marrow to derive stem cells and inject them into the degenerated areas for regenerating the vascular system.

For further information, read https://www.ncbi.nlm.nih.gov/pubmed/26454200.


As C-peptide (aka Connecting Peptide) has shown promising results in treating vascular degeneration, Cebix (read http://www.xconomy.com/san-diego/2015/02/23/cebix-shuts-down-following-mid-stage-trial-of-c-peptide-drug/#) organised a program of $50 million to complete the Phase llb trail in 2014. The trial showed no difference between placebo and C-peptide which caused the company to shut down the program entirely.

Light Treatment

In 2016, Noctura (http://noctura.com/) developed a medical device which the patients can use as a sleeping mask to treat Diabetic Retinopathy. As per the clinical trials, the mask emits green light on the eyelids which supposedly stops the retina’s rod cells to adapt dark light. This, in turn, reduces oxygen requirement which has a counter effect on the formation of blood vessels.


As of now, there are 3 major treatments for Diabetic Retinopathy which aid in restoring vision. Having said that, there’s no single solution for the complete cure of Diabetic Retinopathy till date.

Monitoring the symptoms vigilantly and getting optimal glycemic control is the best way to prevent the onset and delay further development of Diabetic Retinopathy. Here are the 3 main treatments:

1. Laser Photocoagulation

For treating Diabetic Retinopathy, doctors adapt Laser Photocoagulation into two usages. First, Laser Photocoagulation can be used to control neovascularization via panretinal coagulation and secondly for treating macular edema.

  • Panretinal Photocoagulation

Panretinal Photocoagulation aka scatter laser treatment is designed for treating PDR (Proliferative Diabetic Retinopathy). The process involves reducing the oxygen demand in the retina by creating 1,600 to 2,000 burns.

Before the ophthalmologist begins with the procedure, the physician numbs the eye by anaesthetic drops and dilates the pupil. The doctor may choose between pattern scan laser or a single spot laser.

From the patient’s perspective, you will see flashes of light during the procedure. This is accompanied by a stinging-like sensation. After the laser surgery, vision remains blurry for the rest of the day and the patients might suffer from a mild headache later on. Given the effectiveness of Panretinal Photocoagulation, this laser surgery involves several side effects too including reduced night and colour vision.

  • Laser Photocoagulation for macular edema

To treat macular edema with Laser Photocoagulation, doctors create a modified grid; a C-shaped pattern at the posterior pole with low-intensity burns. Clearing macular edemas helps in reducing the risk of vision. Read https://www.ncbi.nlm.nih.gov/pubmed/2866759.

2. Vitrectomy

Apart from laser surgery, Vitrectomy surgery is another treatment that doctors prefer; especially in the case where the vitreous contains lots of blood. To restore vision with vitrectomy, surgeons remove the blurry vitreous and replace it with a saline solution.

Vitrectomy doesn’t require special numbness and can be done under local anaesthesia. The surgery involved the doctoring making a tiny incision in the white portion of the eye to remove the vitreous. The doctor uses the same incision as a gateway to insert the saline solution.

The after-effects of the surgery include redness in the eye and sensitivity. In usual cases, patients are required to wear an eye patch for a couple of days. The doctor also prescribes medicated eye drop for prevention of infection.

3. Medication

Intravitreal anti-VEGF

Multiple doses of anti-VEGF intravitreal injection combined with Modified Grid Laser Photocoagulation works well for treating diabetic macular edema.

Intravitreal triamcinolone acetonide

Steroid preparation including Triamcinolone has lasting benefits in treating macular edema. The steroid is injected in the vitreous cavity which reduces the swelling of the retina that results in increased visual acuity.

In most patients, the effects of this steroid last for a time period of 3 months. This, in turn, necessitates repetition of the dosage to maintain the consistency of benefits.


Management and prevention of the onset of Diabetic Retinopathy (especially Proliferative Diabetic Retinopathy) entirely depends upon the management of diabetes. However, the patients can take several measures to prevent PDR. Some of these measures include:

  • Cholesterol and Blood Pressure Control

Diabetics with abnormal lipid metabolism and high blood pressure are vulnerable to get affected by Diabetic Retinopathy. As these factors can trigger the development of vascular changes at an alarming rate, Doctors recommend diabetics to maintain a normal BP and manage serum lipid levels by undergoing regulated medications.

  • Blood Sugar Control

It is always best to maintain a healthy lifestyle by doing physical activity on a regular basis and maintaining a healthy diet. Diabetics are often advised to consult a diabetic specialist for undergoing the best-suited hypoglycemic medications.

  • Quitting Tobacco

Smoking leads to abnormal blood sugar levels which create the risk of developing atherosclerosis. Similarly, hazardous habits like alcohol consumption and illicit drug abuse are a strict no for diabetics to prevent Diabetic Retinopathy.

  • Eye Examination

It is often recommended that a diabetic should visit a specialist for ensuring the working of hypoglycemic medication. Visiting an eye specialist every once in a while in 3 months is helpful to come up with diagnostics of vascular changes.

Alternatives to medication

As discussed earlier, there’s no definite cure to Diabetes or Diabetic Retinopathy. However, there are several herbal supplements which have seemed to work well for patients in the past. Some of these supplements that help in delaying the onset of Diabetic Retinopathy include:

  • Butcher’s broom

Butcher’s broom

  • Pycnogenol (Pine bark)

Pine bark

  • Bilberry


  • Grape Seed Extract

Grape Seed Extract

  • Gingko Biloba

Gingko Biloba


As the percentage of diabetics suffering from Diabetic Retinopathy is increasing, several communities encourage patients to share up for creating a positive perception. Also, such communities provide information and make the patients aware of the available treatment options. Some of these communities include:

Macular Society: https://healthunlocked.com/macularsociety?utm_campaign=diabetic-retinopathy&utm_medium=syndicated&utm_source=nhs.uk&utm_term=web_part_id_20
Diabetes Research & Wellness Foundation: