Diabetic Retinopathy: Causes, Symptoms, Treatment

Read more below about how Orbis eye teams are tackling one of the fastest growing causes of avoidable blindness.

The retina, at the back of the eye, is what creates the picture for our brain and has many small blood vessels. When blood sugar is too high caused by diabetes, these small blood vessels can break and leak blood or fluid into the eye and damage the retina.

It can also cause new blood vessels to grow and damage or detach the retina, causing loss of vision.

The retina is responsible for clear central vision. Fluid causes the macula - the part of the retina that allows us to see colors and fine detail - to swell leading to blurred vision.

If not treated, diabetic retinopathy can lead to a gradual loss of vision or blindness that cannot be reversed.

Excessive blood sugar levels can cause irreversible damage to vessels in the retina.

Every person living with all types of diabetes (422 million globally) is at risk of developing the condition and may potentially go blind over time.

Other risk factors for the development of diabetic retinopathy are:

• High blood pressure
• High cholesterol

At early stages, there are no symptoms. At later stages, people affected can have:

• Floating spots
• Blurred vision
• Double vision
• Complete loss of vision

Slideshow: Images show vision loss caused by diabetic retinopathy over time

The four stages of diabetic retinopathy are:

Mild Nonproliferative Retinopathy

In the earliest stage of the disease, tiny bulges in the retina’s blood vessels (microaneurysms) can leak fluid into the retina. This can also lead to swelling in the macula causing blurred vision. Symptoms at this stage are usually mild or non-existent.

Moderate Nonproliferative Retinopathy

During this stage, blood vessels in the retina swell and may become blocked. This can contribute to diabetic macular edema (DME) which is a build-up of fluid in the macula region of the retina - causing vision changes or vision loss.

Severe Nonproliferative Retinopathy

At this stage, an increasing number of blood vessels in the eye become blocked. As a result, the retina is signaled to grow new blood vessels. If the blood vessels close off completely, this can lead to blurry vision with dark spots (floaters)

Proliferative Diabetic Retinopathy

In the final stage, the retina is deprived of oxygen and new blood vessels grow inside the retina and into the vitreous gel - the fluid that fills the eye. As these blood vessels are delicate, they may begin to leak and bleed.

Scar tissue may form, causing retinal detachment, where the retina pulls away from underlying tissue. Retinal detachment may cause spotty vision, flashes of lights or severe vision loss.

Healthy Lifestyle

Keeping blood sugar, cholesterol and blood pressure levels well managed as well as maintaining a balanced lifestyle by eating right and exercising regularly, can lower the risk of developing the condition or slow its progression.

Diabetes Eye Health Checks

For people living with diabetes, early detection and diagnosis through regular eye examinations can prevent blindness from diabetic retinopathy in 98% of cases. Once diagnosed, it is essential that treatment begins as quickly as possible to prevent damage to the eye.

While diabetic retinopathy cannot be fully cured, effective treatments have been established that preserve vision and dramatically reduce the risk of further damage and vision loss

Intravitreal Injections

Medication (anti-VEGF) injected into the eye may be recommended as a way to help stop growth of new blood vessels by blocking the effects of growth signals the body sends to generate new blood vessels.

Laser Therapy

Laser therapies are effective treatments for preserving vision and reducing the risk of further vision loss in advanced cases of diabetic retinopathy.

Focal laser therapy stops or slows blood and fluid leaking in the eye. During the procedure, leaks from abnormal blood vessels are treated with laser burns.

Scatter laser (panretinal photocoagulation) laser burns causes the abnormal new blood vessels to shrink and scar.

Eye Surgery

Surgical intervention (vitrectomy surgery) is required when diabetic retinopathy becomes so advanced and laser treatment alone cannot remove blood and scar tissue in the eye.

At Orbis, we're implementing a comprehensive approach to improve eye care for people with diabetes. 

Training: We provide advanced training and mentorship to eye care teams in nearly every country in the world, empowering them to deliver sight-saving care where the need is greatest. Our specialist training is delivered in partnership with local hospitals, public health agencies and governments. It takes place on board our incredible Flying Eye Hospital, through our online mentoring platform, Cybersight, and through our long-term country programs.

Technology: Through innovative technology like our award-winning telemedicine platform Cybersight, artificial intelligence diagnostic technology, virtual reality training, and the world’s first and only Flying Eye Hospital, we're revolutionizing ophthalmic training for eye care professionals and treatment for patients around the world.

Treatment and prevention: Through our long-term country programs we provide equitable access to quality eye care that transforms lives and communities. Orbis puts eye care within reach through programs that serve communities where they are. To reach the most underserved populations, quality care must be not only available, but also easily accessible.

Teamwork: Through support from donors, corporate sponsors, employees, governments, and a team of more than 400 world-renowned medical volunteers, we work in collaboration with local partners to improve the quality and availability of eye care, ensuring our impact endures long term and becomes self-sustaining.