Diabetic retinopathy

What is diabetic retinopathy?

High blood sugar over time weakens retinal capillaries. They can leak, bleed, or grow fragile new vessels. Fluid at the macula (diabetic macular oedema) blurs reading and faces. Seek emergency care for sudden vision loss, a dark curtain, or a sudden swarm of black specks — those can be a vitreous haemorrhage or retinal detachment, and cannot wait for screening.

You can have serious retinopathy with 6/6 vision. That is the whole point of screening. Feeling fine is not a reason to skip the appointment.

Type 1 and type 2 diabetes both cause retinopathy. Type 2 may already have changes at diagnosis. Pregnancy can worsen retinopathy — tell the eye and maternity teams if you are pregnant or planning pregnancy.

Diabetes and your eyesCan diabetes affect your eyes?Diabetic macular oedema

What are the symptoms of diabetic retinopathy?

Early diabetic retinopathy usually causes no symptoms at all, which is why screening matters even when you see well. Symptoms tend to appear once the macula is affected or new vessels bleed.

• Blurred or fluctuating vision, especially for reading
• Difficulty seeing faces or fine detail
• New dark spots or floaters in your vision
• Colours looking faded or washed out
• Sudden vision loss or a shower of dark floaters — an emergency

What are the stages of diabetic retinopathy?

Services grade photographs from no retinopathy through background (mild) changes, to pre-proliferative and proliferative disease where new vessels threaten bleeding. Macular oedema can occur at several stages. Exact grade names vary by country; the practical message is the same: more advanced grades need hospital eye care, not only a repeat photo next year.

What happens at diabetic eye screening?

Screening is not an optician’s refraction. Drops may dilate the pupils. A camera photographs the retina. You are told whether to return next year or go to a hospital clinic. Do not drive until the drops wear off if you were dilated.

Public programmes often invite people with diabetes every year unless your team sets a different interval. We do not invent your local waiting time. If you have never been invited, ask your GP or diabetes clinic how screening works where you live.

Good glucose, blood pressure and cholesterol control slow retinopathy. That is standard public-health advice from diabetes and eye organisations. We do not set your HbA1c target on this page.

• Type 1: screening typically from around age 12, then as advised
• Type 2: from diagnosis, then as advised — often yearly at first
• Pregnancy: extra checks; do not rely on a photo from last year
• If you already attend a hospital eye clinic, they say whether screening still applies

How is diabetic retinopathy treated?

Laser can treat leaking or ischaemic retina in selected patterns. Anti-VEGF injections treat many cases of macular oedema and some proliferative disease. Vitrectomy surgery is for non-clearing blood or traction on the retina. None of these replace diabetes care.

Cataract is more common with diabetes and can hide the view of the retina. Timing cataract surgery around retinopathy is a clinical decision — see the cataracts guide, and do not use an online lens tool as a glucose or retina plan.

Intravitreal injectionsRetinal laser treatmentVitrectomyCataracts

When is diabetic retinopathy an emergency?

Same-day emergency care for sudden vision loss, a shower of new floaters, new flashes, or a curtain. A painful red eye is also not ‘routine retinopathy’. Do not wait for the next screening letter.

Are eye floaters dangerous?What does sudden vision loss mean?World Aid Network diabetic eye page