Draft content, pending review: this article is written to established clinical-education standards but has not yet been read and approved by Dr. Sanjana Bejan Singh. It is not yet considered published or a substitute for professional medical advice.
If you have diabetes, high blood sugar levels can, over time, damage the tiny blood vessels in the retina — the light-sensitive layer at the back of the eye. This is called diabetic retinopathy, and it is one of the leading causes of vision loss in adults with diabetes. The concerning part is that it often causes no symptoms at all in its early stages, which is why routine eye screening matters even when your vision feels normal. The good news is that with good diabetes control and timely treatment, serious vision loss from this condition can usually be prevented or significantly delayed.
What is diabetic retinopathy?
Persistently high blood sugar can weaken and damage the small blood vessels that nourish the retina. These vessels may swell, leak fluid or blood, or become blocked.
In its early stage, called non-proliferative diabetic retinopathy (NPDR), the vessel walls weaken and small bulges (microaneurysms) can leak fluid into the retina.
If the condition progresses, the retina may respond by growing new, abnormal blood vessels — a more advanced stage called proliferative diabetic retinopathy (PDR). These new vessels are fragile and can bleed or lead to scar tissue that pulls on the retina.
Fluid can also collect in the macula (the part of the retina responsible for sharp, central vision), a complication called diabetic macular edema, which can occur at any stage of the disease.
Who is at risk
Anyone with type 1 or type 2 diabetes can develop diabetic retinopathy. Risk increases the longer a person has had diabetes.
Poorly controlled blood sugar, high blood pressure, and high cholesterol all add to the risk of retinal damage.
Pregnant women with diabetes, or those who develop gestational diabetes, should also have their eyes monitored, as retinopathy can progress more quickly during pregnancy.
Given how common diabetes is in India, and the tendency for it to go undiagnosed or under-treated for years, regular eye screening is especially important for this population.
Symptoms to watch for
Early diabetic retinopathy usually has no symptoms — this is exactly why it can go unnoticed until it is more advanced.
As it progresses, you may notice blurred or fluctuating vision, dark or empty areas in your field of vision, difficulty seeing at night, or colours appearing faded.
New floaters (small specks or cobweb-like shapes drifting across your vision) can be a sign of bleeding inside the eye and should not be ignored.
Because symptoms often appear late, waiting for symptoms before getting checked is not a safe strategy for anyone with diabetes.
Diagnosis
Diabetic retinopathy is diagnosed through a comprehensive dilated eye examination, where drops are used to widen the pupil so the retina can be examined closely.
Optical coherence tomography (OCT) is a painless scan that produces detailed cross-section images of the retina and is often used to check for macular swelling.
In some cases, a fluorescein angiogram — where a dye is injected into a vein and photographed as it moves through the retinal blood vessels — helps the doctor map out leaking or blocked vessels.
Everyone with diabetes should have a dilated eye examination at least once a year, or more often if retinopathy has already been found, even if their vision seems fine.
Treatment options
The first and most important step is controlling blood sugar, blood pressure, and cholesterol, since good metabolic control slows the progression of retinopathy at every stage.
For diabetic macular edema or proliferative disease, injections of anti-VEGF medication directly into the eye can reduce swelling and shrink abnormal blood vessels; these are usually given as a course over several visits.
Laser treatment (photocoagulation) can seal leaking vessels or reduce abnormal vessel growth, and remains an effective option for certain stages of the disease.
In advanced cases with significant bleeding or scar tissue, a surgical procedure called a vitrectomy — where the gel-like fluid (vitreous) inside the eye is removed and replaced — may be needed to clear blood and relieve traction on the retina.
Treatment aims to preserve the vision you have and prevent further loss; it does not always restore vision that has already been lost, which is another reason early detection matters.
When to seek care
Book a routine dilated eye examination at least once a year if you have diabetes, even without symptoms. Seek prompt attention if you notice new or worsening blurred vision, difficulty reading, or dark patches in your vision. Sudden vision loss, a sudden increase in floaters, or a sudden shower of new floaters accompanied by flashes of light should be treated as an emergency — these can signal bleeding or a retinal problem and need same-day evaluation by an eye doctor.
Frequently asked questions
I have diabetes but my vision is perfectly normal. Do I still need an eye check?
Yes. Diabetic retinopathy often has no symptoms in its early, most treatable stages, so normal-feeling vision does not rule it out. An annual dilated eye examination is recommended for everyone with diabetes.
Can diabetic retinopathy be cured completely?
There is no complete cure, but it can be controlled effectively. With good blood sugar management and, when needed, treatments like injections or laser therapy, further vision loss can usually be prevented or slowed considerably.
Does having diabetic retinopathy mean I will eventually go blind?
Not necessarily. Most people with diabetic retinopathy do not lose significant vision, especially when it is caught early and blood sugar is well controlled. Regular monitoring and timely treatment make a real difference.
How often should I get my eyes checked if I already have some retinopathy?
This depends on the stage found on your examination — it could range from every few months to once a year. Your retina specialist will recommend a follow-up schedule based on your specific findings.
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Call the appointment desk, or book online — we will confirm your time by phone.
Sources consulted: AAO — Diabetic Retinopathy, NEI — Diabetic Retinopathy, Mayo Clinic — Diabetic Retinopathy . General medical information — not a substitute for professional diagnosis. Pending final medical review by Dr. Sanjana Bejan Singh before publish.
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