Diabetic Retinopathy
Symptoms, causes, treatment, and when to see an optician
Overview
Diabetic retinopathy is a complication of diabetes (Type 1 and Type 2) in which high blood sugar levels damage the tiny blood vessels in the retina. It is one of the leading causes of preventable blindness in working-age adults in the UK. The condition often develops without any noticeable symptoms in its early stages, making the NHS Diabetic Eye Screening Programme — which invites everyone with diabetes for annual retinal photography — an essential safeguard.
Symptoms
- Often no symptoms in the early stages — damage can be occurring without your knowledge
- Gradually worsening vision
- Floaters (dark spots or strings drifting across your vision)
- Blurred or patchy vision
- Sudden vision loss (in advanced stages due to vitreous haemorrhage or retinal detachment)
- Difficulty seeing in the dark
- Colours appearing washed out
Causes & Risk Factors
- Prolonged high blood sugar levels damaging the retinal blood vessels
- Long duration of diabetes — the longer you have had diabetes, the higher the risk
- Poorly controlled blood glucose (high HbA1c)
- High blood pressure
- High cholesterol
- Pregnancy (can accelerate progression in women with pre-existing diabetes)
- Smoking
- Kidney disease (diabetic nephropathy)
Treatment Options
In the early stages (background or non-proliferative diabetic retinopathy), the most effective treatment is not an eye treatment at all — it is optimising your diabetes management. Keeping your blood sugar, blood pressure, and cholesterol well controlled can significantly slow or prevent progression. Your GP, diabetic nurse, or endocrinologist will work with you on this, and the NHS Diabetic Eye Screening Programme will monitor your retina with annual photographs.
If the condition progresses to clinically significant diabetic macular oedema (DMO) — where fluid leaks into the central retina and threatens your reading vision — the standard treatment in the UK is anti-VEGF injections, the same type used for wet AMD. These injections are given in hospital eye departments and are funded by the NHS. Laser treatment (focal or grid laser) may also be used in some cases, often alongside injections.
For proliferative diabetic retinopathy — the most advanced stage, where fragile new blood vessels grow on the retina's surface and risk bleeding — pan-retinal photocoagulation (PRP) laser treatment is the established intervention. This laser is applied to the peripheral retina to reduce the drive for new vessel growth. In cases of vitreous haemorrhage or tractional retinal detachment, vitrectomy surgery may be required. The key message is that attending every diabetic eye screening appointment gives you the best possible chance of catching changes early, when treatment is most effective.
Prevention Tips
- Maintain excellent blood sugar control — aim for the HbA1c target agreed with your diabetes team
- Keep blood pressure below 140/80 mmHg (or the target set by your GP)
- Manage cholesterol levels through diet, exercise, and medication if prescribed
- Attend every NHS Diabetic Eye Screening appointment — do not skip or delay them
- Continue to have regular eye tests with your optometrist in addition to diabetic screening
- Stop smoking — smoking worsens diabetic eye disease
- Report any changes in your vision to your optometrist or GP promptly
When to See an Optician
Book an eye test without delay if you have diabetes and notice any change in your vision, new floaters, or blurred patches — and always attend your annual NHS Diabetic Eye Screening appointment.
Key Facts
- Category
- Urgent condition
- Typically Affects
- All ages with diabetes (risk increases with duration of diabetes)
- Key Symptoms
- 7 identified symptoms
Concerned about diabetic retinopathy?
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Detecting Diabetic Retinopathy
The following eye tests can help detect signs of diabetic retinopathy:
- Standard eye test
- OCT retinal scan
- Visual field test
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Early detection is key. A routine eye test can identify signs of diabetic retinopathy before symptoms become noticeable. Book yours today.
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