Table of Contents

Key Takeaways

  • Diabetic retinopathy is a prevalent diabetes complication that affects the eyes, particularly the retina.
  • It has no noticeable symptoms at its early stage, so it’s recommended for people with diabetes to get annual eye checkups.
  • Dilated eye exams, optical coherence tomography, and fluorescein angiography are some methods doctors use to detect bleeding or swelling in the retina.
  • Treatments, such as vitrectomy, anti-VEGF injections, and laser therapy, can reverse or delay the progression of diabetic retinopathy.
  • Controlling blood sugar levels through medications and lifestyle changes can help prevent diabetes-related vision changes.

Diabetic retinopathy is an eye-related diabetes complication that happens when extreme blood sugar fluctuations damage the retina. Learn what it is, how it’s diagnosed, available treatments, and tips to preserve your eye health.

What Is Diabetic Retinopathy?

closeup of eye

Uncontrolled diabetes can cause complications — one of them is diabetic retinopathy. It affects the light-sensitive tissue at the back of your eye, known as the retina. When blood sugar levels fluctuate significantly, they hurt the small blood vessels carrying oxygen and nutrients to the retina. Weakened vessels may leak fluid or blood, leading to swelling and vision changes. In short, the primary cause of diabetic retinopathy is poorly controlled blood sugar levels, which harm the blood vessels in the retina.

There are two stages of diabetic retinopathy: non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR).

Non-proliferative Diabetic Retinopathy

The first stage, NPDR, occurs when high blood sugar harms the retinal blood vessels, leading to small balloon-like bulges called microaneurysms. These weakened vessels may leak fluid or blood into the retina. When the central part of the retina (the macula) becomes swollen from this leakage, it’s known as macular edema, a major cause of blurred vision that can worsen if blood flow becomes blocked.

Proliferative Diabetic Retinopathy

Proliferative diabetic retinopathy is an advanced stage that occurs when the retina begins to form new, fragile blood vessels in an attempt to compensate for poor blood circulation. This process is called neovascularization. The problem is these vessels are weak, so they often bleed, resulting in scar tissue and, in worst cases, detachment of the retina and vision loss.

Both type 1 and type 2 diabetes can cause this vision complication. The risk increases the longer a person has had diabetes. For individuals with diabetes, regular eye exams, combined with consistent blood sugar monitoring, can help identify issues that may impact eye function.

Diabetic Retinopathy Symptoms

Diabetic retinopathy starts quietly. It doesn’t come with obvious warning signs. If you’re diagnosed with diabetes, expect that this complication may happen. To preserve eye health, it’s essential to recognize eyesight problems or symptoms that may later lead to diabetes-related vision loss. They may include:

    • Blurry vision
    • Trouble seeing colors
    • Spots or dark shapes in your vision
    • Floaters that drift across your line of sight
    • Dark or empty areas in your vision
    • Cloudy or distorted vision
    • Vision loss

These symptoms manifest when your blood sugar levels are persistently high, harming the retinal blood vessels. Some patients with diabetes may not experience any symptoms at all until the condition has caused significant damage to the eyes.

Anyone living with diabetes must include routine eye exams in their treatment regimen to detect early damage in the retina. A simple dilated eye exam can help your doctor detect early signs of vision problems.

How Diabetic Retinopathy Affects Vision

Diabetes-related vision problems can affect the function of your eyes in many ways.

  • 1

    Blurry Vision

    The retina is the part of your eyes that captures light and relays visual signals to the brain. Diabetic retinopathy can lead to vision loss caused by weakened retinal vessels from prolonged, dangerously high blood sugar levels. The vessels can leak fluid or blood, cause swelling of the retina, and distort the way light is focused. As a result, your vision may become blurry and spotty.
  • 2

    Macular Edema

    Macular edema is a complication that occurs when damaged retinal blood vessels leak fluid into the macula — the central part of the retina. It’s responsible for sharp, detailed vision. This swelling can make it difficult to recognize faces, read, or see distant objects clearly.
  • 3

    Retinal Detachment

    If diabetic retinopathy gets worse, repeated bleeding can occur, causing scar tissue to form. Sometimes, this results in the retina pulling away from the underlying tissue. This requires a medical emergency and immediate treatment to prevent permanent vision loss.

You can sidestep these vision complications by following your treatment plan. Take your medications on time and adopt healthy lifestyle habits to keep your blood sugar, blood pressure, and cholesterol within healthy parameters.

How Diabetic Retinopathy Is Diagnosed

Signs of Diabetic Retinopathy

A dilated eye test can help spot diabetic retinopathy and vision issues. Your doctor will use special eye drops to dilate your pupils so they can directly check the retina for early signs of damage. This test can detect whether tiny bulges have started to form in the blood vessels, the areas of bleeding, or if fat has begun to accumulate from leaking vessels.

An ophthalmologist may also use imaging tests, such as optical coherence tomography (OCT) and fluorescein angiography, to get a detailed view of your eye health. How often should you get an eye exam? Below are recommendations from the American Diabetes Association.

    • Individuals with type 1 diabetes should visit an eye specialist for their first dilated and comprehensive eye test within 5 years after the onset of diabetes.
    • People with type 2 diabetes should have their first dilated and comprehensive eye test at the time of diagnosis.

If initial results are OK, you may be required to undergo eye screenings every 1 to 2 years. If results show a possible diabetic retinopathy, you should get checked at least once a year. Depending on how fast the condition progresses, your doctor may recommend more frequent eye exams.

ICD-10 Codes and Medical Classification

Healthcare providers use ICD-10 codes to classify every diagnosis and condition. The main codes for diabetic retinopathy fall under the E10.3 to E11.3 series, depending on the type of diabetes you have.

Here are some ICD-10 codes for diabetic retinopathy in type 1 diabetes:

    • E10.31: Type 1 diabetes mellitus with unspecified diabetic retinopathy
    • E10.311: Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edema
    • E10.319: Type 1 diabetes mellitus with unspecified diabetic retinopathy without macular edema

Here are some ICD-10 codes used for diabetic retinopathy in type 2 diabetes:

    • E11.31: Type 2 diabetes mellitus with unspecified diabetic retinopathy
    • E11.32: Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy
    • E11.321: Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema

These codes help your doctor classify the exact stage and type of eye damage caused by diabetes.

Treatments for Diabetic Retinopathy

TREATMENT OF DIABETIC RETINOPATHY

There’s no cure for diabetic retinopathy, but existing treatments can help prevent permanent blindness or stop its progression. Depending on how severe the damage to the eyes is, your doctor may suggest the following interventions:

    • Injections: Your doctor may inject anti-VEGF or corticosteroids to reduce eye swelling, leakage, and bleeding.
    • Laser treatment: They may recommend a medical procedure called laser photocoagulation to shrink swollen blood vessels and prevent new ones from forming.
    • Eye surgery: If there’s a lot of bleeding, your doctor may recommend vitrectomy, a surgical procedure that removes the blood from inside the eyes.

Your doctor will choose between these three treatment options after determining which method suits you best, according to how severe the damage to the retina is.

Prevention and Eye Care Tips for People With Diabetes

Protecting your vision begins with maintaining stable blood glucose and keeping its levels as close to the normal range as possible. To achieve this, here are some tips you can follow.

  • Eat a wholesome diet: Choose lean proteins, whole grains, and vegetables.
  • Exercise for at least 150 minutes per week: Dancing, walking, and cycling are great ways to add movement to your daily routine.
  • Quit smoking: If you use cigarettes, know that they promote inflammation and worsen the damage to your blood vessels.
  • Get 7-9 hours of sleep: Sufficient sleep can help reduce stress and inflammation and boost blood sugar control.
  • Monitor your cholesterol and blood pressure: High readings of either can increase the risk of retinal damage.

In addition to these tips, remember to visit an eye specialist regularly to check for symptoms. If your diabetic retinopathy is mild, your doctor may recommend regular monitoring until treatment becomes necessary. Combining healthy habits and good eye care can protect one of your precious senses for as long as possible.

When to See an Eye Doctor

What is the first sign of diabetic retinopathy? In most cases, there are no early warning signs. That’s why the rule of thumb is to visit an eye doctor for a comprehensive eye exam every 1 to 2 years. Annual checkups can help doctors detect subtle changes in the retina and diagnose problems before they affect your vision. Early diagnosis can improve the chances of treatments being effective.

Vision changes can also happen as part of aging, but they can also be triggered by diabetes. If your loved one has diabetes and is over 60, avoid assuming that blurry vision is simply due to aging. Schedule an eye exam with their doctor.

You should get immediate medical attention if you experience these signs of diabetic retinopathy:

    • Sudden vision loss
    • Distorted or blurred vision
    • Appearance of dark patches or floaters

These signs may indicate retinal detachment or bleeding inside your eyes. They require urgent treatment to prevent blindness.

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Diabetic Retinopathy Is Treatable

Diabetes can cause irreversible complications, such as vision loss. However, it’s in your control to prevent these from happening. Diabetic retinopathy may not have a cure, but it’s highly treatable, especially when detected early.

Regardless of whether you don’t feel any symptoms, get annual eye exams to monitor eye function. In addition, take your diabetes medications as prescribed to keep your blood sugar levels steady. Make mindful food choices, stay active, get enough sleep, and manage stress effectively. Adopting these positive lifestyle habits enhances glucose control and reduces the chance of complications, including diabetic retinopathy.

Frequently Asked Questions

Diabetes doesn’t cause actual sugar accumulation in the eyes. What happens is that when blood sugar levels are consistently high, it causes a build-up of fluid in the focusing lens of the eye, which results in blurry vision. Without treatment, this may lead to permanent vision loss.

A diabetic eye — which usually refers to diabetic retinopathy — rarely manifests obvious symptoms. That’s why many call it a “silent” eye disease. Only an eye exam can diagnose it.

Diabetes affects the eyes in many ways, causing mild to severe vision problems. Diabetic retinopathy is the key cause of permanent blindness in those with uncontrolled blood sugar levels.

The primary trigger of diabetes-related vision loss is prolonged high blood sugar levels. Poorly managed diabetes can damage the retina, leading to changes in vision.

No. Without treatment, diabetic retinopathy can progress to a severe stage that increases the risk of blindness. However, you can slow its progression with medications, laser, surgery, and lifestyle adjustments.

Some warning signs of diabetic retinopathy include blurred vision, floaters that seem to drift across your sight, difficulty reading, or trouble seeing at night.

Anti-VEGF injections, laser photocoagulation, and eye surgery can help reverse or slow the progression of diabetic retinopathy.

Original Publish Date: 5/27/2021 – Updated 10/21/2025