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Symptoms and Complications of Diabetic Retinopathy

Symptoms and Complications of Diabetic Retinopathy

Characterized by the body's inability to use and store sugar properly, diabetes is a chronic condition that affects the entirety of the body. Over time it can cause severe damage throughout the body, including damaging small blood vessels and capillaries. 

When this damage to blood vessels affects the retina (tissue at the back of the eye that senses light), it can cause blood and other fluids to leak out, leading to swelling of the eye called diabetic retinopathy. 


The longer an individual has diabetes, the greater their chance of developing diabetic retinopathy. While controlled blood sugar levels can slow the onset and progression, it is a severe complication that will eventually cause loss of sight if left untreated. 

For those with diabetes, it is essential to be aware of the symptoms and risk factors tied to this particular condition. Not all diabetics will develop diabetic retinopathy. But as with most eye diseases, early detection allows for treatment that can delay severe damage to eyesight.

Symptoms and Complications of Diabetic Retinopathy

Diabetic Retinopathy has two distinct stages. In the first and most common stage, non-proliferative diabetic retinopathy (NPDR), blood vessels in the retina become weakened enough to cause blood and fluid leakage into the surrounding tissue. This leakage causes swelling and increases eye pressure which can distort the eye's surface. 

In the very earliest stages of the disease, you may not notice any symptoms at all. As the NPDR advances, you may begin to see the following symptoms during the early onset of the disease: 

  • Slight blurriness in vision
  • Difficulty focusing on fine details
  • Trouble differentiating differences in color
  • Floaters (dark spots or strings that move around)

Disease Advancement

The damage caused to blood vessels and swelling of the eye during the first stage of diabetic retinopathy decreases circulation and slowly deprives the retina of oxygen. The second advanced stage of the disease is proliferative diabetic retinopathy (PDR). It is during this stage that most people begin to realize they have a problem seeing.

Symptoms and complications of advanced stage PDR include:

  • Blurred and cloudy vision
  • Dark or empty spots, especially in the center of vision
  • Difficulty seeing in low light
  • Detachment of the retina due to scar tissue
  • Optic nerve damage causing glaucoma

New blood vessels begin to grow in the retina to compensate for damage and lack of oxygen. These new vessels are fragile, breaking easily and leaking even more fluid into the vitreous (clear jelly-like center). This leakage causes a domino effect of adding even more pressure to the eye. Without proper treatment, PDR will eventually cause severe vision loss or blindness.

Contributing Risk Factors

As mentioned previously, the longer you have had Type-1 or Type-2 diabetes, the greater your risk of developing diabetic retinopathy, especially if the diabetes is poorly controlled. However, other factors increase the chance of PDR. 

  • Family history of diabetic retinopathy or other eye diseases
  • Being of Hispanic or African descent
  • Pregnancy when diabetic or developing gestational diabetes while pregnant
  • Poorly controlled high blood pressure or high cholesterol
  • Regular use of tobacco products

For those women who develop gestational diabetes when pregnant and begin to have vision issues, it is essential to note that vision often returns to normal after term once fluid retention and swelling subside and gestational diabetes resolves. You should still speak to an ophthalmologist if you notice any changes to your vision during pregnancy and if your sight doesn’t return to normal.

Getting a Diagnosis

The good news is that both stages of diabetic retinopathy can be detected and diagnosed through a comprehensive eye exam. If you have a family history of the disease or are diabetic, making sure to schedule annual eye exams can catch the disease earlier and aid in treatments that can help prolong your good vision.

If you notice any of the symptoms listed above begin or worsen, have an appointment scheduled with your eye care doctor as soon as possible to have your retina and macula checked. Healthy adults should have a comprehensive eye exam every two to three years. If you have Type-1 or Type-2 diabetes, you should have one yearly.

Prevention and Treatment Options

The best way to help prevent and lessen the potential symptoms of vision loss from PDR is with careful management of diabetes and early detection. Keeping your blood sugar in check, eating healthier, and exercising can all increase the health of your circulatory system. For those with NPDR, maintaining the integrity of blood vessels can delay the second stage of the disease for some time.

As diabetic retinopathy  worsens in later stages, more treatments are available that might help stop vision from worsening, such as:

  • Scatter laser surgery to shrink blood vessels in the retina and lessen swelling
  • A vitrectomy procedure to reattach a retina or remove darkened vitreous from the eye
  • Injections of corticosteroids or anti-VEGF drugs to reduce swelling

Diabetic Eye Care in Western North Carolina

If you have recently been diagnosed with diabetes or have concerns that you may be experiencing symptoms of diabetic retinopathy, schedule a comprehensive eye exam with a trusted eye care professional. For Buncombe and surrounding counties in North Carolina, Asheville Vision and Wellness has the expertise, care, and technology you can trust with your vision.

Since 1989, our staff has served the area using the latest science and medical treatments to keep your vision healthy. Our optometrists are certified in diagnosing, treating, and managing the ocular disease with examinations customized just for your unique eye-care needs.

If you have concerns about developing PDR or any other ocular diseases, schedule an appointment online or call us at (828) 747-9260.