Understanding Diabetic Retinopathy

Diabetes is a disease that affects the blood vessels throughout the body, particularly vessels in the kidneys and the eyes. When the blood vessels in the eyes are affected, this is called diabetic retinopathy.

The retina lies in the back of the eye and is a multi-layered tissue that detects visual images and transmits these to the brain. When blood vessels in the retina are damaged due to diabetes, they may leak blood or fluid. Fluid leakage, known as diabetic macular edema, affects the ability of the retina to detect and transmit images.

Types of Diabetic Retinopathy

There are two types of diabetic retinopathy. Background retinopathy is considered the early stage. Reading vision is typically not affected, but it can advance and cause severe problems with your vision. There are usually no symptoms with background diabetic retinopathy. A comprehensive eye exam is the only way to diagnose changes in the vessels of your eyes.

When the retinopathy becomes advanced, new vessels grow, or proliferate, in the retina. If left untreated, they may bleed, which causes vision to become hazy and sometimes causing a total loss of vision. These new vessels can also damage the retina by forming scar tissue by pulling the retina away from its proper location. This stage, called proliferative retinopathy, requires immediate medical attention.


Our doctors at NH Eye Associates have extensive experience diagnosing and treating diabetic retinopathy. Regular eye exams are crucial for all persons with diabetes. If problems are detected early, treatment can be offered to help prevent severe loss of vision.

Proliferative diabetic retinopathy is usually treated with laser photocoagulation, which helps shrink new blood vessels before they can cause damage. Surgery may be required in more advanced cases. Diabetic macular edema is treated with laser or intraocular injections to help reduce swelling.

What To Expect During Your Visit

An examination for diabetic retinopathy will typically last about one hour from the time you enter the exam room. You will be given eye drops that will dilate your pupils. These drops take about 15-20 minutes to work. They may make your eyes light sensitive and difficult to focus, especially up close, for several hours.

Your doctor will then shine several lights into your eyes, using both an eye microscope and ophthalmoscope. These instruments allow for a thorough examination of the various parts that make up both the outside and inside of your eyes, including a detailed view of your retina.

Specialized imaging may also be required to further evaluate any abnormal findings on your exam, including optical coherence tomography (OCT), wide-field fundus photography, ultrasonography, and fluorescein angiography.

At the completion of your visit, your doctor will review the results of your evaluation and discuss follow-up care with you.

Communication With Your Physician

A visit summary will also be sent to your physician managing your diabetes care. This communication is important in assisting your physician to better manage your diabetes. Several studies have shown that better management of diabetes helps lower the rate of the development of diabetic eye disease.