Diagnosis and Treatment of Diabetic Retinopathy

How is diabetic retinopathy diagnosed?

A medical eye examination can find changes inside your eye. An eye care specialist can often diagnose and treat serious retinopathy before you are aware of any vision problems. Your doctor dilates your pupil and looks at the inside of your eye.

If your eye doctor finds diabetic retinopathy, he or she may order color photographs of the retina and a special test called fluorescein angiography to find out if you need treatment. In this test, fluorescent dye is injected into a vein in your arm and your eye is photographed as the dye passes through the blood vessels in the back of the eye.

Treatment of diabetic retinopathy

The best treatment for diabetic retinopathy is to prevent it’s development. Strict control of your blood sugar will significantly reduce the long-term risk of vision loss from diabetic retinopathy. If high blood pressure and kidney problems are present, they need to be treated.

Laser surgery is often recommended for people with macular edema, PDR and neovascular glaucoma. For macular edema, the laser is focused on the macula to decrease the fluid leakage. The main goal of treatment is to prevent further loss of vision. It is uncommon for people who have blurred vision from macular edema to recover normal vision, although some may experience partial improvement.

For PDR, the laser is focused on all parts of the retina except the macula. This panretinal photocoagulation treatment causes abnormal new vessels to shrink and often prevents them from growing in the future. It also decreases the chance that vitreous bleeding or retinal distortion will occur. Recently, eye injections have become a useful tool in the management of diabetic retinopathy.

Multiple eye injections or laser treatments over time are sometimes necessary. These procedures do not cure diabetic retinopathy and does not always prevent further loss of vision. Sometimes, in severe cases, a patient may need to see a retina specialist to discuss more involved surgery.

Diabetic Retinopathy Treatment Overview

Vision loss to diabetic retinopathy is largely preventable.

If you have diabetes, it is important to know that today, with improved methods of diagnosis and treatment, only a small percentage of people who develop retinopathy have serious vision problems. Early detection of diabetic retinopathy is the best protection against loss of vision. You can significantly lower your risk of vision loss by maintaining strict control of your blood sugar and visiting your eye care specialist regularly.

When to schedule an examination.

In general, you should have your eyes checked promptly if you have visual changes that:

  • Affect only one eye.
  • Last more than a few days.
  • Are not associated with a change in blood sugar.

People with diabetes should schedule examinations at least once a year. More frequent medical eye examinations may be necessary after the diagnosis of diabetic retinopathy. Pregnant women with diabetes should schedule an appointment in the first trimester because retinopathy can progress quickly during pregnancy.

If you need to be examined for glasses, it is important that your blood sugar be in consistent control for several days when you see your doctor. Glasses that work well when the blood sugar is out of control will not work well when blood sugar is stable. Rapid changes in blood sugar can cause fluctuating vision in both eyes, even if retinopathy is not present. 

Get EyeSmart

Visit the American Academy of Opthalmology’s webpage on Diabetic Retinopathy.