Diabetic retinopathy

Diabetic retinopathy is a term used to describe abnormal changes to the network of blood vessels that supply the retina. Approximately 40 per cent of people with type 1 diabetes show signs of the disease and 20 per cent of people with type 2 diabetes.

What is diabetic retinopathy?

Diabetic Retinopathy (DR) describes abnormal changes to the blood vessels that supply the retina. Missing areas of vision may impact someone’s ability to see everything in their environment and avoid hazards when moving around objects in corridors or crossing roads safely.

DR is common in individuals with poorly controlled diabetes, as prolonged high blood sugars can damage small blood vessels in the eyes, as well as the kidneys and feet.

Diabetic maculopathy

Diabetic maculopathy is a condition under the umbrella term of diabetic retinopathy. It describes the condition where blood vessels in the macula of the retina are blocked or leaky. This will affect your central vision and your ability to see detail (acuity).

Symptoms

In the early stages of diabetic retinopathy, an eye test will show changes to the retina but you won’t experience any noticeable change in your vision. If the condition progresses, small blood vessels in the retina can leak, grow abnormally and burst. This disrupts the light-receptive cells in the retina and their ability to receive light, so your vision will become blurry. Blind spots in your vision can also appear because of damage to the retina. Eventually, scar tissue and bleeding can cause the retina to detach suddenly, resulting in a high risk of sudden vision loss. 

Treatment

It’s important to attend regular diabetic eye checks to catch diabetic retinopathy early as it can be controlled through diet and medication. Treatment options include eye surgery and laser. The laser treatment aims to destroy areas of abnormal blood vessels and prevent further damage, and is not the same as the treatment for people who wear glasses to correct distance vision.

Practical implications 

If you have diabetic retinopathy, missing areas of vision, sometimes called blind spots, will mean that you can’t see everything around you. It may be more difficult, for example, to move around objects in corridors or to cross roads safely. If you have diabetic maculopathy, you may have blurry central vision. This can reduce your ability to read and see colour, details and faces. 

You may have difficulty with:

• Completing everyday tasks because your vision has become restricted and fragmented as a result of multiple blind spots. For example, applying make-up, peeling or chopping food, setting the oven or microwave or making a drink can be particularly difficult.
• Reading small print such as medication instructions, blood sugar monitor results, receipts, food ingredient and nutrient labels, bus or train timetables and laundry care labels.
• Reading text on a background colour and colour-coded signs, due to reduced colour vision and sensitivity to colour contrast. 
• Getting out and about on dark days, as similar dull colours are difficult to tell apart, for example kerbs, cars, street bins and signs. 
• Going outside on brighter days, or in brighter environments, as glare can be both uncomfortable and affect your vision. If you’re experiencing glare whilst outdoors, for example, you might need to walk on the shaded side of the street to maximise your vision and minimise discomfort.

Find out more about symptoms, diagnosis and treatment on the NHS website.

Diabetes UK also has some useful information.