Marathi: मधुमेहामुळे होणारा डोळ्यांचा आजार (डायबेटिक रेटिनोपॅथी)
Diabetic retinopathy is damage to the small blood vessels of the retina — the light-sensitive layer at the back of your eye — caused by long-standing high blood sugar. It is the most common eye complication of diabetes and the leading cause of preventable blindness in working-age adults in India. The good news: with timely diagnosis and modern treatment, severe vision loss is largely preventable.
What Happens Inside the Eye
Think of the retina as the film of your eye’s camera, nourished by a fine network of tiny blood vessels. In diabetes, these vessels gradually weaken. Some leak fluid and blood. Others close down completely, starving parts of the retina of oxygen. In response, the eye tries to grow new vessels, but these new vessels are fragile and harmful — they bleed easily, pull on the retina, and can cause blindness if untreated.
Who Is at Risk?
- Long duration of diabetes — the longer you have had diabetes, the higher the risk.
- Poor blood sugar control — particularly an HbA1c above 7.5%.
- High blood pressure and high cholesterol.
- Kidney disease related to diabetes.
- Pregnancy — diabetic retinopathy can worsen quickly.
- Smoking.
- Family history of diabetic eye disease.
Both type 1 and type 2 diabetes cause retinopathy, and so can gestational diabetes if it becomes chronic.
Symptoms — and Why You May Have None
In early stages, diabetic retinopathy causes no symptoms at all. As the disease progresses you may notice:
- Blurring of vision
- Difficulty reading small print
- Floaters — black spots, strings or cobwebs drifting across your sight
- Sudden dark patches or a “curtain” over part of your vision
- Distorted or wavy lines (when the macula is involved)
- Sudden, painless drop in vision (a vitreous haemorrhage)
- Poor night vision
The Stages of Diabetic Retinopathy
Non-Proliferative vs. Proliferative
- Non-Proliferative DR (NPDR) — the earlier stage. Vessels become leaky and fragile but no new abnormal vessels have grown yet. Sub-classified as mild, moderate or severe.
- Proliferative DR (PDR) — the advanced stage. Abnormal new vessels grow, which can bleed into the eye, cause scarring, retinal detachment, or a severe form of glaucoma. PDR is a sight-threatening emergency.
A Special Complication — Diabetic Macular Edema (DME)
At any stage of diabetic retinopathy — even mild — fluid can leak into the macula, the central part of the retina. This is called Diabetic Macular Edema and is the most common cause of vision loss in diabetics. See our separate article on DME for more.
How We Diagnose Diabetic Retinopathy
A complete diabetic eye check-up at Suraj Eye Institute takes 60–90 minutes and includes:
- Vision testing for distance and near
- Dilated retinal examination
- OCT — a non-contact scan that shows the layers of the macula and detects fluid
- OCT-Angiography — a dye-free scan of the retinal blood vessels
- Fundus photography to track changes over time
- Fluorescein angiography when needed
- Ultra-widefield imaging for a panoramic view of the peripheral retina
How Often Should I Be Checked?
| Your situation | Recommended exam frequency |
|---|---|
| Type 2 diabetes — at diagnosis | Immediately, then once a year |
| Type 1 diabetes | Within 5 years of diagnosis, then yearly |
| Pregnancy with pre-existing diabetes | Each trimester and 3 months postpartum |
| Mild–Moderate NPDR | Every 6–9 months |
| Severe NPDR | Every 3–4 months |
| PDR or DME | Monthly to every 3 months, as advised |
Treatment Options
- Strict diabetes control is the foundation — no eye treatment works fully without controlled blood sugar, BP, lipids and kidney function.
- Intravitreal anti-VEGF injections (Bevacizumab, Ranibizumab, Aflibercept, Brolucizumab, Faricimab) — first-line for centre-involving DME and important in PDR. Most patients need 5–7 injections in year 1.
- Intravitreal steroids (Ozurdex implant, intravitreal triamcinolone) — for selected resistant cases.
- Laser treatment — Pan-Retinal Photocoagulation (PRP) for PDR; focal/grid laser for some DME cases; subthreshold/micropulse laser for selected macular disease.
- Vitrectomy surgery — for non-clearing vitreous haemorrhage, tractional retinal detachment involving the macula, and dense pre-macular haemorrhage.
What to Expect from Treatment
- Stabilisation, not always cure. The aim is to protect remaining vision and slow further damage.
- Recovery is gradual — vision gains, when they happen, occur over weeks to months.
- Most patients need ongoing follow-up for life, even after the eye stabilises.
- Skipping injections or follow-up is the commonest reason for vision loss in patients already under care.
- Treating one eye does not protect the other — both eyes are followed separately.
Prevention — What You Can Do
- HbA1c below 7% wherever safely possible
- Blood pressure below 140/90 mmHg (lower if advised)
- LDL cholesterol controlled
- Stop smoking completely
- Daily moderate activity — walking, swimming, yoga
- Annual dilated eye exam, even if you see perfectly well
- Amsler grid test at home (we will give you one)
- If you are planning a pregnancy, see us before conception
- Take your medicines regularly — including injections of anti-VEGF if prescribed
When to Come to Us Immediately
Frequently Asked Questions
My sugar is well controlled. Do I still need an eye check?
Yes. Even well-controlled diabetes can cause retinopathy. An annual dilated exam is essential.
I have no symptoms. Why are you recommending treatment?
Because diabetic retinopathy damages the retina silently. Treatment given before you have symptoms gives the best chance of preserving good vision lifelong.
Will the injections last forever?
For many patients, the frequency of injections gradually reduces as the disease becomes stable. Some patients can be tapered off; others need long-term maintenance. Each patient is different.
Are the injections painful?
We use anaesthetic drops, the injection itself takes a few seconds, and most patients feel only a brief pressure. Mild redness or grittiness for a day is normal.
I have cataract and diabetic retinopathy. Which should be treated first?
It depends on the severity of each. Often we stabilise the retinopathy first, then plan cataract surgery. We will plan this together.
Can diet, supplements or yoga reverse diabetic retinopathy?
A healthy lifestyle helps slow progression, but no diet, supplement or exercise can replace medical treatment of established disease.
Is diabetic retinopathy hereditary?
Diabetes runs in families and so does the tendency to develop retinopathy. But good control reduces the risk regardless of family history.
Will I go blind?
With timely diagnosis and treatment, the great majority of our patients keep useful vision lifelong. Most blindness from diabetic retinopathy occurs in patients who never came for screening, or who stopped follow-up.
Book your annual diabetic eye check at Suraj Eye Institute today.
Book Appointment Now for Retina Evaluation