Mild diabetic retinopathy refers to the early stage of the condition. During this stage, people usually do not have symptoms. But some may begin to notice vision changes, such as difficulty in reading.

When the condition is mild, doctors usually monitor rather than treat it.

Measures to help prevent diabetic retinopathy from worsening include controlling high blood sugar and high blood pressure. Certain lifestyle changes, such as quitting smoking and regular exercise, can also help a person slow the progression of the condition.

This article discusses mild diabetic retinopathy, including how doctors monitor it, how a person can prevent it from worsening, and whether treatment is available. It also examines other stages of diabetic retinopathy and when to see a doctor.

A pair of glasses representing mild diabetic retinopathy. -1Share on Pinterest
Photographer, Basak Gurbuz Derman/Getty Images

In diabetic retinopathy, high blood sugar levels can harm blood vessels in the retina. The retina is the structure in the back of the eye that plays an important role in vision.

In the mild or early stage, also known as “non-proliferative diabetic retinopathy,” tiny blood vessels leak, which can form small aneurysms or bulges. These may burst and create dot-like hemorrhages (called dot-and-blot hemorrhages).

If these blood vessels cannot provide enough oxygen to the retina, it can lead to fluffy, white patches known as cotton wool patches or spots.

Additionally, small blood vessels can become closed off, restricting the amount of fresh oxygen that gets into the retina. At times, small lipid accumulations (exudates) can develop alongside the compromised blood vessels.

People usually do not have symptoms in the early stage. Fluctuations in blood sugar levels can alter the focusing power of the lens inside the eye. If so, some individuals may notice vision changes, such as difficulty seeing faraway objects or reading. Stabilizing blood sugar levels can greatly relieve these symptoms.

Can you reverse mild diabetic retinopathy?

No, mild diabetic retinopathy is not reversible. However, it is worth striving for good blood sugar control because sometimes that can restore some lost vision.

Monitoring may involve a comprehensive dilated eye exam every 2–4 months. This is a painless procedure that starts with the insertion of drops in the eye that widen the pupil.

Afterward, a doctor conducts a vision test and views the eye’s interior.

Learn more about diabetic eye screening here.

Doctors typically do not treat the mild form of the condition.

However, in the later stage, they recommend starting treatment quickly — particularly if changes in vision are present. This can prevent further vision loss.

Treatment options include:

  • Injections: Anti-VEGF drugs, such as aflibercept (Eyelea), can slow or reverse the condition. Corticosteroids, such as triamcinolone acetonide (Cinolar), may also help.
  • Laser treatment: This makes the blood vessels shrink and stop leaking, which decreases swelling in the retina.
  • Surgery: If bleeding or much scar tissue is present, doctors may perform a vitrectomy. This procedure repairs sources of bleeding and replaces cloudy vitreous, the gelatinous tissue in the eyeball.

Preventing diabetic retinopathy from worsening

According to the American Optometric Association, the following measures can help prevent or slow the progression:

  • taking prescribed medications to control blood sugar
  • exercising regularly
  • sticking to a diet that helps manage diabetes
  • controlling high blood pressure, as elevated blood pressure is a risk factor
  • avoiding smoking and alcohol consumption

The more advanced stage is called proliferative diabetic retinopathy, which occurs when the retina begins growing new blood vessels. The atypical vessels may bleed into the vitreous, resulting in decreased vision. This is known as diabetic vitreous hemorrhage.

Also, the new blood vessels may produce scar tissue, which may either cause the retina to detach or harm the macula. Retinal detachment is a serious problem that may result in a total loss of vision.

The effects of this stage may lead to a loss of both central and peripheral (side) vision.

Because high blood sugar can damage blood vessels, a person with diabetes should talk with their doctor about managing their condition.

Since high blood pressure and kidney problems can affect the eyes, someone with either of these conditions should ask a doctor about how to keep them under control.

Any individual should have regular dilated eye exams so that a doctor can detect diabetic retinopathy before it causes vision loss.

People who notice any vision changes, such as blurred vision or increased floaters, in one or both eyes should see a doctor.

A person with a diagnosis of diabetic retinopathy should talk with a doctor about starting treatment, which can help prevent vision loss.

In mild diabetic retinopathy, tiny blood vessels in the retina leak and may cause small retinal hemorrhages. Although people usually do not have symptoms at the early stage, fluctuations in blood sugar levels and their effect on the lens may lead to vision changes.

Since there is no proven benefit to early, aggressive treatment for these mild changes, doctors typically just monitor it with periodic dilated eye exams. Once it worsens, treatment may include injections, laser treatment, and surgery.

Key ways to prevent worsening involve managing high blood sugar and high blood pressure. This involves taking prescribed medications and following an eating plan for diabetes.

Early detection can lead to treatment that prevents vision loss, so a person should see a doctor promptly when they notice any vision changes.