Diabetic retinopathy (DR) is a common complication of diabetes that affects the retina lining the inner eye. The condition can result in changes to blood vessels in the eye, which may damage the retina and lead to vision problems.

DR is a potential complication that may develop in a person living with diabetes. Over time, high blood sugar levels may damage the retinal blood vessels. These small vessels may leak blood and other fluid, which can result in swelling of the retinal tissue. This swelling and leaking causes blurred vision.

If untreated, vision loss can occur. In fact, DR is the leading cause of preventable vision loss in the United States. The risk of developing DR increases the longer a person has diabetes. Evidence suggests more than half of people with diabetes will develop DR. However, managing blood sugar levels and maintaining eye health can help reduce this risk.

In this article, we compare a healthy retina with DR and other conditions affecting the retina. We also suggest ways to help prevent DR development.

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The human eye is a specialized organ that enables people to see. The eye has many structures that enable vision, including the retina. The retina is a layer of highly specialized nerve tissue that lines the inner eye and receives focused light rays from the lens, which it converts it into electrical signals. The brain interprets these signals into the images a person sees.

Eye doctors can view the retina through a piece of special equipment known as a fundoscope, which they use during an eye exam. The parts of the retina include:

  • Rods: Rods are one type of photosensitive cell that perceives vision at low light levels.
  • Cones: Cones, also a type of photosensitive cell, perceive vision at high light levels.
  • Macula: The macula is the center area of the retina, which plays a role in central vision.
  • Fovea centralis: The fovea centralis is the small depression in the center of the macula where visual acuity or sharpness is the highest.

In a typical retina, the blood vessels appear healthy and do not bulge or leak fluid.

In most cases, DR develops in both eyes. The symptoms of DR may become worse over time as continued damage to the retina develops.

In the early stage, blood vessels in the retina weaken and start to bulge. These bulges form small pouches that an eye doctor can detect through an eye exam. If the weakened blood vessels leak fluid, it may cause the macula to swell. At this point, vision may become blurry.

As the condition progresses, the retina may grow new vessels in response to the impaired circulation. However, the vessels are atypical and weak. In some cases, the fragile vessels leak blood into the area between the retina and the lens. Depending on the extent of the bleeding, visual issues may develop.

Learn more about the stages of DR.

Various other conditions may also impact the retina, independent of living with diabetes. These can include:

  • Retinitis pigmentosa: This genetic condition causes the cells in the retina to gradually deteriorate. Over time, this can lead to vision loss.
  • Retinoblastoma: This is a form of eye cancer that affects the tissues of the retina. It usually occurs in children under 5 years old.
  • A macular hole: Macular holes are circular openings in the macula, which is part of the retina. The formation of a hole leads to distorted vision and, eventually, a blind spot in central vision.
  • Retinal vein occlusion: This describes when a blot clot forms and blocks the retinal vein. It is most common in older adults. It can develop due to diabetes, high blood pressure, and other conditions that affect blood flow.

Learn more about other retinal problems.

The best way to help prevent DR is through diabetes management. This involves maintaining blood sugar levels within a suitable range.

Several factors can affect blood sugar management, including the following:

  • getting regular exercise
  • eating a healthy diet with fresh vegetables, lean protein, and fruits
  • taking diabetes medication as prescribed
  • following medical recommendations for certain lifestyle changes, such as not smoking, if applicable

High blood pressure may also affect eye health and increase a person’s chances of developing vision loss. Along with controlling blood sugar levels, maintaining healthy blood pressure is also critical.

According to the American Academy of Ophthalmology, managing blood sugar and pressure may prevent vision loss. In some instances, it may even reverse some vision loss.

Additionally, it is essential to attend regular eye exams to help maintain good eye health and spot problems early. Some eye conditions may not cause symptoms in their early stages. However, an eye doctor can diagnose many of these through an eye exam.

Learn more about diabetic eye screening.

Diabetic retinopathy (DR) causes changes to the retina. It develops due to blood vessel damage from continued high blood sugar levels. The damage causes the retinal blood vessels to swell and leak fluid or blood. New atypical and fragile blood vessels may also form.

These changes impact retinal health and may cause vision loss. Optimal diabetes management, including maintenance of recommended blood sugar levels, can decrease the risk of developing DR.