Diabetic Retinopathy is the leading cause of blindness in working age adults.

Diabetic retinopathy is caused by the repeated damage to the small blood vessels in the retina. Poorly controlled blood sugar levels are believed to be responsible for this damage. Diabetic retinopathy has no early warning signs.

Non proliferative retinopathy, or background diabetic retinopathy, is an early stage of diabetic retinopathy. Blood vessels in the eye become larger in certain spots (called microaneurysms). Blood vessels may also become blocked. There may be small amounts of bleeding (retinal hemorrhages), and fluid may leak into the retina.

Proliferative diabetic retinopathy is a more advanced form that to the growth of abnormal new blood vessels in the retina. This occurs in response to poor circulation in the eye and the lack of oxygen delivered to the cells. These new blood vessels do not help to increase circulation in the retina and cause more harm than good. These fragile new vessels bleed into the center of the eye obscuring vision. Symptoms vary depending on the amount of blood that mixes with the vitreous in the eye; it can vary from a few dark floaters to near blindness of one eye.  The blood can take days to months to be reabsorbed. If it does not clear up on its own, a surgical procedure called vitrectomy may be warranted. The visual prognosis is typically good if there is no damage to the macula.

Diabetic retinopathy can also lead to retinal detachments.  This occurs when the new blood vessels shrink and form scar tissue that tugs on the retina and can pull it from its normal position. If the macula is involved, severe visual loss may occur.

When abnormal new blood vessels form, as in proliferative diabetic retinopathy, they may bleed and appear as small specks or large floaters obscuring the vision. If a large hemorrhage occurs, vision often becomes very blurry.

A thorough eye examination by a general ophthalmologist or retina specialist is the only reliable means of diagnosing diabetic retinopathy. After the pupil is dilated, the doctor uses a device called an ophthalmoscope  to view the retina and determine the extent of the retinopathy. If diabetic retinopathy is detected, a fluorescein angiogram (dye test) and/or and optical coherence tomogramy (OCT) will likely be recommended.  A fluorescein angiogram is procedure that is used to document the blood circulation of the retina.  It involves the injection of a dye into a vein in the arm followed by several minutes of intermittent photos with a special digital camera focused on the retina.  An OCT is a scan that creates a detailed cross sectional image of the macula.

Prevention is the always best therapy. Studies show that strict control of blood sugar significantly lowered the risk of vision loss from diabetic retinopathy.