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Diabetes affects small blood vessels all around your body, including the small vessels that supply blood to the retina at the back of your eye. Persistent high blood sugar levels can lead to problems arising from these vessels and cause damage to the retina; this may be from blocked or leaking vessels, or from them growing haphazardly. This is called diabetic retinopathy, or often just 'retinopathy'. Retinopathy is the most common cause of blindness among people of working age in the UK.


There are different types of retinopathy: background retinopathy, maculopathy and proliferative retinopathy.


Background retinopathy

The earliest visible change to the retina is known as background retinopathy. This will not affect your sight, but it needs to be carefully monitored. The capillaries (small blood vessels) in the retina become blocked, they may bulge slightly (microaneurysm) and may leak blood (haemorrhages) or fluid (exudates).



This is when the background retinopathy (see above) is at or around the macula. The macula is the most used area of the retina. It provides our central vision and is essential for clear, detailed vision. If fluid leaks from the enlarged blood vessels it can build up and causes swelling (oedema). This can lead to some loss of vision, particularly for reading and seeing fine details, and everything may appear blurred, as if you are looking through a layer of fluid not quite as clear as water.


Proliferative retinopathy 

This occurs as background retinopathy develops and large areas of the retina are deprived of a proper blood supply because of blocked and damaged blood vessels. This stimulates the growth of new blood vessels to replace the blocked ones. These growing blood vessels are very delicate and bleed easily. The bleeding (haemorrhage) causes scar tissue that starts to shrink and pull on the retina - leading to it becoming detached and possibly causing vision loss or blindness. Once the retinopathy has reached this stage it will be treated with laser therapy. Beams of bright laser light make tiny burns to stop the leaking and to stop the growth of new blood vessels.


It is important to remember that retinopathy will damage your vision if left untreated. The damage can cause a variety of symptoms, often a haphazard loss of vision across your visual field. Although laser treatment can help to stop this damage from progressing, there is no way to reverse this partial sight loss.


Sometimes, a fluctuating blood sugar level can affect your prescription on the day of an eye examination. For this reason, if your blood sugar levels are prone to large changes, it's useful to have an idea of your current levels when your optometrist examines you.


Normal methods, as advised by your doctor, to control your diabetes will help to prevent it from causing any damage to your eyes.

Diabetic retinopathy can cause haphazard distortion or loss of vision.

Diabetic Effects