Diabetic Retinopathy
Protecting Your Vision if You Have Diabetes
Diabetic retinopathy is damage to the blood vessels in the retina caused by diabetes. Early detection through regular screening and prompt specialist treatment are essential to preserve sight. Comprehensive diagnosis and management at The Eye Doctor clinic in Huddersfield.
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Carol PeelWhat Is Diabetic Retinopathy?
Diabetic retinopathy is damage to the small blood vessels in the retina (the light-sensitive tissue lining the back of the eye) caused by prolonged exposure to high blood glucose levels. It is the most common cause of sight loss in working-age adults in the UK, affecting approximately one in three people with diabetes.
High blood sugar damages the walls of the retinal capillaries, causing them to leak fluid and blood into the retina. Over time, this leads to progressive vessel closure (ischaemia — lack of oxygen supply to the retina), triggering abnormal new vessel growth in an attempt to restore oxygen supply. These new vessels are fragile and prone to bleeding, causing further vision damage.
The critical feature of diabetic retinopathy is that it often progresses silently with no symptoms until significant damage has occurred. This is why regular screening through the NHS Diabetic Eye Screening Service is essential for all people with diabetes.
Stages of Diabetic Retinopathy
Non-Proliferative Diabetic Retinopathy (NPDR)
Early damage to retinal blood vessels. Microaneurysms (tiny vessel outpouchings), haemorrhages, hard exudates (fatty deposits), and cotton-wool spots are visible on examination. No new vessel growth. Classified as mild, moderate, or severe depending on extent of changes.
Proliferative Diabetic Retinopathy (PDR)
Advanced stage with new abnormal vessel growth (neovascularisation) on the optic disc and elsewhere, triggered by severe retinal ischaemia. Risk of vitreous haemorrhage, retinal detachment, and neovascular glaucoma. Requires urgent treatment.
Risk Factors
Symptoms & Warning Signs
Screening & Diagnosis
Early detection is the key to preserving sight. Most people with diabetic retinopathy have no symptoms, which is why regular screening is essential.
Management & Treatment
Treatment is individualised based on the type, stage, and severity of diabetic retinopathy. The goal is to slow progression and preserve vision.
Optimise Diabetes Control
Tight glycaemic control (HbA1c at or below target, typically <7% or 53 mmol/mol) is the single most effective way to slow or prevent progression of diabetic retinopathy. Regular monitoring and medication adjustment by your GP or diabetes specialist is essential.
Blood Pressure & Lipid Management
Good blood pressure control (typically <140/90 mmHg) and management of cholesterol reduce the risk and slow progression of retinopathy. Medications such as ACE inhibitors or statins may be recommended.
Anti-VEGF Intravitreal Injections
Injections of anti-VEGF drugs (such as bevacizumab, ranibizumab, or aflibercept) directly into the eye block the signals that trigger abnormal new vessel growth and reduce macular oedema. Monthly injections may be required initially, with frequency adjusted based on response.
Panretinal Photocoagulation Laser
Multiple small laser burns applied to the peripheral retina to reduce the stimulus for abnormal new vessel growth in proliferative retinopathy. Performed over one or more sessions. Reduces risk of severe vision loss by approximately 50%.
Corticosteroid Implants
Long-acting corticosteroid implants (such as dexamethasone or fluocinolone acetonide) inserted into the eye to reduce macular oedema over several months. Used when anti-VEGF injections are ineffective or in specific clinical scenarios.
Vitrectomy Surgery
Surgical removal of the vitreous gel (the fluid filling the eye) to treat persistent vitreous haemorrhage (bleeding inside the eye) or tractional retinal detachment (abnormal scar tissue pulling the retina off).
Related Condition
Diabetic macular oedema is fluid accumulation in the macula caused by leaking retinal blood vessels — a common cause of vision loss in diabetes.
Diabetic Macular Oedema (DMO)
Fluid accumulation in the central retina requiring specialist treatment to prevent permanent vision loss. Often managed with anti-VEGF or corticosteroid injections.
Learn more →Prevention & Lifestyle
Glycaemic Control
Maintain HbA1c at or below your target level. Work with your diabetes specialist to optimise medications and insulin dosing.
Regular Screening
Attend annual NHS Diabetic Eye Screening appointments. More frequent screening may be recommended if retinopathy is detected.
Blood Pressure Control
Maintain blood pressure below 140/90 mmHg. Take antihypertensive medications as prescribed.
Healthy Lifestyle
Regular physical activity (150 minutes per week), healthy diet, maintain healthy weight, do not smoke, and limit alcohol.
Lipid Management
Manage cholesterol with diet and medications (statins) as recommended. Target LDL cholesterol <1.8 mmol/L.
Prompt Treatment
If diabetic retinopathy is detected, commence specialist treatment promptly. Delay in treatment increases risk of vision loss.
Diabetic Retinopathy FAQs
Diabetic retinopathy is damage to the blood vessels in the retina (the light-sensitive tissue at the back of the eye) caused by prolonged exposure to high blood glucose levels. High blood sugar damages the walls of the small blood vessels in the retina, leading to leakage of fluid and blood, vessel closure, and abnormal new vessel growth. It is the most common cause of sight loss in working-age adults in the UK.
High blood glucose levels cause several damaging processes in the retinal blood vessels: (1) thickening of the basement membrane of capillaries, making them leaky; (2) loss of pericytes (supporting cells that stabilise the vessel wall), leading to vessel fragility; (3) activation of inflammatory pathways causing further endothelial damage; (4) increased vascular permeability leading to oedema (fluid accumulation); and (5) progressive vessel closure and ischaemia (lack of oxygen), triggering abnormal new vessel growth as the eye attempts to restore oxygen supply.
Diabetic retinopathy progresses through two main stages: (1) Non-proliferative diabetic retinopathy (NPDR) — characterised by microaneurysms (tiny vessel outpouchings), haemorrhages, hard exudates, cotton-wool spots, and venous beading, with no new vessel growth; and (2) Proliferative diabetic retinopathy (PDR) — characterised by new abnormal vessel growth (neovascularisation) on the optic disc and elsewhere, vitreous haemorrhage, and risk of retinal detachment. NPDR can be mild, moderate, or severe depending on the extent of retinal changes.
In the UK, people with diabetes are offered annual retinal screening through the NHS Diabetic Eye Screening Service, involving digital photography of the retina (with pupils dilated) and specialist assessment of retinal images. Some people with higher risk factors may be offered more frequent screening. Optical coherence tomography (OCT) is used to detect macular oedema and assess retinal thickness. If diabetic retinopathy is detected, referral to a specialist ophthalmologist is arranged for detailed assessment and management.
All people with diabetes should be offered regular screening — typically annual screening through the NHS Diabetic Eye Screening Service. Those with known diabetic retinopathy, poor glycaemic control, hypertension, or kidney disease should be screened more frequently. People with type 1 diabetes should begin screening five years after diagnosis; those with type 2 diabetes should be screened at diagnosis and annually thereafter.
Where to Find Us
Three convenient locations across West Yorkshire. Visit us for consultations, diagnostics, and treatments.
Bolton
136 – 140 Newport St
Bolton, Greater Manchester
BL3 6AB
Huddersfield
Woodlands, 4 Longbow Close
Huddersfield, HD2 1GQ
Protect Your Vision if You Have Diabetes
Regular screening and early specialist assessment are essential. Book a comprehensive eye examination at The Eye Doctor. Call +44 1484 627779 or book online.
