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👁️ Men's Health

Diabetic Eye Disease (Retinopathy)

Protecting your eyesight from the silent effects of diabetes.

Diabetic retinopathy is the leading cause of preventable blindness in working-age adults globally. It causes no symptoms until it is advanced. An annual eye examination detects it early — at a stage when laser treatment and tight blood sugar control can prevent blindness in virtually all cases.

Signs and Symptoms

✓ NO SYMPTOMS in early stages — the most dangerous aspect
✓ Blurred vision — not easily corrected with glasses
✓ Sudden change in vision or new visual disturbance
✓ Floaters — dark spots or cobwebs moving across vision
✓ Difficulty with colour vision
✓ Gradual loss of central or peripheral vision
✓ Dark or empty areas in vision
✓ Sudden complete vision loss (vitreous haemorrhage) — emergency

Risk Factors

When to Seek Help

NowSudden vision loss, a curtain across vision, or a shower of floaters — vitreous haemorrhage or retinal detachment; ophthalmological emergency.
SoonAny new visual disturbance or change in vision quality in a person with diabetes.
RoutineAnnual dilated fundus examination for every person with diabetes — from diagnosis for type 2, from 5 years after diagnosis for type 1. Even if vision feels completely normal.

Tests & Diagnosis

🧪 Dilated Fundus Examination
Eye drops widen the pupil allowing the retina to be examined directly. The standard screening test — performed annually. Detects all stages of retinopathy.
🧪 Optical Coherence Tomography (OCT)
Detailed imaging of the retina — detects diabetic macular oedema (swelling at the centre of vision) with high precision. Used to guide treatment decisions.
🧪 Fundus Photography
Wide-field retinal photographs document retinopathy severity and track progression over time.
🧪 Fluorescein Angiography (FFA)
Injection of dye to visualise retinal blood vessels — identifies areas of leakage, abnormal vessels, and ischaemia. Used to plan laser treatment.

Treatment Options

1
Blood Sugar Control — Prevents and Slows Retinopathy
Every 1% reduction in HbA1c reduces retinopathy progression by 35–40%. This is the most powerful single intervention — there is no substitute.
2
Blood Pressure Control
Target below 130/80 mmHg. Blood pressure control reduces retinopathy progression independently of blood sugar control.
3
Laser Photocoagulation
For proliferative retinopathy (abnormal new vessel growth) — laser seals leaking vessels and prevents further vision loss. Very effective when applied early.
4
Intravitreal Anti-VEGF Injections
For diabetic macular oedema (swelling affecting central vision) — injections of drugs (e.g. bevacizumab, ranibizumab) directly into the eye reduce swelling and often improve vision. Multiple injections over months are typically needed.
5
Vitrectomy Surgery
For advanced complications — vitreous haemorrhage or tractional retinal detachment. Removes the blood-filled vitreous and repairs the retina.

Frequently Asked Questions

My vision seems fine — do I still need an eye test?
Absolutely yes. Retinopathy is asymptomatic until it is advanced. By the time vision changes are felt, significant and potentially irreversible damage may have occurred. Annual eye tests are non-negotiable for all diabetics.
Can I go blind from diabetes?
Without treatment and poor blood sugar control, yes — diabetic retinopathy is the leading cause of blindness in working-age adults. With annual screening and good blood sugar control, the vast majority of diabetic blindness is preventable.
Does laser treatment hurt?
Laser is performed with anaesthetic eye drops and is generally tolerable. It may cause temporary vision disturbance immediately after treatment. It is a day procedure requiring no hospital admission.
I have been diabetic for 20 years but have no eye problems — am I safe?
You have likely benefited from good control or luck. However, 20 years of diabetes with no screening is concerning — retinopathy can be present without symptoms. Please have a dilated eye examination if you have not had one recently.
Will my glasses prescription change with diabetes?
Blood sugar changes cause temporary changes in the lens shape, affecting vision. This is why glasses prescriptions should not be changed during periods of poorly controlled blood sugar — wait until glucose is stable.

Related Pages

Type 2 Diabetes GuideWhat Is HbA1c?

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