Diabetic eye disease / diabetic retinopathy stages

Diabetic eye, also known as diabetic retinopathy, is a complication of diabetes that involves damage to the blood vessels in the eye, as a result of high blood sugar levels.

The retina is the area at the back of the eye composed of nerve cells that is responsible for converting light into nerve signals to be sent to the brain. It relies on blood supply in order to function normally and is sensitive to the level of glucose in the blood.

The signs and symptoms of the condition progress over time when the glucose levels in the blood are not adequately controlled. There are several stages of disease according to the progression of damage and the symptoms experienced.

Diabetic retinopathy

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Background Retinopathy


The first stage of the disease is background retinopathy, which is characterized by the appearance of microaneurysms in the blood vessels of the eyes. In some cases, this can lead to the leakage of blood or other fluid from the vessel but does not usually affect the vision.

Animation: Diabetic Retinopathy

Pre-Proliferative Retinopathy

The second stage of the disease is pre-proliferative retinopathy, which is when more severe changes begin to become evident in the retina. Bleeding from the blood vessels can cause damage to the macula of the retina, leading to swelling of the area known as macular edema. This can cause changes in the focus of sight and the ability to distinguish colors, affecting the clarity of vision in particular.

Proliferative Retinopathy

The third stage of the disease is proliferative retinopathy, which involves the formation of new blood vessels in the retina in an effort to restore blood flow to the damaged area. However, these new vessels are unstable and are likely to blood, causing blurred vision and may lead to the formation of scar tissue over time.

Advanced Diabetic Retinopathy

The most severe stage of the disease is advanced diabetic retinopathy, which involves serious consequences as a result of the damage that continues of over time.

The leakage of fluid and blood from the blood vessels into the eye causes extensive scarring in the eye, which can affect the position of the retina. In some cases, retinal detachment and repositioning may occur, leading to changes in vision. Initially, darkening of vision and floating blind spots may present and, if left untreated, complete blindness can result. Vitreous hemorrhage is another serious complication of advanced diabetic retinopathy.

Disease Stage Progression

The primary risk factor for diabetic retinopathy is high blood glucose levels over time in individuals with uncontrolled diabetes. The progression is usually evident when there are high levels consistently for an extended period of time.

Once they have appeared, the changes in or loss of vision are largely irreversible and thus should be prevented before it reaches the later stages of the disease. For this reason, it is important that individuals with diabetes seek adequate treatment to control the blood glucose and prevent damage to the retina and macula associated with diabetic eye disease.


Further Reading

Last Updated: Feb 26, 2019

Yolanda Smith

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Yolanda Smith

Yolanda graduated with a Bachelor of Pharmacy at the University of South Australia and has experience working in both Australia and Italy. She is passionate about how medicine, diet and lifestyle affect our health and enjoys helping people understand this. In her spare time she loves to explore the world and learn about new cultures and languages.


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