Diabetic Eye Disease

Diabetes affects the tiny blood vessels of the eye and if they become blocked or leak then the retina and possibly your vision will be affected, this is called diabetic retinopathy. The extent of these changes determines what type of diabetic retinopathy you have.

Background diabetic retinopathy

This is the most common type of diabetic retinopathy and many people who have had diabetes for some time will have this early type. The blood vessels in the retina are only very mildly affected. As long as the macula is not affected, vision is normal and you will not be aware that anything is wrong.


Maculopathy means that your macula is affected by retinopathy. If this happens, your central vision will be affected and you may find it difficult to see detail such as recognising people's faces in the distance or seeing detail such as small print. Most maculopathy can be treated with laser with the aim of preserving as much vision as possible. The amount of central vision that is lost varies from person to person. However, the vision that allows you to get around at home and outside (peripheral vision) is not affected. New treatments have emerged which enable maculopathy to be treated far more effectively, which are not available on the NHS yet, such as the Ellex 2RT laser which gently stimulates the retina to reabsorb leaked fluid. This laser is only available at the London Eye Hospital. There are a new class of medications which are also not provided by the NHS which also treat diabetic maculopathy with great success.

Proliferative diabetic retinopathy

If diabetic retinopathy progresses, it can cause the larger blood vessels in the retina to become blocked. These blockages can result in areas of the retina becoming starved of oxygen. This is called ischaemia. If this happens the eye is stimulated into growing new vessels, a process called neo-vascularisation. This is the proliferative stage of diabetic retinopathy, and is nature's way of trying to repair the damage by growing a new blood supply to the oxygen starved area of your retina.
Unfortunately, these new blood vessels are weak, and grow in the wrong place - on the surface of the retina and into the vitreous gel. As a result, these blood vessels can bleed very easily which may result in large haemorrhages over the surface of the retina or into the vitreous gel.
Extensive haemorrhages can lead to scar tissue forming which pulls and distorts the retina. This type of advanced diabetic eye disease can result in the retina becoming detached with the risk of serious sight loss. Proliferative diabetic retinopathy can be treated with laser to reduce the amount of retina requiring oxygen, and also other new treatments which are not available on the NHS, that provide useful adjuncts to stabilise vision.

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