There are two stages of Diabetic Retinopathy:

(1) Nonproliferative Retinopathy, the early form of the disease, weakens the tiny blood vessels in the eye, which develop small bulges (microaneurysms) that may burst and leak fluid and protein into the retina causing the formation of gray or white spots in the retina. White-yellow deposits of fatty protein may also form on the retina. When fluid and protein from the damaged blood vessels cause swelling in the center of the retina (macula), visual impairment, called macular edema, distorts a person's central vision

(2) Proliferative Retinopathy, the advanced and more serious form of Diabetic Retinopathy features the growth (proliferation) of fragile new blood vessels on the surface of the retina. These abnormal blood vessels may break easily, bleeding into the middle of the eye and clouding vision. If not treated, proliferative retinopathy can permanently damage the retina and other parts of the eye, leading to severe vision loss or blindness.

While Diabetic Retinopathy eventually develops to some degree in most people with type 1Diabetes and type 2 Diabetes, those at especially high risk are patients with juvenile-onset Diabetes. Among this group 24% will have Diabetic Retinopathy after 5 years, nearly 60% after 10 years and 80% after 15 years. Controlling blood sugar levels can help lower the risk of progression to severe retinopathy and vision loss, however, once retinopathy develops early detection and prompt treatment can help prevent, delay, or reverse vision loss.

Therefore, the American Diabetes Association recommends yearly screening (starting within 3 to 5 years after diagnosis of type 1 Diabetes and immediately after diagnosis of type 2) for the following reasons: Diabetic Retinopathy often does not exhibit symptoms until damage to the retina is already severe. Treatment is most effective when it is done early before symptoms and complications of retinopathy have developed. By doing regular, thorough eye exams, an eye doctor can detect signs of retinopathy early when it is most easily treated. Many of these cases of vision loss and blindness are preventable by doing yearly eye exams.

Unfortunately, too many people with Diabetes do not have yearly eye exams to check for Diabetic Retinopathy and, as a result, they do not find out that they have the condition until significant vision loss occurs. Contact your eye care professional for more information.

Individuals with reduced vision can use vision aids, develop a support network, and receive counseling and training to help them cope with their reduced vision and maintain their quality of life as much as possible.