Diabetic eye problems (diabetic retinopathy): symptoms, tests, treatment and which doctor to see
How diabetes affects the eyes, why regular eye checks matter before symptoms start, the tests and treatments, and when vision changes are an emergency.
Also known as: Diabetic Retinopathy
What diabetic eye problems are
Over time, high blood sugar damages the tiny blood vessels of the retina, the light-sensitive layer at the back of the eye. This is diabetic retinopathy. The vessels can leak fluid or blood, close off, or — in the advanced, 'proliferative' stage — be replaced by fragile new vessels that bleed and pull on the retina.
When fluid collects in the macula, the central part of the retina used for reading and recognising faces, it is called diabetic macular oedema, a common cause of blurred vision. Diabetes also makes cataract develop earlier and raises the risk of some forms of glaucoma.
Diabetic eye disease is a leading cause of preventable vision loss in working-age adults. Most of that loss can be prevented if changes are found early and treated in time — which means regular eye checks even when you see perfectly well.
Symptoms — often none early on
Retinopathy usually causes no symptoms until it is advanced or the macula is affected. By the time vision changes, treatment is more urgent and some loss may be permanent. Symptoms include:
- Blurred vision, or vision that fluctuates from day to day
- Floaters — dark specks or strings drifting across your vision
- Dark spots or empty areas in your vision
- Difficulty seeing at night or in dim light
- Colours that look faded
- Sudden loss of vision in one eye
Blurring can also come from large swings in blood sugar, which changes the shape of the lens temporarily. Do not buy new glasses during such a phase without an eye check.
Who is at higher risk
Anyone with type 1 or type 2 diabetes can develop retinopathy. The risk is higher if you:
- Have had diabetes for many years
- Have high blood sugar that is not well controlled
- Have high blood pressure or high cholesterol
- Have diabetic kidney disease
- Are pregnant — retinopathy can worsen quickly in pregnancy
- Smoke
In India, type 2 diabetes often goes undiagnosed for years, so some people already have eye changes when diabetes is first found. That is why an eye examination is recommended soon after diagnosis of type 2 diabetes.
How it is diagnosed
Diabetic eye disease is found by an eye specialist or a trained screening team, not by checking how well you read the letter chart:
- Dilated eye examination — drops widen the pupils so the doctor can examine the retina in detail. Vision is blurred for a few hours afterwards, so arrange not to drive.
- Retinal photography — photographs of the retina, used in screening programmes and to track changes over time.
- Optical coherence tomography (OCT) — a quick, painless scan that measures swelling of the macula.
- Fluorescein angiography — a dye injected into an arm vein shows leaking or blocked vessels, used in some cases to plan treatment.
Eye pressure is also checked for glaucoma, and the lens for cataract. Your doctor will grade the retinopathy and set the date of your next check.
Which doctor to see
An ophthalmologist examines the retina and treats diabetic eye disease; advanced cases are treated by a retina specialist. Your diabetologist or physician manages sugar, blood pressure and cholesterol, which is just as important for protecting your sight. The national programme for control of blindness and visual impairment includes diabetic retinopathy among the eye conditions it treats at government facilities.
You can find ophthalmologists in Bengaluru or diabetologists in Bengaluru on The Doctor Index, each with a registration you can check.
Treatment
Early retinopathy needs no eye treatment, only better control of sugar, blood pressure and cholesterol and regular review. When treatment is needed, the aim is to prevent further loss and, with macular oedema, often to improve vision:
- Anti-VEGF injections — medicines injected into the eye under local anaesthetic drops reduce macular swelling and abnormal vessels. They usually need a course of repeated injections.
- Laser treatment — seals leaking vessels or treats the outer retina to stop new vessels growing in proliferative retinopathy.
- Steroid injections or implants — another option for macular oedema in selected people.
- Vitrectomy — surgery to remove blood or scar tissue from inside the eye in advanced disease.
- Cataract surgery — when a cataract affects vision; retinopathy is assessed and treated around the time of surgery.
Treatment can preserve sight but does not remove the cause, so follow-up continues. Keep taking your diabetes and blood pressure medicines as prescribed, and do not stop them on your own.
Living with it: eye checks and follow-up
- A dilated eye examination at least once a year, or more often if retinopathy is found — your doctor will set the interval
- Extra checks in pregnancy, and before and after starting intensive sugar-lowering treatment if advised
- Keeping HbA1c, blood pressure and cholesterol in the ranges your doctor sets
- Stopping smoking
- Asking about low-vision aids and support if your sight has already been affected
When it is an emergency
Go to an eye emergency service the same day, or call 112 or 108, for:
- Sudden loss of vision, or a shadow or curtain coming across your vision
- A sudden shower of new floaters or flashing lights
- A painful, red eye with blurred vision, headache or vomiting
- Sudden loss of vision with weakness of the face, arm or leg or difficulty speaking — this may be a stroke
Questions to ask at your appointment
- Do I have diabetic retinopathy or macular oedema, and how advanced is it?
- Do I need treatment now, or monitoring?
- How many injections or laser sessions might I need?
- When should my next eye check be?
- Is my vision safe for driving?
- What sugar, blood pressure and cholesterol targets will protect my eyes?
Common questions
Questions people ask
- If I see clearly, do I still need an eye check?
- Yes. Diabetic retinopathy usually causes no symptoms until it is advanced. A yearly dilated eye examination, or as often as your doctor advises, finds changes early when treatment is most effective at protecting your sight.
- Can diabetic retinopathy be reversed?
- Early changes can stabilise, and sometimes improve, with good control of sugar and blood pressure. Treatment for macular oedema often improves vision. Damage from advanced disease may be permanent, which is why early detection matters.
- Are injections into the eye painful?
- Most people feel pressure rather than pain, as the eye is numbed with drops first. The procedure takes a few minutes. Your eye may feel gritty for a day; report increasing pain, redness or reduced vision straight away.
- Will new glasses fix blurred vision from diabetes?
- Not if the blurring is from retinopathy or macular oedema, which need treatment. Blurring from fluctuating sugar may settle once sugar is stable. Have a full eye examination before buying new glasses.
This condition is usually assessed by an ophthalmologist. Every profile shows the doctor’s registration and what has been checked.
Ophthalmologists in Bangalore
A few ophthalmologists listed on The Doctor Index. They are shown because of their speciality, not a stated interest in Diabetic Eye Problems; ask the clinic whether the doctor sees it.
Related conditions
- Diabetes Type 1
- Diabetes Type 2
- Diabetic Foot
- Diabetic Heart Disease
- Diabetic Kidney Problems
- Diabetic Nerve Problems
- Hyperglycemia
- Hypoglycemia
Practical reading
All postsSources
- MedlinePlus, US National Library of Medicine — Diabetic Eye Problems
- American Academy of Ophthalmology — What is diabetic retinopathy?
- Public Health Department, Government of Maharashtra — National Program for Control of Blindness and Visual Impairment
- MedlinePlus, National Library of Medicine — Diabetic Eye Problems — Public-domain health-topic summary
Diabetic eye problems (diabetic retinopathy): symptoms, tests, treatment and which doctor to see is original text by The Doctor Index; the compiled source draft was used for research. Source: MedlinePlus, National Library of Medicine. Orphadata Science: Free access data from Orphanet. © INSERM 1999; July 2026 data, CC BY 4.0. This product uses the Human Phenotype Ontology (hp/releases/2026-09-01). Only sources listed for this article apply. Source material has been selected and arranged; HPO definitions are reproduced without alteration. No source organisation endorses this compilation. Köhler S et al. The Human Phenotype Ontology project: linking molecular biology and disease through phenotype data. Nucleic Acids Research 2014;42(D1):D966–D974. doi:10.1093/nar/gkt1026.
General information, not advice about your situation. Errors can be reported through the corrections process. Reference TDI-C-0735.