According to SingHealth, in Asia, diabetic retinopathy (DR) is the primary cause of visual loss. With 10% of Singaporean individuals between the ages of 18 and 69 having diabetes, Singapore has one of the highest prevalence rates of diabetes mellitus (DM) in the world. Around 30% of these people have DR, with 10% having vision-threatening DR.
The most common type of diabetic eye disease is diabetic retinopathy. It is a consequence of diabetes that damages the back of the eye due to excessive blood sugar levels (retina). If left misdiagnosed and untreated, it might result in blindness.
Diabetic retinopathy includes two stages:
Yes. Diabetic retinopathy can be treated, and treatment is genuinely effective at reducing the risk of severe vision loss, particularly when started early. That said, it’s worth understanding what treatment can and can’t do: the goal is generally to stop or slow further damage and protect the vision you currently have, rather than to fully reverse vision already lost, especially in more advanced disease. This is exactly why early detection through regular eye screening (covered below) matters so much – treating diabetic retinopathy before it reaches an advanced stage gives you the best chance of preserving your sight long-term.
Long-term elevated blood glucose levels induce diabetic retinopathy. High sugar glucose levels in the retina can weaken and destroy tiny blood vessels over time. This can result in retinal hemorrhages, exudates, and even edema. As a result, the retina is deprived of oxygen, and aberrant vessels may form.
Diabetic retinopathy can affect everyone who has diabetes. However, the following factors might enhance your chances of having the condition:
This is one of the most important things to understand about diabetic retinopathy: in its early stages, it often causes no noticeable symptoms at all. This is precisely why regular screening matters more than watching for symptoms. As the condition progresses, symptoms can include:
Sudden eye pain, a sudden significant change in vision, or the sudden appearance of many new floaters isn’t a typical early symptom of diabetic retinopathy itself, but can signal a complication like vitreous haemorrhage or retinal detachment – if this happens, seek prompt medical attention rather than waiting for a routine appointment.
Fluorescein angiography involves injecting a yellow dye called fluorescein into a vein. The color is absorbed by your blood vessels. Then the dye flows through the retina’s blood vessels, a unique camera captures pictures of it. When any blood vessels are clogged or leaking fluid, this will be visible. Moreover, it also reveals whether any abnormal blood vessels are developing.
OCT angiography is a modern technology that examines blood arteries without the use of dye. Your doctor may use an OCT scan to examine your retina more precisely. The retina is scanned by a machine, which produces detailed pictures of its thickness. This helps your doctor in locating and measuring macula edema.
The foundation of diabetic retinopathy screening – eye drops widen (dilate) the pupil so your doctor can examine the retina directly.
The anti-VEGF drug is one sort of treatment. Avastin, Eylea, and Lucentis are among them. Anti-VEGF therapy reduces macula swelling, which slows vision loss and may even improve eyesight. This medication is administered by eye injections (shots). Another method for reducing macular edema is a steroid medication. This can also be administered as an eye injection.
To assist shut off bleeding blood vessels, laser surgery may be utilized. This can help to minimize retinal edema. Blood vessels can be shrunk and prevented from developing again via laser surgery. Occasionally, more than one therapy is required. Several types of laser treatments include:
When you get advanced PDR, your ophthalmologist may suggest vitrectomy surgery. Vitreous gel and blood from leaky vessels at the back of your eye are removed by an ophthalmologist. Light rays may now concentrate properly on the retina once again. The retina may also have scar tissue removed.
Because diabetic retinopathy often causes no symptoms until it’s advanced, annual dilated eye exams are the single most important step for anyone with diabetes — early diagnosis and treatment can prevent severe vision loss in the large majority of cases. Ask your doctor how often you specifically should be screened, since this can vary based on your current retinopathy status.
High blood sugar affects blood vessels in the eyes over time, and it can also distort the shape of your lenses, blurring your vision. If you’re sick or stressed, you may need to check and record your blood sugar level multiple times a day. Consult your doctor about how frequently you should test your blood sugar.
To reduce your risk of eye problems and vision loss you should keep your blood pressure and cholesterol levels within your desired range by following healthy eating habits and regular exercise. Medication is another way for you to do this.
Smoking raises your chances of developing diabetes problems including diabetic retinopathy. Therefore, quitting smoking decreases your risk of diabetes-related eye damage and improves your overall health.
Yes – treatments like anti-VEGF injections, laser therapy, and vitrectomy can slow or stop progression and help preserve vision, though the goal is generally to protect remaining sight rather than fully reverse existing damage, especially in advanced cases.
There’s no single “best” treatment – it depends on the stage and specific findings, such as whether macular edema or abnormal blood vessels are present. Your ophthalmologist will recommend the most suitable option for your situation.
Anti-VEGF injections (like bevacizumab, aflibercept, or ranibizumab) and corticosteroid injections are the main medication options, both aimed at reducing macular swelling.
Not typically, especially in early stages – it’s usually painless, which is part of why regular screening matters. Sudden eye pain or vision changes can signal a complication and need prompt medical attention.
Generally at least once a year, though your doctor may recommend more frequent monitoring depending on your current retinopathy status and risk factors.
Diabetic retinopathy is a serious but genuinely manageable condition – treatment options like anti-VEGF medication, laser therapy, and vitrectomy can meaningfully reduce the risk of severe vision loss, particularly when caught early through regular screening. Because it often develops without symptoms, staying on top of dilated eye exams matters just as much as any specific treatment. If you have diabetes and haven’t had a recent eye screening, or you’re noticing changes in your vision, consult a doctor through the MaNaDr app to discuss your risk and get guidance on the right next steps, including a referral to an ophthalmologist if needed.
