Christen Richard, M.D.November, Diabetic Eye Disease month, is a good time to discuss the most common cause of diabetic eye problems: diabetic retinopathy. This condition causes bleeding behind the eye, also called retinal hemorrhage.

Diabetic retinopathy symptoms can include blurred vision, floaters and flashes of light. Untreated diabetic retinopathy can lead to blindness.

The most common diabetic eye condition

Diabetic retinopathy causes leakage and bleeding behind the eye, or more precisely, in the delicate tissue at the back of the eye called the retina. It causes vision loss because the retina is where the eye forms images and sends them to the brain.

Stages of diabetic retinopathy

Eye anatomy

Diabetic retinopathy happens in four stages. Some medical terms can help you understand how your doctor describes them. A tiny swelling in the side of a vessel is called a microaneurysm. Growth of abnormal blood vessels in a diabetic eye is called neovascularization. And leaking and bleeding of retinal blood vessels is a retinal hemorrhage.

Stage 1. Mild nonproliferative diabetic retinopathy. Microaneurysms (small swellings) in retinal blood vessels.

Stage 2. Moderate nonproliferative diabetic retinopathy. Microaneurysms and some blocked blood vessels in the retina.

Stage 3. Severe nonproliferative diabetic retinopathy. Many blocked retinal blood vessels. Risk of neovascularization (growth of new, abnormal vessels) in areas of retina that are no longer getting oxygen because the regular vessels are blocked.

Stage 4. Proliferative diabetic retinopathy. Neovascularization on retina and vitreous (the clear gel in front of the retina). Leaking and bleeding of new vessels causes severe vision loss and even blindness.

“Nonproliferative” means new blood vessels are not spreading across the surface of the retina yet. “Proliferative” means they are.

See the stages of diabetic retinopathy and watch a video

A new diabetic eye treatment

Diabetic retinopathy can be treated with a laser to seal leaking blood vessels, surgery or a newer treatment in which medication is injected into the eye. This is called “anti-VEGF” treatment (VEGF stands for “vascular endothelial growth factor,” and anti for “antibodies”). The drug goes directly to the retina to act on the molecule that is causing damage. However, anti-VEGF injections are not for everyone. Most people need a monthly injection for a while, and the treatment itself can damage your retina.

Preventing diabetic eye problems

Regular diabetic eye exams and good blood sugar control are the best way to prevent diabetic eye conditions. Blood sugar control can also keep bleeding problems from progressing in the diabetic eye.

Do you have diabetic eye problems?

If you have diabetes and need an eye physician, call 503-935-5580 or request an appointment at Oregon Eye Specialists. We have 10 convenient locations, and all our physicians are experienced in caring for diabetic eye conditions.

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About the Expert

Dr. Christen Richard practices general ophthalmology, caring for patients with cataracts, diabetes, glaucoma, macular degeneration and dry eye. She specializes in advanced no-stitch cataract surgery and does plastic surgery in the eye area. She has been with Oregon Eye Specialists since 2004. Learn more about Dr. Christen Richard »