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Diabetic Retinopathy

AMBULATORY CARE:

Diabetic retinopathy (DR)

is eye damage caused by long-term high blood sugar levels. The walls of the blood vessels in the retina weaken and leak blood. This causes swelling and vision problems. Over time, new, weak blood vessels grow, leak blood, and cover the center of the retina. DR can lead to blindness.

Eye Anatomy

Common symptoms include the following:

  • Blurred vision
  • Seeing red or black wavy lines that look like a curtain or spider web
  • Seeing light flashes or red, black, or grey floating spots (floaters)
  • Vision loss

Call your local emergency number (911 in the US) or have someone call if:

  • You suddenly cannot see.

Call your doctor or eye specialist if:

  • Your blurred vision gets worse, or you start to see double.
  • You see more floating spots.
  • You see dark spots.
  • You have questions or concerns about your condition or care.

Treatment

may not be needed if you have mild DR. Healthcare providers will check your eyes regularly to monitor the damage to your retinas. Treatment may include any of the following:

  • Laser treatment may slow DR and prevent blindness. This treatment shrinks the new blood vessels and seals the areas that have leaks.
  • Anti-vascular endothelial growth factor (anti-VEGF) treatment helps reduce swelling and improves vision. During this treatment, medicine is injected into the vitreous of the eye. The vitreous is the gel-like material that fills the inside of the eye.
  • Vitrectomy is surgery for severe DR. A vitrectomy may be needed if there is bleeding in the vitreous that does not clear.
  • Medicines may be used to control your blood pressure and prevent kidney disease. Medicines may also help lower your cholesterol or triglyceride (fatty acid) levels.

Prevent or control DR:

  • Control your blood sugar. Keep your blood sugar levels as close to normal as possible. You may need to check your blood sugar levels 3 times each day.
    How to check your blood sugar
  • Get your eyes checked at least 1 time each year. Your eye doctor may want to see you every 6 months or more often. If you are pregnant, get your eyes checked during the first 13 weeks of your pregnancy. You will need eye exams more often during pregnancy and for 1 year after you give birth.
  • Check your blood pressure as directed. High blood pressure can damage the blood vessels in your eyes. This can lead to retinopathy. A normal blood pressure is 119/79 or lower. Talk to your healthcare provider about your blood pressure goals. Together you can create a plan to lower your blood pressure if needed and keep it in a healthy range. The plan may include lifestyle changes or medicines to lower your blood pressure.
    How to take a Blood Pressure
  • Talk to your healthcare provider about your cholesterol level. Lab tests are used to measure the amount of cholesterol in your blood. Your provider can help you create a plan to lower your cholesterol level if needed. You may need to make lifestyle changes or take medicines to control your cholesterol level.
  • Plan for pregnancy if you are female. Pregnancy increases the risk for DR. Pregnancy can worsen existing DR and lead to serious vision problems. You can lower the risk by making sure your blood sugar is controlled before you get pregnant. Your provider may recommend you reach an A1c level of 6.5% or lower before pregnancy. Talk to your healthcare provider about ways to prevent or control DR during pregnancy.
  • Exercise regularly. Ask your healthcare provider about the best exercise plan for you. He or she will tell you how to control your blood sugar when you exercise. You may need to check your blood sugar more often during exercise. Bring a snack with you when you exercise in case your blood sugar gets too low. If you have proliferative or severe DR, you may not be able to exercise hard or do resistance training. These activities increase the risk for retinal detachment (pulling away) or other vision problems. An eye specialist may need to help you with your exercise plan.
    Walking for Exercise
  • Do not smoke. Nicotine can damage blood vessels in your eyes and make it more difficult to manage your diabetes. Do not use e-cigarettes or smokeless tobacco in place of cigarettes or to help you quit. They still contain nicotine. Ask your healthcare provider for information if you currently smoke and need help quitting.

Follow up with your doctor or eye specialist as directed:

Write down your questions so you remember to ask them during your visits.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Diabetic Retinopathy (Ambulatory Care)

Associated drugs

IBM Watson Micromedex

Mayo Clinic Reference

Medicine.com Guides (External)

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.