Diabetic retinopathy often has no early warning signs. Don’t wait for diabetic retinopathy symptoms to appear. Be sure to have a comprehensive dilated eye exam at least once a year.

If diabetic retinopathy symptoms do appear, you will see a few specks of blood, or spots, “floating” in your vision. If spots occur, see your eye care professional as soon as possible. You may need diabetic retinopathy treatment before more serious bleeding occurs. Hemorrhages tend to happen more than once, often during sleep.

Sometimes, without treatment, the spots clear, and your vision will improve; however, bleeding can recur and cause severely blurred vision. You need to be examined by your eye care professional at the first sign of blurred vision, before more bleeding occurs.

If left untreated, proliferative retinopathy can cause severe vision loss and even blindness. Also, the earlier you receive treatment, the more likely it will be effective.

Making a Diagnosis

Macular edema and diabetic retinopathy are detected during a comprehensive eye exam that includes:

* Visual acuity test. This eye chart test measures how well you see at various distances.

* Dilated eye exam. Drops are placed in your eyes to widen, or dilate, the pupils. Your eye care professional uses a special magnifying lens to examine your retina and optic nerve for signs of damage and other eye problems. After the exam, your close-up vision may remain blurred for several hours.

* Tonometry. An instrument measures the pressure inside the eye. Numbing drops may be applied to your eye for this test.

Your eye care professional checks your retina for early signs of diabetic retinopathy, including:

* Leaking blood vessels
* Retinal swelling (macular edema)
* Pale, fatty deposits on the retina — signs of leaking blood vessels
* Damaged nerve tissue
* Any changes to the blood vessels.

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If your eye care professional believes you need treatment for macular edema, he or she may suggest a fluorescein angiogram. In this test, a special dye is injected into your arm. Pictures are taken as the dye passes through the blood vessels in your retina. The test allows your eye care professional to identify any leaking blood vessels and recommend treatment.

Treating Diabetic Retinopathy

During the first three stages, no diabetic retinopathy treatment is needed, unless you have macular edema. To prevent progression of diabetic retinopathy, people with diabetes should control their levels of:

* Blood sugar
* Blood pressure
* Blood cholesterol.

For proliferative diabetic retinopathy, treatment may involve laser surgery or a vitrectomy.

Rotecting Vision

People with diabetes need to have a comprehensive dilated eye exam at least once a year. If you have diabetic retinopathy, you may need an eye exam more often. People with proliferative retinopathy can reduce their risk of blindness by 95 percent with timely treatment and appropriate followup care.

A major study has shown that better control of blood sugar levels slows the onset and progression of diabetic retinopathy. The people with diabetes who kept their blood sugar levels as close to normal as possible also had much less kidney and nerve disease. Better control also reduces the need for sight-saving laser surgery.

This level of blood sugar control may not be best for everyone, including some elderly patients, children under age 13, or people with heart disease. Be sure to ask your doctor if such a control program is right for you.

Other studies have shown that controlling elevated blood pressure and cholesterol can reduce the risk of vision loss. Controlling these will help your overall health as well as help protect your vision.