What are My Diabetic Retinopathy Options? | Magruder Eye Institute

What are My Diabetic Retinopathy Options?

Did you know 422 million people worldwide were living with diabetes in 2014 alone?

That amounts to 8% of the entire Earth’s population.

But there are ways you can protect yourself from this potentially deadly disease.

Let’s take a look at diabetic retinopathy and your options for diabetic retinopathy treatment.

What is Diabetes?

Diabetes is a condition in which your body doesn’t properly produce or respond to insulin, causing harmful levels of glucose in the blood. This can lead to a condition known as diabetic retinopathy.

Prevalence of Undiagnosed Diabetes

According to the Center for Disease Control (CDC), diabetes is currently undiagnosed in 7.2 million people in the U.S. alone.

This is why it’s so important to receive check-ups from a medical doctor. And you’ll want to receive regular eye exams from an optometrist, ophthalmologist or other vision specialist.

What Is Diabetic Retinopathy?

Diabetic retinopathy is when the blood vessels near the retina of the eye begin to behave abnormally. This can eventually damage eyesight and lead to total blindness if not properly treated.

Diabetes and the Retina

The high blood sugar levels in the body due to diabetes can damage the blood vessels of the retina. The retina is the nerve coating that covers the back of your eye. The retina records what you see and sends this information to your brain for processing.

Damaged Blood Vessels

These damaged blood vessels may become inflamed and begin to leak around the eyeball. This is one cause of diabetic retinopathy.

The blood vessels can also completely shut down, preventing needed blood flow to the retina. This is called macular ischemia. Or irregular new blood vessels can grow around the retina, disrupting its proper functioning.

Any of these consequences from diabetes contribute to diabetic retinopathy. And any one of them can lead to blindness.

The Progression of Diabetic Retinopathy: 4 Stages

The progression of diabetic retinopathy goes through 4 stages. These include the mild, moderate, severe and proliferative stages.

Stage 1. Mild Diabetic Retinopathy

At this early level of severity, you may experience no symptoms. And you may not even know you have the condition. Your eye doctor will be able to detect diabetic retinopathy even in its most mild forms.

Stage 2. Moderate Diabetic Retinopathy

This second level of severity doesn’t always have any obvious symptoms either.

Two of the symptoms that may be present for you in this stage are blurred vision and the experience of floaters. Floaters are dark spots or strange auras at the periphery of your field of vision.

Stage 3. Severe Diabetic Retinopathy

In this more advanced phase of the condition, you may experience any of the following in one or both eyes:

  • Fluctuations in your eyesight
  • Dark or blank areas in your line of sight
  • Temporary or permanent blindness

Stage 4. Proliferative Diabetic Retinopathy

The final stage is typically marked by the presence of floaters and total vision loss in both eyes.

It occurs when your retina begins growing new, abnormal and highly vulnerable blood vessels. This process is called neovascularization. When the new blood vessels bleed, you experience floaters.

When the bleeding subsides, the area will develop scar tissue which can further damage the retina and obstruct healthy sight.

Most people who arrive at this stage experience a complete loss of both their central and peripheral eyesight.

Diabetic Retinopathy as a Precursor to Other Conditions

Diabetic retinopathy can often signify the presence of other serious conditions related to diabetes. One of these is coronary heart disease.

Research conducted by the American Diabetes Association revealed that people with diabetic retinopathy are twice as likely to develop coronary heart disease. And retinopathy sufferers were three times as likely to die from coronary heart disease. Both statistics were in comparison to their diabetic counterparts without diabetic retinopathy.

What Are My Risks Factors for Diabetic Retinopathy?

There are several risk factor in developing diabetic retinopathy. The most obvious one is being diagnosed with diabetes. The longer you’ve been diagnosed the higher your chances are. Some other factors include:

  • Unwillingness to manage your blood sugar
  • High cholesterol
  • Pregnancy
  • High blood pressure
  • Tobacco usage
  • Genetic makeup including Native American, Hispanic or African American genes

What Is Diabetic Retinopathy Treatment?

Diabetic Retinopathy Treatment is an approach that addresses the damage done to the retina and your eyesight by diabetic retinopathy.

Treatment for Mild and Moderate Stages

There are different diabetic retinopathy treatment options available. The one you choose will depend on the progression of the condition. If the retinopathy has been caught at the mild or moderate stages, extensive diabetic retinopathy treatment may not be necessary.

In the first two stages, you can usually sufficiently slow the progression by assessing and controlling blood sugar alone.

Treatment for Severe and Proliferative

If the condition has passed the mild and moderate phases, more extensive diabetic retinopathy treatment options may be needed. These interventions range from drug treatments to surgery.

1. Medically Administered Injections as a Diabetic Retinopathy Treatment

There are injected medications used to treat retinopathy during the early progression period. They are administered by a health care provider once a month. These injections are often accompanied by injections of corticosteroids to boost your body’s healing process.


The injections are administered directly to the eye and act as VEGF-inhibitors. VEGF stands for vascular endothelial growth factor. Therefore, these medications block this growth factor in the body.

VEGF-inhibitors such as Eylea or Lucentis are used as diabetic retinopathy treatment during the early stages. These injections block a particular protein that can damage blood vessels in the eye.

A 2015 clinical trial by the National Eye Institute showed that Lucentis is extremely effective for the proliferative stage of retinopathy.

These drug treatments are used for those who don’t yet need surgical interventions.

And this intervention has been shown to provide significant visual improvement to approximately 40% of patients in the early stages of diabetic retinopathy.

What to Expect with VEGF-Inhibitor Injections

As with any intravenous injection, you’ll likely experience acute discomfort at the injection site. But you shouldn’t feel any serious pain.

You could experience slight swelling near the area of your eye where the needle is injected. This should subside within 24 hours.

Plan Ahead

You should arrange for someone to drive you home following each round of injections. Some people may be able to operate a vehicle, but we suggest playing it safe and having a designated dr.

2. Focal Laser Treatment

A second intervention used is focal laser treatment. This treatment involves a specialized laser method performed by a qualified professional.

Focal laser treatment enables an ophthalmologist to shrink irregular blood vessels with a laser. This diabetic retinopathy treatment has been shown to reduce the chances of vision loss in 50% of patients.

Possible Side Effects and Rare Complications of Focal Laser Treatment

The most typical side effect of focal laser treatment is the experience of dots in your field of vision. These are usually on the periphery of your vision and quite annoying.

While this common side effect disappears 9 times out of 10, there are some cases where this effect is more permanent.

Rare Complications

It is an extremely rare occurrence, but a total loss of sight can happen as an adverse reaction to the treatment.

It’s worth noting that focal laser treatment is one of the safest kinds of laser eye intervention available.

What to Expect With Focal Laser Treatment

This diabetic retinopathy treatment does not require a hospital stay. You come in for your scheduled appointment and leave the same day.


You’ll receive a topical anesthetic near the future injection site. You may also receive additional anesthetic around the eye near the site. This is to prevent that particular area from moving during the injection process.


The diabetic retinopathy treatment itself typically lasts only a few minutes. But it could have a longer duration depending on your particular situation.


You might experience some discomfort or pain over the next 48 hours following treatment. But it usually is quite mild in nature.


You may not notice an improvement for a few months following this treatment. And you’ll need to ensure a follow-up appointment with your ophthalmologist to assess your body’s response to treatment.

You may need additional focal laser treatment. And your eye doctor will speak with you about your options moving forward.

In The Case of Proliferative Diabetic Retinopathy

If your condition has reached the proliferative stage, your focal laser treatment will likely last 40-60 minutes. And this stage often requires 4 to 5 rounds.

Protective Eyewear

Be sure to wear sunglasses for several hours after the procedure due to dilation. Your eyes will be quite sensitive to light.

Plan Ahead

You should plan to have someone accompany you to your appointment and drive you home afterwards.

3. Vitrectomy

A vitrectomy is a surgical method of diabetic retinopathy treatment. It’s designed to remove obstructions from the eye.

When blood vessels of your eye have serious bleeding, an ophthalmologist will remove the following:

  • Vitreous gel
  • Scar tissue
  • Any excess bleeding from the retina

Laser treatment may be used following this procedure. Laser treatment helps stop the resurgence of irregular blood vessel growth and excessive bleeding.

Possible Side Effects

Potential side effects of this kind of surgery include:

  • Cataracts
  • Elevated pressure inside the eye
  • Retinal detachment
  • Continued bleeding
  • An infection from the surgical procedure

What to Expect with a Vitrectomy

The vitrectomy can be performed on an outpatient basis. But it is possible you’ll need to stay one night in the hospital.


The surgery lasts about 3 hours. Your ophthalmologist will either use a general or local anesthetic based on your needs.

After the surgeon removes the vitreous gel and scar tissue, they can then do whatever needs to be done to enhance retinal functioning.

Gas or Oil Bubbles

Towards the conclusion of surgery, the doctor will inject a gas bubble or oil bubble into the eye. This procedure helps the retina to re-attach or more securely attach to the wall of the eye. And you will need a follow-up appointment for the doctor to remove these.

Monitor Movement Afterward

Your surgeon will brief you on the need to minimize your head movements over the next few days to allow the bubble to work properly.

Plan Ahead

You shouldn’t operate a motor vehicle after this operation. Have someone pick you up following this procedure.

What Does an Ophthalmologist Do?

An Ophthalmologist is a medical doctor. An Ophthalmologist has received advanced training on the inner workings of the eye and various vision ailments.

Education and Training

The Ophthalmologist performs surgeries and holds two main degrees. These include a Doctor of Medicine and a Doctor of Osteopathic Medicine.

Ophthalmologists have completed a minimum of 11 years of formal education. They’ve also completed:

  • 4 years of college training
  • 4 years of specialized medical training
  • 3 years of supervised internship in a residential setting.

How Can an Ophthalmologist Help Protect My Eyesight?

Ophthalmologists are able to address complex and advanced eye conditions. These may include retinopathy and can deliver surgical procedures.

An ophthalmologist can help you maintain healthy eyesight. They can provide the diabetic retinopathy treatment needed to save your vision by:

  • Administering the VEGF-inhibitor injections
  • Performing focal laser treatments
  • Performing a vitrectomy

What Does an Optometrist Do?

An optometrist performs routine eye exams.

Education and Training

Optometrists are eye care professionals who’ve received a 4-year degree. They are able to assess, diagnose and offer prescriptions for many eye concerns.

How Can an Optometrist Help Protect My Eyesight?

An optometrist will be able to recognize the symptoms of early onset and advanced diabetic retinopathy. They can perform your regular eye exams to ensure the proper intervention for any developing eye conditions.

Can I Do Anything to Prevent Diabetic Retinopathy?

Diabetic retinopathy treatment works well to address the signs and symptoms of the condition. But there are ways to lessen your risk if you haven’t already been diagnosed with it.

Some of the best ways to protect yourself from developing diabetic retinopathy and its progression include:

  • Closely monitoring and controlling your blood sugar, cholesterol, and blood pressure
  • Getting Regular exercise
  • Stopping or never starting to smoke cigarettes
  • Maintaining regular optometrist visits and routine eye health exams
  • Eating healthy fruits and veggies to support your body’s natural defenses

Finding the Right Diabetic Retinopathy Treatment Option

Diabetes can be a life-threatening condition if not properly treated. It can also rob you of your eyesight through the progression of diabetic retinopathy.

But there is diabetic retinopathy treatment available to help you avoid these issues.

If you’re looking for guidance and vision services to help keep your sight at the level it’s meant to be, check us out at Magruder Eye Institute.