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Condition Focus · Diabetes & the Retina
Diabetic Retinopathy
A clear, reassuring guide to how diabetes can affect the eyes — the stages to know, why screening matters, and the steps that help protect your sight.
Guidance you can trust, from a UK optometry team
Understanding the condition
What is diabetic retinopathy?
Diabetic retinopathy is damage to the tiny blood vessels of the retina — the light-sensitive layer at the back of the eye — caused by persistently high blood sugar levels.
Over time, raised glucose can weaken these vessels, making them leak fluid or blood, or become blocked. In its early stages there are often no symptoms at all, which is why it can progress unnoticed.
Anyone with type 1 or type 2 diabetes can be affected. The good news: with regular screening and well-managed diabetes, serious sight loss is largely preventable.
High blood sugar weakens the retina's tiny blood vessels, which can leak or become blocked.
How it progresses
The stages of diabetic retinopathy
Diabetic retinopathy develops in stages. Understanding where you are helps you and your care team act at the right time.
Background retinopathy
Tiny bulges appear in the blood vessels. Vision is not usually affected, but it's a sign to keep diabetes well controlled and attend screening.
Pre-proliferative
More widespread changes and some bleeding in the retina. This stage needs closer monitoring and often more frequent screening.
Proliferative
Fragile new blood vessels grow and can bleed, threatening sight. This stage needs prompt specialist treatment.
Diabetic maculopathy can occur at any stage, when leakage affects the macula (the centre of the retina) and causes blurring of central vision. It's one of the most common reasons diabetic eye disease affects sight.
Know your risk
What increases the risk?
The longer you have diabetes, the higher the chance of some retinopathy — but how well your diabetes is managed makes a real difference.
Duration of diabetes
The longer you've lived with diabetes, the greater the likelihood of retinopathy developing.
Blood sugar control
Consistently high blood glucose (HbA1c) is the biggest modifiable risk factor.
High blood pressure
Raised blood pressure adds strain to the retina's blood vessels and speeds up damage.
Cholesterol levels
High cholesterol can contribute to leakage and deposits within the retina.
Smoking
Smoking damages blood vessels throughout the body, including in the eyes.
Pregnancy
Diabetes during pregnancy can accelerate changes, so extra screening is offered.
Signs to watch for
Symptoms & warning signs
Early diabetic retinopathy usually has no symptoms — vision can seem perfectly normal while changes are already developing. This is exactly why routine screening is so important. As it advances, you may notice:
Gradually worsening or blurred vision that may fluctuate with blood sugar.
Floaters or dark, drifting spots in your field of vision.
Difficulty seeing in the dark or patches of missing vision.
Sudden loss of vision — treat as urgent and seek help straight away.
Your best protection
Why diabetic eye screening matters
In the UK, everyone with diabetes aged 12 and over is invited to free annual diabetic eye screening. It's a quick appointment where photographs of the back of your eyes are taken and checked for early changes.
Because early retinopathy has no symptoms, screening is the only reliable way to catch it before it affects your sight — when treatment works best.
Never miss your screening invitation. Attending every year is one of the most important things you can do to protect your vision with diabetes.
A quick eye photograph
Drops widen your pupils, then painless photos capture the retina in detail.
Expert review
Trained graders examine the images and grade any changes by stage.
Clear next steps
You're told the result and whether you need routine, closer monitoring or referral.
Diagnosis & treatment
How it's diagnosed and treated
Beyond screening, an optometrist or eye clinic may use detailed imaging to assess the retina. When treatment is needed, several effective options can protect and preserve sight.
OCT & retinal imaging
Detailed scans reveal swelling or leakage affecting the macula.
Laser treatment
Seals leaking vessels and slows the growth of new, fragile ones.
Eye injections
Medicines injected into the eye can reduce swelling and protect central vision.
- →Your vision suddenly gets worse or goes dark
- →A sudden shower of floaters or spots appears
- →You see flashes of light or a "curtain" over your sight
These can signal bleeding or retinal detachment, which need urgent assessment. Contact your eye clinic or go to your nearest eye casualty (A&E) straight away.
Taking control
Protecting your sight with diabetes
Managing your diabetes well is the single most powerful way to prevent diabetic retinopathy or slow its progression. Small, consistent habits add up.
Manage blood sugar
Keeping your glucose (HbA1c) in your target range is the best protection for your retina.
Blood pressure & cholesterol
Keeping these in check reduces strain on the delicate vessels in your eyes.
Attend every screening
Never skip your annual diabetic eye screening — it catches changes before you notice them.
Healthy lifestyle
A balanced diet, regular activity and not smoking all support healthy blood vessels.
Nutrition & eye health
Nutrients that support the retina
Good diabetes control is the foundation of eye health. Alongside it, research is exploring how certain antioxidant and vascular-supportive nutrients may help protect the retina's tiny blood vessels.
Supplements never replace your medication, screening or the advice of your diabetes team — but for some people they can complement a healthy routine.
| Lutein & zeaxanthin | Carotenoids concentrated in the retina and macula |
| Antioxidants (C & E) | Help defend cells against oxidative stress |
| Zinc | A mineral that contributes to normal vision |
| Omega-3 fatty acids | Support general eye and cardiovascular health |
Supplements are not a treatment for diabetic retinopathy and do not replace medication, screening or specialist care. Always speak to your optometrist, GP or diabetes team before starting a supplement.
From our range · Optional support
Glycoshield — daily nutritional support for the diabetic eye
If you and your optometrist feel a supplement could complement your diabetes care, Glycoshield brings together antioxidants and retina-supportive nutrients in one convenient daily capsule.
In their words
Living with diabetes, in their own words
"My early retinopathy was spotted at screening before I had any symptoms. The team explained the stages so clearly — I finally understood why my annual check really matters."
"As a type 2 diabetic I felt overwhelmed. The advice here helped me understand what to watch for and how managing my blood sugar protects my eyes. Genuinely reassuring."
Common questions
Frequently asked questions
This page is for general information and awareness only and does not constitute medical advice or a diagnosis. It is not a substitute for diabetic eye screening or a professional eye examination. If you have concerns about your vision, please consult a GOC-registered optometrist, your GP or diabetes team. Content clinically reviewed by the Ocular Express optometry team — last reviewed July 2026.