What Are the Four Stages of Diabetic Retinopathy?

December 16, 2021

Most people don’t realize that diabetes can affect much more than just their blood sugar levels. Diabetic retinopathy is one of the less common and well-known complications of diabetes – a metabolic disorder characterized by the body’s inability to control its blood sugar levels.

In most cases, diabetic retinopathy develops slowly, with hardly any symptoms manifesting until the condition is quite well advanced. This means that many people are likely to be walking around experiencing it without even knowing about it. For this reason, patients who are diagnosed with diabetes are recommended to undergo regular diabetic screening exams which assess the structures inside your eye to determine if you are suffering from diabetic retinopathy. Early diagnosis and treatment are essential to minimize its effects and to preserve your long-term vision.


There are four stages of diabetic retinopathy. These are:


Mild, nonproliferative retinopathy. This is the mildest stage of the condition and is sometimes referred to as ‘background’ retinopathy. During this stage, your eye doctor may be able to see small areas of swelling in the blood vessels that serve the retina. These are called microaneurysms, and they can cause the blood vessels to leak blood into the retina. Patients won’t even know this is happening, although it is something that is detectable at a diabetic eye screening. You probably won’t experience any symptoms at this stage.


Moderate, nonproliferative retinopathy. Also known as pre-proliferative retinopathy, this is a slightly more advanced stage of the condition. At this point, the blood vessels of the retina swell, affecting the flow of blood to the retina which results in damage starting to occur. Blood and other fluids can also pool in the macula, which is found in the central part of the retina and is responsible for central vision. When blood and fluid accumulate here, it can start to affect the quality of your eyesight.


Severe, nonproliferative retinopathy. At this stage, diabetic retinopathy becomes much more severe. The blood vessels that serve the retina become even more congested thanks to severe swelling, and this limited blood flow causes blurry vision with dark spots in the field of vision appearing. These are known as floaters, and you may find yourself blinking more frequently to try and clear them – unsuccessfully.


Proliferative diabetic retinopathy. This is the most advanced stage of the condition. At this point, abnormal blood vessels will start to grow along the retina and the surface of the clear, vitreous fluid found in the eyes. These new blood vessels aren’t only abnormal but extremely fragile and this means that they leak prolifically, sending blood into the retina that causes scarring, and severe vision loss which may become permanent.

How to Keep Diabetic Retinopathy at Bay

If you suffer from diabetes, keeping diabetic retinopathy at bay should be a priority so that you can preserve your long-term vision. Keeping your diabetes firmly under control is the best way to do this. You can do this using a combination of medication and managing your blood sugar levels through your diet. Your doctor will be able to advise you on which medications you should take and what foods you should avoid.


You should also make sure that you attend your regular comprehensive eye exams and diabetic retinopathy screening appointments (if these are carried out at a different time). They will give your eye doctor the best opportunity to detect early signs of diabetic retinopathy before it can damage your vision.


To find out more about diabetic retinopathy, visit Eye Associates of New York, in Midtown East, New York. Call (212) 650-4888 to schedule an appointment today.

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