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Symptoms & Diagnosis

If you have type I or II diabetes, you are at risk for developing this degenerative eye disease. Learn more about the symptoms and diagnosis of diabetic retinopathy.

Diabetic Retinopathy Symptoms

There are several important signs and symptoms to look for when it comes to diabetic retinopathy. Although many of these symptoms are not present in the earliest stages of non-proliferative diabetic retinopathy, they often present themselves as the disease progresses toward advanced or proliferative diabetic retinopathy.

Retinal Changes

Even though a patient may have no vision impairment, retinal changes noticed during a vision exam can be symptoms of diabetic retinopathy. These changes include retinal swelling, blood vessels leaking fluids, and any scar tissue or abnormal deposits on the retina.

Floaters

Floaters are small shadows cast on the retina by tiny floating cells of vitreous gel as the vitreous pulls away from the back of the eye. Blood cells that have leaked into the vitreous can also lead to floaters. Floaters are manifested as small spots that are suspended or move around within the line of vision. They can also create a "spider web" effect, which gives the impression of looking through a mesh of thin fibers.

Spotty, Blurry, or Hazy Vision

When floaters become more plentiful in the vitreous, and microaneurysms cause blood and other fluid to leak into the retina, vision becomes increasingly impaired. Patients lose the ability to see objects with great detail, and often have difficulty driving at night or experience blind spots in parts of their visual field.

Difficulty Reading or Seeing Close Up

When the retina is damaged, it often distorts the eye's ability to focus on things close-up. Reading, sewing, writing, and other activities requiring adequate focusing power become more and more difficult. Although this type of vision impairment is typical as the body ages, it is also one of the primary symptoms of diabetic retinopathy.

Diabetic Retinopathy Diagnosis

Because the signs and symptoms of diabetic retinopathy are typically not present during the first stage of the disease, it can often go undiagnosed until damage to vision has occurred. This can be prevented with yearly eye exams that include a visual acuity test, pupil dilation, ophthalmoscopy, and tonometry tests. Since the main cause of diabetic retinopathy is uncontrolled blood sugar levels, patients with type I and II diabetes need to be sure that their vision is tested regularly by an ophthalmologist. If a diabetic retinopathy diagnosis is made, patients should seek treatment such as vitrectomy or laser photocoagulation surgery.

Visual Acuity Test

A visual acuity test is one of the first steps an eye care specialist will take toward a diabetic retinopathy diagnosis. This test measures your eyesight at different distances by determining the smallest letter you can read on a standard eye chart. The score of a visual acuity test is expressed as a fraction, with the top number referring to the distance from the chart, and the bottom number referring to the distance at which a person with normal eyesight can read the same line that you correctly read. A score of 20/20 is considered normal, while a score of 20/60 indicates that you can read at 20 feet what a person with normal vision can read at 60 feet.

Pupil Dilation

A pupil dilation test begins by placing special eye drops into the patient's eye. These drops stimulate the pupil, causing it to widen and allowing the ophthalmologist to check the retina. After the examination, the pupils will remain dilated for a little while longer, and the patient must wear protective sunglasses to prevent overexposure to sunlight.

Ophthalmoscopy

An ophthalmoscopy is a very important part of diabetic retinopathy diagnosis because it allows the ophthalmologist to see the entire back portion of the eyeball, which includes the optic disc, choroid, retina, and blood vessels. The test is a common part of routine eye exams and takes just a few minutes to complete. During the exam, the doctor will beam a bright light through your pupil using an ophthalmoscope, which has a series of rotating lenses through which the back of the eye can be viewed. Because the human eye is a natural magnifier, the ophthalmologist is able to easily see the retina and other parts of the eyeball.

Tonometry

Generally used to detect glaucoma, tonometry measures intraocular pressure (IOP) and can also assist in a diabetic retinopathy diagnosis. There are several different methods of tonometry testing, the most popular being the "air puff" test. During this test, the ophthalmologist uses a special instrument to calculate the IOP by measuring changes in the light reflected off the corneas when the air puff is blown into the eyes. A more specialized form of tomography called optical coherence tomography (OCT) produces an image of the inner structures of the eye to detect macular edema, which is one of the telltale signs of diabetic retinopathy.

Contact a Doctor

Researchers estimate that only half of all diabetes patients in the United States have regular yearly eye examinations. In order to prevent and slow the progression of diabetic retinopathy, seeing a highly skilled ophthalmologist is crucial. To facilitate your search for the right doctor, DocShop provides a directory of eye care specialists in your community. DocShop can also help answer some of the most important questions on diabetic retinopathy.

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