Eyes on diabetes
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In people with diabetes, uncontrolled blood sugar can damage the tiny blood vessels (capillaries) in the retina. Over time, this damage can cause diabetic eye disease and may lead to vision loss.¹
Types of diabetic eye disease
Diabetic retinopathy (DR) occurs when damage to the blood vessels and the formation of new blood vessels causes blood and/or fluid to leak into the retina, leading to swelling, as well as blockage of blood supply to some areas of the retina.2,3
Diabetic macular edema (DME) is a vision threatening complication of DR.4 DME occurs when the damaged blood vessels leak into, and cause swelling in the macula.2 The macula is the central area of the retina responsible for sharp vision and is essential for reading, driving and recognising faces.2,5
Impact
Around 589 million people, or nearly 1 in 10, live with diabetes.6
DR affects 93 million people globally.7.8
DME affects 21 million people globally.4
Diabetes is the leading cause of new cases of blindness among adults aged 20-75.9
Global prevalence of DME is expected to increase by 25% from 2020 to 2030.10
People with diabetic eye diseases face more than double the healthcare costs than those with diabetes alone.11
Risk factors¹²⁻¹⁴
Poor glucose control
Length of time with diabetes
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High blood pressure
Fluid retention (edema)
Kidney disease
Type of diabetes
About 90% of people with type 1 diabetes, and between 67–80% of people with type 2 diabetes will have some degree of damage to the blood vessels in the retina (retinopathy) after 10 years.
Signs and symptoms ¹,¹⁴,¹⁵
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Blurred vision
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Difficulty distinguishing between shades of light and dark
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Patches of vision loss, appearing as ‘floating’ small black dots or lines
Current treatment options
In many cases, conditions such as DME and DR can be managed, and vision loss can be prevented if they are detected and treated early.13,14,16
The most common treatment involves injections into the eye called VEGF inhibitors or dual VEGF/Ang-2 inhibitors.12,17,18 These treatments help prevent new, abnormal blood vessels from forming and reduce leakage from damaged vessels, which helps protect vision.12,17,18
In some situations, laser therapy may be offered, especially if the DME doesn’t affect the central part of the macula (the fovea). However, laser treatment usually stabilises vision rather than improves it and can sometimes cause side effects like scarring, which may create permanent blind spots.12-14 Because of these risks, laser therapy is now rarely used and has mostly been replaced by more advanced treatments.12-14
Annual eye tests are vital to keep on top of your eye health, particularly if you live with diabetes. If you notice any changes in your vision, report these to your eye doctor or visit: https://retina-international.org/
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Not sure where to start? Here are some questions you can take to your next appointment with your doctor:
What treatment options are available for my diabetic eye condition?
What can I do to maximise my vision?
How can I better manage my condition?
How can I improve my symptoms?
References
National Eye Institute. Diabetic retinopathy. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/diabetic-retinopathy.Accessed October 14, 2025.
American Optometric Association. Diabetic retinopathy. https://www.aoa.org/healthy-eyes/eye-and-vision-conditions/diabetic-retinopathy.Accessed October 14, 2025.
Yau JWY, Rogers SL, Kawasaki R, et al. Global prevalence and major risk factors of diabetic retinopathy. Diabetes Care. 2012;35(3):556-564. doi:10.2337/dc11-1909.
Macula lutea. All About Vision. August 14, 2019. https://www.allaboutvision.com/resources/macula.Accessed October 14, 2025.
International Diabetes Federation. https://idf.org/Accessed October 14, 2025.
Leasher JL, Bourne RRA, Flaxman SR, et al. Erratum. Global estimates on the number of people blind or visually impaired by diabetic retinopathy: a meta-analysis from 1990 to 2010. Diabetes Care. 2016;39(11):1643-1649. doi:10.2337/dc16-er11.
World Health Organization. World report on vision. https://www.who.int/docs/default-source/documents/publications/world-vision-report-accessible.pdf?sfvrsn=223f9bf7_2. Accessed October 14, 2025.
BrightFocus Foundation. Facts & figures—macular degeneration. https://www.brightfocus.org/macular/facts-figures/.Accessed October 14, 2025.
Pugazhendhi A, Hubbell M, Jairam P, Ambati B. Neovascular macular degeneration: a review of etiology, risk factors, and recent advances in research and therapy. Int J Mol Sci. 2021;22(3):1170. doi:10.3390/ijms22031170.
Choi K, et al. JMIR Public Health Surveill. 2024;10:e56741.
Macular Society. Diabetic macular oedema. https://www.macularsociety.org/macular-disease/macular-conditions/diabetic-macular-oedema/.Accessed October 14, 2025.
Prevent Blindness. Diabetic macular edema (DME). https://preventblindness.org/diabetic-macular-edema-dme/Accessed October 14, 2025.
EyeWiki. Diabetic macular edema. https://eyewiki.org/Diabetic_Macular_EdemaAccessed October 14, 2025.
National Eye Institute. Macular edema. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/macular-edema.Accessed October 14, 2025.
National Institute of Diabetes and Digestive and Kidney Diseases. Diabetic eye disease. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/diabetic-eye-disease.Accessed October 14, 2025.
Heier JS, et al. Retina. 2021;41(1):1-19. Wykoff CC, et al. Lancet. 2022;399(10326):741-755.
Wykoff CC, et al. Lancet. 2022;399(10326):741-755
Udaondo P, et al. Ophthalmol Ther. 2022;11(2):489-502.
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