Diabetic retinopathy

Damage to the blood vessels of the retina. The leading cause of sight loss in working-age adults, and screening prevents most of it.

What it is

Diabetic retinopathy is damage to the small blood vessels supplying the retina, caused by high blood glucose over time. It is the leading cause of certifiable sight loss in working-age adults in the UK.

Almost everybody with type 1 diabetes and a large proportion of people with type 2 diabetes develop some degree of it over decades.

Here is the part that decides outcomes: it causes no symptoms until it is advanced. By the time vision changes, significant damage has usually occurred, and treatment then preserves rather than restores.

The NHS Diabetic Eye Screening Programme exists precisely to catch it before symptoms. Attendance is the entire intervention.

Signs you might notice

Nothing at all, for years. That is the point.

Later: blurred or fluctuating vision, floaters, dark patches, or sudden loss of vision from a bleed.

Fluctuating vision after a change in glucose control is common and usually settles; it should still be mentioned.

Sudden floaters, flashes or a curtain across vision needs same-day assessment.

How it can affect day-to-day life

Missed screening appointments are the commonest failure, and the reasons are practical: transport, work, the dilating drops that make driving impossible afterwards, and simply not understanding why it matters when nothing hurts.

Rapid improvement in glucose control can temporarily worsen retinopathy, which surprises people and occasionally leads them to abandon the improvement. It is temporary and the long-term benefit is clear.

Pregnancy accelerates retinopathy and needs more frequent screening.

Supporting someone well

Attend screening every year without fail. Arrange transport and a lift home, because the drops blur vision for hours.

Explain why it matters: nothing hurts and nothing looks wrong, and that is exactly when it is treatable.

Control glucose and blood pressure. Both slow progression substantially, and blood pressure is the one most often overlooked.

Report any sudden visual change the same day.

In a care setting, treat the screening invitation as a clinical appointment with a named person responsible, not as post.

Where to get help

The local diabetic eye screening service, by invitation. Contact them directly if an invitation has not arrived.

Diabetes UK helpline: 0345 123 2399.

Sudden loss of vision, a curtain, or a shower of floaters is an emergency.