Humans rely on five senses: sight, hearing, smell, taste, and touch. While all of them play important roles, people tend to prioritize them differently. For instance, a YouGov public survey found that only 2% of Americans believe they’d miss their sense of smell the most, followed by 3% for touch, 5% for taste, and 7% for hearing. The overwhelming favorite was sight, with a significant 70% of Americans stating they would miss their vision more than any other sense.

Various eye conditions can impair vision, but myopia (nearsightedness) is the most common, affecting around 30% of the global population. Other more serious eye diseases, like age-related macular degeneration, retinitis pigmentosa, and glaucoma, can lead to complete blindness.

Diabetic retinopathy (DR) is another major cause of vision impairment, particularly prevalent among those with diabetes. “Diabetic retinopathy is the leading cause of irreversible vision loss and blindness in working-age adults in the USA and several other countries,” says Dr. Charles Wykoff, a specialist in medical and surgical retina care based in Texas.

Understanding Diabetic Retinopathy

Diabetic retinopathy is a complication that affects people with diabetes, harming the blood vessels in the retina—the eye’s light-sensitive tissue at the back. Dr. Wykoff explains that DR can lead to loss of peripheral vision, problems like light sensitivity and floaters, and, if not treated, can result in blindness.

According to Dr. Sun Kim, an endocrinologist at Stanford University, DR progresses through two stages. The first, nonproliferative retinopathy, occurs when swelling in the retina leads to mild vision loss. The second stage, proliferative retinopathy, is more severe and can cause significant or complete vision loss.

The National Eye Institute estimates that nearly half of the 800 million people globally with diabetes will experience some level of diabetic retinopathy. “The primary risk factor for developing DR in type 2 diabetes is the duration of the illness—how long an individual has had it,” Dr. Sara Weidmayer from the LTC Charles S. Kettles VA Medical Center in Michigan explains.

What Leads to Diabetic Retinopathy?

@Diabetic retinopathy is triggered by prolonged high blood sugar levels that damage the small blood vessels in the retina, known as capillaries,” says Weidmayer. These elevated glucose levels can harm the inner lining of these capillaries, leading to leakage and retinal damage. Eventually, this can also cause blockages, further depriving parts of the retina of necessary blood flow.

While the effects of leakage and blockages might not show immediate vision problems, if untreated, they can result in permanent vision loss,” warns Dr. Lloyd Paul Aiello, a professor of ophthalmology at Harvard Medical School.

Furthermore, the longer a person has diabetes and the less controlled their blood sugar levels are, the greater the chance of developing serious diabetic retinopathy. This is critical as many individuals remain unaware they have prediabetes or diabetes until they receive an official diagnosis, as lack of screening is common,” cautions Weidmayer.

The U.S. Centers for Disease Control and Prevention indicates that one in three American adults have prediabetes, and more than 80% are unaware they have it.

Treating Diabetic Retinopathy

To manage diabetic retinopathy effectively, it’s crucial to monitor blood sugar levels and get regular screenings for prediabetes and type 2 diabetes. This is vital for preventing serious vision loss related to DR since, unlike type 1 diabetes, where severe DR is rare in the first five years after diagnosis, individuals with type 2 diabetes can have retinopathy at the time they are diagnosed. “That’s why we recommend an initial retinal exam as soon as type 2 diabetes is diagnosed—and even if no retinopathy is found initially, patients usually need annual eye exams,” Aiello emphasizes.

Once a diagnosis is made, treatments typically focus on preventing further damage. “In the early stages of DR, managing risk factors such as high blood sugar, high blood pressure, and elevated cholesterol is crucial for preventing the progression of diabetic retinopathy,” Weidmayer adds.

Recommended approaches include dietary changes, regular cardiovascular exercise, and quitting smoking. Losing weight can greatly help in controlling blood sugar, especially for individuals with a high body mass index (BMI), according to Dr. Kim.

If vision damage continues despite lifestyle changes and DR advances, further treatments may be needed. “Treatments can include injections into the eyes, laser therapy, and sometimes surgical procedures to address complications of DR,” Weidmayer explains.

“Fortunately, most individuals with diabetic retinopathy do not end up blind if they have regular screenings and follow appropriate treatment from a retina specialist,” adds Wykoff. “Therefore, don’t wait until your vision deteriorates to consult an eye doctor.”