How does diabetic retinopathy cause vision loss?

David R. Demartini, MD
Diabetic retinopathy can cause vision decrease by leaking fluid into the retina causing it to swell. This makes vision blurry but is often reversible with medicines or laser treatments. Diabetic retinopathy can also cause new fragile vessels to form (proliferate). The new vessels (neovascularization) often break and cause bleeding onto the eyes and can lead to severe scarring, vision loss or blindness. Retinopathy can also cause a significant loss of circulation underneath the retina causing the overlying retina to die with permanent vision loss. 

Blood vessels damaged from diabetic retinopathy can cause vision loss in two ways:

Fragile, abnormal blood vessels can develop and leak blood into the center of the eye, blurring vision. This is proliferative retinopathy and is the fourth and most advanced stage of the disease. Fluid can leak into the center of the macula, the part of the eye where sharp, straight-ahead vision occurs. The fluid makes the macula swell, blurring vision. This condition is called macular edema. It can occur at any stage of diabetic retinopathy, although it is more likely to occur as the disease progresses. About half of the people with proliferative retinopathy also have macular edema.

This answer is based on source information from National Eye Institute.

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