What causes diabetic retinopathy?

Jeffrey S. Heier, MD
Diabetic retinopathy occurs when abnormal blood sugar levels damage small blood vessels in the retina (the innermost layer of the eye). Ongoing high blood sugar levels that result from poorly managed diabetes can cause the tiny blood vessels in the retina to break down and leak fluid into surrounding tissues, leaving deposits of protein and fat called hard exudates. The vessel walls can also develop tiny bulges called microaneurysms. Eventually, the damage blocks the retina's blood supply. Nerve fibers die, creating white fluffy patches known as cotton-wool spots.
Diabetic retinopathy, the leading cause of blindness in American adults, is caused by damage to the eyes' blood vessels. High blood sugar levels and high blood pressure associated with diabetes can cause the tiny blood vessels of the eyes to swell, weaken and leak fluid, which can lead to blurry or double vision and ultimately to partial or total blindness. In some people, abnormal blood vessels grow on the surface of the retina. Notify your doctor at the first sign of any vision problems and have eye exams yearly to minimize your own risks of diabetic retinopathy.

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