Singapore Optometric Association

Diabetic Retinopathy: What you need to know

What is Diabetic Retinopathy?

Normal Retina

Diabetic retinopathy is one of the leading causes of blindness in Singapore. It is a complication of diabetes (both type 1 and type 2) that occurs in the retina (light sensitive tissue at the back of the eye). Diabetic retinopathy usually has few to no symptoms in the early stages. However, in advanced cases, it can lead to severe loss of vision or even blindness. In some cases, it could even be the first tell-tale sign of poor control of diabetes.



In non-proliferative diabetic retinopathy, the walls of the blood vessels on the retina become weak and start to bleed or leak fluid. As the disease progresses, the fluid accumulation may cause the retina to swell, leading to a condition known as retinal edema.

Diabetic Retinopathy with haemorrhages & hard exudates

Diabetic retinopathy can also affect the macula, which is the part of the retina that is responsible for providing sharp vision.


Proliferative diabetic retinopathy is the more severe form of diabetic retinopathy. At this stage, new blood vessels that are weak and leaky start to grow into the inner layers of the retina. Very often, they bleed into the vitreous (the jelly-like substance that fills the eyeball) and may lead to other serious complications such as retinal detachment and loss of vision.

Risk Factors
• Duration of diabetes (the longer you have had diabetes, the greater the risk)
• Poor blood sugar control
• High blood pressure
• High cholesterol
• Smoking

Visual Symptoms
• Blurred vision
• Fluctuating vision
• Dark patches in vision
• Floaters

Common Signs of Diabetes
• Increased thirst
• Increased hunger
• Frequent urination
• Weariness
• Slow-healing wounds
• Frequent infection
• Numbness in hands or feet

Multiple Dark Patches in Vision due to Diabetic Retinopathy

Is there any treatment?

Diabetic Retinopathy in the early stage requires no treatment. Maintaining good blood sugar control via a healthy diet, exercise and compliance with medication is necessary to slow down progression of the condition.

In the advanced stage of diabetic retinopathy, treatment may be needed. This is done through laser, injection of drugs into the eye and/or surgery.

Currently, treatment for diabetic retinopathy is only done to slow down or stop the progression of diabetic retinopathy, but further vision loss is still possible. Ultimately, good blood sugar control remains important.

Hence, it is important to have your eyes examined regularly by an optometrist or ophthalmologist – particularly if you are diabetic.

Photo Credits

Cover and CBD photo: Jerome Lee
Diabetic Retinopathy photos: Dr Koh Liang Hwee