Diabetic Retinopathy

Retinopathy covers various disorders of the retina, which affect your vision. It is the damage to blood vessels in the retina which is commonly caused by diabetes, though it is sometimes caused by other diseases such as very high blood pressure. Having a high blood sugar level over a prolonged time can weaken and damage the tiny blood vessels in the retina.

This can result in problems which include:

  • Small swellings of blood vessels known as microaneurysms.
  • Small haemorrhages or bleeds from damage to blood vessels.
  • Blockages may occur in blood vessels, cutting off the blood and oxygen supply to small sections of the retina.
  • New abnormal blood vessels may grow from damaged vessels. This is called proliferative retinopathy. These new vessels are delicate and can bleed easily.

The leaks, bleeds and blocked blood vessels have the potential to damage the cells of the retina. In some severe cases, blood vessels can bleed into the centre of the eye resulting in vision damage.


Most people with diabetic retinopathy do not have any symptoms. However, left untreated, diabetic retinopathy can gradually become worse and lead to blindness. Diabetic retinopathy is the most common cause of blindness in people of working age in the UK.

If you suffer from diabetes, it is vital to have annual eye checks.

Initial symptoms that may occur include blurred vision, seeing floaters and flashes, or even having a sudden loss of vision.

Different parts of the retina can be affected

The macula is the small part of the retina in the centre at the back of the eye where you focus your vision. When you look at an object, light is focused on the macula. The central and most important part of the macula is called the fovea. The outer part of the retina is used for peripheral vision.

Retinopathy can affect the macula, the outer part of the retina, or both. It is much more serious if the macula is affected.

Severity of the retinopathy

Retinopathy tends to develop gradually, often becoming worse over a number of years. Some of the varying degrees of retinopathy are:

  • Background retinopathy does not affect your sight. There will be some tiny leaks of fluid or blood (microaneurysms) in various parts of the retina. When examined these can be seen as tiny dots and blots on the retina.
  • Pre-proliferative retinopathy is more extensive than background retinopathy. There are signs of restricted blood flow, however new blood vessels have not yet begun to appear.
  • Maculopathy is when there is some damage to your macula.
  • Proliferative retinopathy occurs when the damaged blood vessels in the retina produce chemicals called growth factors. These chemicals can cause new blood vessels to grow (proliferate) from the damaged ones. This is the body’s attempt to repair the damage. However, the new blood vessels are delicate, and can bleed very easily, obscuring your vision. In this type of retinopathy, without treatment, vision is likely to become badly affected. If the proliferative retinopathy remains untreated it may become severe. Many abnormal new blood vessels may block the drainage channels in your eye, causing glaucoma, or the retina to detach from the back of the eye.

The effects of retinopathy may vary in each eye. If you have high blood pressure in addition to diabetes, the severity of retinopathy may progress at a quicker rate.

Risk factors

Retinopathy is common in people with diabetes, though more common with type 1 diabetes.

Risk factors for diabetic retinopathy include:

  • Duration of diabetes. The longer you have had diabetes, the higher your risk level. For those who have had diabetes for less than 5 years, the risk is low. Around 90% of people who have had diabetes for longer than 30 years can be affected with retinopathy.
  • High blood pressure. If your blood pressure is not well-controlled, your risk of developing retinopathy will increase.
  • Nephropathy (kidney disease). Having kidney disease as a result of your diabetes has been linked with worsening retinopathy.
  • Pregnancy. Being pregnant may make retinopathy worsen, especially if your blood sugar (glucose) is not managed properly.
  • Other risk factors include smoking, obesity and high cholesterol.

Eye checks

Treatment can prevent blindness and loss of vision in most cases. If you have diabetes, it is crucial that you have regular eye checks to detect any retinopathy before your vision becomes badly affected. You should have your eyes check at least once a year.

To examine your eyes properly you will have drops put into your eyes to dilate (widen) your pupils as much as possible. The drops may blur your vision for up to 6 hours so it is important to make alternative travel arrangements and not drive to and from the appointment.

Another test that can be done is a fluorescein angiogram. A special dye is injected into one of the veins in your arm where it will make it’s way to the blood vessels in your eye. A special camera is then used to show any swollen, leaking or abnormal blood vessels.

If you are found to have no or only mild signs of retinopathy and your vision is not affected, then you may simply be invited back for another screening in 12 months’ time. The retinopathy may never progress to more serious forms, particularly if you control your diabetes and blood pressure. If more severe changes are detected, you may be referred to an eye specialist for a more thorough examination, and treatment if necessary.


If you have mild diabetic retinopathy then you will not usually require any treatment other than controlling any other risk factors (for example, blood pressure, glucose and cholesterol levels).

Laser treatment

Laser treatment is mainly used if you have new vessels growing (proliferative retinopathy), or if any type of retinopathy is affecting the macula. The laser is powerful enough to make tiny burns on whatever it is focused on and is accurate enough to target even very tiny abnormal blood vessels. The laser treatment can seal leaks from blood vessels, and stop new vessels from growing further. In some cases several hundred burns may be needed to treat retinopathy.

Treatment usually works well to prevent retinopathy getting worse, and often prevents loss of vision, or blindness. However, this treatment cannot restore vision that is already lost.

After your laser treatment you may find that your sight becomes dim or blurred. This will normally improve in the coming few days.

Other treatments

Other eye operations may be needed if you have a bleed into the vitreous humour or have a detached retina. An operation might also be needed if the laser treatment has been unsuccessful.

Contact us

Our Appointments Team have a dedicated and caring approach to finding you the earliest appointment possible with the best specialist.

If you do not have a GP, then we have an in-house private GP practice that you can use. Alternatively we can suggest the most appropriate course of action for you to take, given your location and individual circumstance.

If you have medical insurance (e.g. Bupa, Axa PPP, Norwich Union), you will need to contact your insurer to get authorisation for any treatment and, in most cases, you will require a referral letter from your GP.

For the next available diabetic retinopathy appointment you can contact us by emailing [email protected] or by calling our team on 020 7078 3848

A woman receiving an eye examination

Eye Clinic

The Eye Unit offers exceptional diagnosis, intervention and aftercare for all eye conditions using modern treatment techniques and cutting-edge diagnostics for all eye complaints.

A patient speaking to a receptionist

Patient information

Our Hospital is renowned for providing exemplary levels of care across more than 90 services. From orthopaedics, to urology, our private GP practice and Urgent Care Clinic, our services are led by some of London’s leading Consultants. For more information, and to find a service suitable for your care, find out more about the services that we offer.

Make an enquiry

If you have any questions relating to treatment options or pricing information, get in touch with us by filling out one of our contact boxes or giving us a call on 020 7078 3848.

Our Appointments Team have a dedicated and caring approach to finding you the earliest appointment possible with the best specialist.

If you are self-paying you don’t need a referral from your GP for a consultation. You can simply refer yourself* and book an appointment.

If you have health insurance (e.g. Bupa, Axa Health, Aviva), you will need to contact your insurer to get authorisation before any treatment, and in most cases you will also require a referral letter from your GP.

If you are not registered with a GP, we have an in-house private GP practice you can use. Alternatively, we can suggest the most appropriate course of action for you to take, given your location and individual circumstances.

*Please note – for investigations such as X-rays and MRIs, a referral will be required. However, we may be able to arrange this for you through our on-site private GP.

    Make an enquiry

    Latest articles

    The latest news, insights and views from St John and Elizabeth Hospital.

    Find out what we’re doing to keep you safe, read expert articles and interviews with our leading specialist Consultants, learn more about common conditions and get your questions answered.

    09th November 2023

    KFM and St John & St Elizabeth Hospital enter into partnership to deliver an end-to-end procurement and supply chain service

    On Wednesday 1 November 2023, KFM entered into a contract with St John…

    01st November 2023

    Men’s Health Awareness Month With Dr Adam Wander, Private GP

    November is Men’s Health Awareness Month, widely known as Movember. This is a…

    19th October 2023

    Kidney Stones – Prevention & Treatment with Mr Leye Ajayi

    Mr Leye Ajayi is a Consultant Urological Surgeon with a specialist interest in…

    03rd October 2023

    Preventing Rugby Injuries with Lead Outpatient Physiotherapist – Kolade Awobowale

    We are extremely proud that our Lead Outpatient Physiotherapist, Kolade Awobowale, flew out…

    Mr Akash Patel

    26th September 2023

    Top Tips for New Runners – with Mr Akash Patel

    Mr Akash Patel, Consultant Trauma and Orthopaedic Surgeon specialises in hip and knee…

    26th May 2023

    What to expect at our Stroke Clinic – with Dr Sageet Amlani

    It’s a tough reality that many of those who have had a stroke,…

    12th April 2023

    What does a Bowel Consultant do? Mr Asif Haq answers

    Mr Asif Haq is a highly experienced Colorectal Consultant and General Minimal Access…

    16th January 2023

    Skiing Q&A with an orthopaedic surgeon

    Mr Parag Jaiswal is a lower limb orthopaedic surgeon who specialises in complex…

    11th January 2023

    Shred it this ski season

    If you’re planning a holiday in the mountains this ski season, preparing your…

    10th January 2023

    Ski season and ACL injuries

    An interview with Mr Ghias Bhattee – Lower Limb Orthopaedic Surgeon on what…

    06th January 2023

    Getting treatment after a skiing injury

    Mr Satya Naique is a Lower limb Orthopaedic and Trauma Surgeon, who has…

    14th November 2022

    An insight into HoLEP – minimally invasive prostate surgery

    Mr Andrew Ballaro is a Consultant Urological Surgeon who practices at our hospital….