The only way to delay the ocular complications of diabetes is to exercise the tightest possible control of blood glucose. Therefore, the primary treatment for diabetic retinopathy is intensive control of the diabetes. In addition, blood pressure and serum lipid levels should be kept normal, if possible.

There are two commonly used treatments for diabetic retinopathy.

Severe macular edema and proliferative retinopathyare treated with laser surgery, called laser photocoagulation. Laser photocoagulation is a painless treatment in which a laser beam is aimed through the eye to destroy any new blood vessels and seal off those that are leaking. During the treatment, you may see bright flashes of light. Your vision will remain blurred for a few hours after the procedure and you may feel some discomfort in the eyes. People with proliferative retinopathy may lose some side (peripheral) vision after this surgery. Laser photocoagulation may also affect color and night vision. Laser photocoagulation is not a cure. It just prevents further deterioration of vision, by preventing new blood vessels from leaking.

Visual improvement is not guaranteed

Laser surgery (photocoagulation) is the standard and only proven treatment for established (stage 2 or 3) retinopathy and/or macular edema, and it may slow the progression of vision loss. However, this treatment is destructive to the peripheral retina and does not stop the progression of the disease. Laser surgery reduces by 90% the chances that a person with diabetes will become legally blind.

Photographs with fluorescein angiography is used to plan laser treatment. Once the retinopathy advances to the proliferative phase, it is very difficult to reverse.


Leaks in the retina noticed in extensive disease and the clearing after laser photocoagulation Pictures of fundus fluorescein angiography.

People who have proliferative retinopathy are always at risk for new bleeding. If you have had extensive bleeding from damaged blood vessels, you may need an operation called a vitrectomy. The area of the eyeball closest to the retina is filled with a gel-like substance called the vitreous humor, which helps give the eyeball its shape. A vitrectomy is performed if you have a lot of blood in the vitreous.

Vitrectomy is often done under local anesthesia. With this procedure, the doctor makes a small incision in the white part of the eye (sclera). A small instrument is used to remove the cloudy vitreous and replace it with a vitreous substitute. Your eye will be red and sensitive right after the procedure so you will need to wear an eyepatch for a short time to protect it. Your doctor will also give you medicated eye drops to prevent infection. Vision gradually improves after the vitrectomy, and the vitreous humor is gradually replaced. Even people with advanced retinopathy have a good chance of keeping their vision if it is treated before the retina is severely damaged.