What Is the First Sign of Diabetic Retinopathy?
Hi, I’m Dr. Advaith Sai Alampur, an ophthalmologist based in Hyderabad. If you or someone you love has diabetes, I want to talk to you about something very important. Something that could protect your eyesight for life.
Have you ever noticed blurry vision that comes and goes? Do colors seem faded sometimes? Or maybe you see little floaters dancing across your eyes now and then?
Let me gently say this: these might be early signs of diabetic retinopathy.
But don’t worry — I’m here to explain it all, step-by-step, in the simplest way possible. My goal is to help you understand everything clearly so you feel confident about what to do next.
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Ophthalmologist/ Eye Surgeon 13+ Years Exp
MBBS, MS – Ophthalmology
TSMC- TSMC/FMR/05251 (2018)
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What Exactly Is Diabetic Retinopathy?
Your eye works like a camera. At the back of your eye, there’s a layer called the retina, which is responsible for capturing light and sending the information to your brain, so you can see everything around you.
When someone has diabetes, high blood sugar levels over time can cause damage to the small blood vessels that supply the retina. This condition is called diabetic retinopathy.
There are two stages:
- Non-Proliferative Diabetic Retinopathy (NPDR) – This is the early stage, where the damage to the blood vessels is still mild and can be treated with early intervention.
- Proliferative Diabetic Retinopathy (PDR) – This is the advanced stage, where the damage is more severe and can cause more serious vision problems.
The key to protecting your vision is to catch the condition in the early NPDR stage. Early detection and proper treatment can help prevent further damage to your retina.
So, What Is the First Sign of Diabetic Retinopathy?
One of the first signs of diabetic retinopathy can be blurry vision that comes and goes. It might happen to you at random times, like when you wake up in the morning and notice that your phone screen or computer text seems hazy.
After a while, as you go about your day, things might seem clearer again. The blurry vision doesn’t stay constant but fluctuates throughout the day.
It’s easy to ignore or think this might just be because of tired eyes, too much screen time, or simply getting older. However, in individuals with diabetes, these fluctuations in vision can often be an early warning sign of diabetic retinopathy.
The reason behind this is related to the damage that high blood sugar causes to the small blood vessels in the retina. When these blood vessels get damaged, they might leak fluid or become blocked.
This leads to swelling in the retina, especially in a part of the retina called the macula, which is responsible for central vision. This swelling can cause blurry vision.
The blurriness can be intermittent because sometimes, the fluid might move or get absorbed, allowing your vision to improve temporarily. But when the underlying damage isn’t addressed, it can come back or worsen over time.
Let me tell you a real story:
A patient named Meena (name changed), 42 years old, visited me and said, “Doctor, sometimes I can’t read messages in the morning, but by afternoon it gets better. Is it just age?”
When I examined her eyes with a fundus camera, I found early signs of diabetic retinopathy. She was shocked because she had no pain, no redness, nothing alarming.
That’s how silent this condition can be.
Other Early Signs to Watch For
Apart from blurry vision, here are other subtle clues:
1. Difficulty seeing at night
Have you noticed it’s harder to see when the lights are dim, like while driving at night or walking through a dark hallway?
That’s because the retina needs a healthy blood supply to work well in low light. In diabetes, the tiny blood vessels in the retina can get damaged. This means your retina doesn’t get enough oxygen, especially in the dark — making it harder for you to see clearly when the lights are low.
2. Colors appearing faded or washed out
Maybe your favorite red dress or a green traffic light doesn’t look as bold as it used to.
That’s because swelling in the retina (especially in the center part called the macula) can affect how you see color.
It’s like your eye’s “color filter” is getting a bit foggy — not enough to go completely colorblind, but just enough that everything seems a little dull.
3. Floaters – tiny specks or strings in your vision
These can look like small black dots, thread-like strands, or cobwebs drifting in front of your eyes — especially when you look at a bright background like the sky or a white wall.
Floaters happen when the blood vessels in your retina leak tiny amounts of blood into the gel-like part of your eye. That blood forms little specks, which cast shadows on your retina. It’s like seeing tiny dirt particles floating inside a snow globe.
4. Fluctuating vision – sometimes better, sometimes worse
This can be confusing — one moment you see clearly, the next moment everything is blurry again.
These ups and downs happen because high blood sugar levels affect the shape of your eye’s natural lens and how light bends inside your eye.
Also, fluid leaking into the retina can swell and settle over time. So, depending on the time of day or your blood sugar levels, your vision can keep changing.
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👁️ All of these are your retina’s way of whispering:
“Something’s not right. I’m being affected.”
And because these symptoms don’t cause pain or redness, people often ignore them — thinking it’s just tired eyes, screen time, or age.
But if you have diabetes, it’s especially important not to overlook these clues. Getting a regular eye exam can catch diabetic retinopathy early — before serious damage happens.
Noticing floaters, faded colors, or blurry vision with diabetes?
Get checked for diabetic retinopathy at Saijyothi Eye Hospital, Hyderabad — trusted experts in protecting your sight.
Why Does This Blurry Vision Happen?
Let me explain in simple terms:
When blood sugar is high for too long, it affects the walls of tiny blood vessels in the retina. These vessels can:
- Leak fluid or blood • Swell up • Get blocked
This creates swelling and irritation in the retina, especially in the central part called the macula. That’s what causes blurriness.
It’s like trying to take a photo with a camera that has water droplets on the lens. The image becomes unclear.
What If I Have No Symptoms? Am I Safe?
Here’s the tricky part. In the early stages, diabetic retinopathy often has NO symptoms.
That’s why I strongly recommend every diabetic patient to get an eye check-up at least once a year — even if you see perfectly fine.
Early detection can save your vision.
How Do Eye Doctors Diagnose Diabetic Retinopathy?
When you visit my clinic in Hyderabad, here’s what we usually do:
- Dilated Eye Exam: We use drops to widen your pupils and carefully examine the retina.
- Fundus Photography: We take high-resolution pictures of your retina.
- OCT (Optical Coherence Tomography): This gives a cross-sectional image of your retina and helps spot any swelling.
- Fluorescein Angiography: If needed, we inject a dye to check how blood is flowing through your retina.
These tests are painless and help us catch even the tiniest changes.
What Happens If You Ignore It?
Let me be honest — if diabetic retinopathy is ignored, it can slowly damage your eye in serious ways:
1. 🔵 Macular Edema (swelling of the central retina):
The center of your retina is called the macula — it’s what helps you see fine details like text on your phone or faces.
In diabetes, leaky blood vessels can make this area swell. That swelling blurs your sharp vision — like trying to read through water.
2. 🔴 Retinal Bleeding:
The small blood vessels in your retina can weaken and burst. When they bleed inside your eye, it blocks your vision — just like trying to look through a smudged or dirty window.
3. 🌱 Growth of Fragile New Blood Vessels (PDR stage):
In advanced stages, your eye tries to fix the damage by growing new blood vessels. But these new ones are weak and break easily — causing even more bleeding and damage.
4. 💧 Vitreous Hemorrhage (bleeding into the eye gel):
The middle of your eye is filled with a clear gel called the vitreous. If blood leaks into this gel, your vision can suddenly go dark or cloudy — like ink spreading through water.
5. 🪢 Retinal Detachment:
Scar tissue from bleeding or abnormal vessels can pull on your retina and make it peel away from the back of the eye. This is very dangerous — like wallpaper peeling off a wall. If it’s not fixed quickly, it can cause permanent vision loss.
6. 🚫 Complete Vision Loss:
Over time, all this damage adds up. If not treated, it can lead to total blindness.
That’s why regular eye checkups — especially if you have diabetes — are not just a formality. They’re your best protection. Once vision is lost from diabetic retinopathy, it’s very hard to get it back.
Can Diabetic Retinopathy Be Treated?
Yes! And especially in the early stages, treatment is very effective.
Here’s how we manage it:
- Control Blood Sugar: The number one step. Keeping HbA1c levels under control slows down damage.
- Manage Blood Pressure and Cholesterol: These increase the risk.
- Laser Treatment: Stops or slows the leakage of fluid from vessels.
- Anti-VEGF Injections: These are given inside the eye to reduce swelling and stop abnormal vessels from growing.
- Vitrectomy Surgery: Done in advanced cases to remove blood or scar tissue from the eye.
⇒Can It Be Prevented?
Absolutely. Prevention is the best treatment.
Here is my personal prevention checklist for all diabetic patients:
✓ Check sugar levels regularly
✓ Take medications on time
✓ Eat a balanced diet (low sugar, more vegetables)
✓ Exercise 30 minutes daily
✓ Avoid smoking and alcohol
✓ Visit an eye doctor once a year
Stick to this, and you protect not just your eyes, but your overall health.
FAQs: Real Questions from My Patients
1.Can eye drops treat diabetic retinopathy?
No. Eye drops won’t help here. This is a deeper issue in the retina that needs internal treatment.
2.Is diabetic retinopathy reversible?
Early damage can stabilize and sometimes improve with good sugar control. But advanced stages need medical treatment.
3.Will glasses help with blurry vision?
Not if the blurriness is caused by retinal swelling. Glasses can’t fix that — you need proper eye care.
4.Can I ignore blurry vision if it goes away later?
No, please don’t ignore it. Blurry vision that comes and goes is often the first warning sign. Come in for a check-up.
5.How often should I see an eye specialist?
Once a year minimum. More frequently if changes are found.
A Final Word from Dr. Advaith Sai Alampur
I know diabetes already demands a lot of you — food control, medicines, sugar checks. Adding one more thing may feel hard.
But your eyes are priceless. You use them every moment of every day.
A 30-minute eye check once a year can literally save your sight.
So here’s my humble request: if you’ve noticed even a small change in your vision, please don’t ignore it. And even if your vision seems perfect, get your eyes checked every year.
If you’re in or near Hyderabad, I’d be happy to meet you and guide you through everything gently.
Take care. Stay healthy. And see clearly.
⇒About Dr. Advaith Sai Alampur.
Dr. Advaith Sai Alampur is a trusted ophthalmologist in Hyderabad with special expertise in diabetic eye diseases. Known for his patient-first approach and simple explanations, Dr. Advaith is dedicated to spreading awareness and offering the most advanced eye care solutions.
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If this blog helped you, please share it with a friend or family member who has diabetes. You could save their sight.
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AUTHOR
Ophthalmologist/ Eye Surgeon 13+ Years Exp
MBBS, MS – Ophthalmology
TSMC- TSMC/FMR/05251 (2018)
CONDITION
CALL US 24/7 FOR ANY HELP
GET IN TOUCH ON
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