Diabetic retinopathy is damage to the tiny blood vessels in the retina, the light-sensitive layer at the back of the eye, caused by high blood sugar. Treatment depends on how far it has progressed: in early stages the usual plan is regular dilated eye exams, and in later stages the standard options are laser treatment, eye injections and surgery, which aim to keep your vision from getting worse. As of October 2026, the NEI diabetic retinopathy page from the National Eye Institute lists injections, laser treatment and surgery as the treatments.
What is diabetic retinopathy, and how does diabetes affect your eyes?
The NEI diabetic retinopathy page describes it as an eye condition that can cause vision loss and blindness in people who have diabetes. It affects the blood vessels in the retina.
Here is how the NEI explains the process. High blood sugar changes the tiny blood vessels that go to the retina. Blood has a harder time flowing, so some vessels block and leak fluid or bleed. To make up for the blocked vessels, the eye grows new ones that do not work well and can leak or bleed easily.
Diabetes can also affect your eyes in other ways. The NEI says having diabetes makes you 2 to 5 times more likely to develop cataracts, and nearly doubles your risk of open-angle glaucoma. The NIDDK page on insulin resistance and prediabetes notes that type 2 diabetes can affect almost every part of your body, including your heart, eyes, kidneys, and nerves.
What are the first signs of retinopathy?
Early retinopathy usually causes no symptoms. The NEI says some people notice trouble reading or seeing faraway objects, and these changes may come and go. The Prevent Blindness Iowa guest column on treatment adds that the signs can include floaters, decreased visual acuity, blurred vision and decreased color vision, and that retinopathy can be present without symptoms even in advanced stages.
Later signs are more serious. When blood vessels bleed into the vitreous (the gel that fills the eye), the NEI says you may see dark, floating spots or streaks that look like cobwebs. Sometimes the spots clear on their own, but the NEI says to get treatment right away.
The NEI says that if you have diabetes, you should get a comprehensive dilated eye exam at least once a year. That exam is the way to find early changes.
How long does it take for diabetes to cause retinopathy?
None of these pages give a fixed timeline. The NEI says your risk rises the longer you have diabetes, and that over time more than half of people with diabetes will develop diabetic retinopathy. The Iowa column says the retinal vessels become damaged slowly, over years.
Screening timing depends on the type of diabetes. The Iowa column says people with type 1 diabetes should start screening within five years of diagnosis, and people with type 2 should have a first eye exam at the time of diagnosis. Women with diabetes who become pregnant can develop retinopathy and vision loss much more rapidly, so they need more frequent exams.
Does diabetic retinopathy ever go away?
The NEI says treatment will not undo damage to your vision, but it can stop your vision from getting worse. That is the goal of the treatments below: protect the vision you still have.
Some changes can settle. The NEI notes that bleeding spots sometimes clear up on their own, though they still need prompt treatment. The Iowa column says that once full laser treatment is completed, its effect is permanent. It also says that proliferative retinopathy and macular edema can lead to permanent vision loss if they are not treated.
What is the treatment for a leaking blood vessel in the eye?
The NEI says that in later stages it is important to start treatment right away, especially if your vision has changed. The main options are laser, injections and surgery. The table below sets them side by side. Which one fits depends on the stage, whether there is swelling in the macula (the central part of the retina used for sharp vision), whether there is bleeding, and whether you can keep up with follow-up visits. The Iowa column says a personalized plan depends on those factors.
| Option | What the pages say it does | Who it tends to suit | Cost and visits | Limits |
|---|---|---|---|---|
| Monitoring with dilated eye exams | Tracks changes so treatment starts at the right time (NEI) | Early stages, when the NEI says eye doctors usually keep track | Some people need an exam as often as every 2 to 4 months (NEI) | Does not treat leaking vessels; it watches them |
| Anti-VEGF injections | The NEI says anti-VEGF drugs can slow down diabetic retinopathy. The medicine is injected into the vitreous gel (Iowa) | Proliferative retinopathy and diabetic macular edema (Iowa); often the first choice for macular edema when the center of the macula is affected (Iowa) | Done in an office in the US; the medicine lasts a few months, so repeated injections and follow-up are often needed (Iowa) | Very small risk of cataract, raised eye pressure, bleeding, infection or a retinal tear (Iowa) |
| Corticosteroid injections | Reduce swelling (MU Health); the NEI says corticosteroids can also help | Macular edema in people who do not improve first with anti-VEGF injections (Iowa) | Repeated visits may be needed; ask your clinic for the schedule | Usually a second step, not the first (Iowa) |
| Focal laser | A less intense laser that can reduce macular edema (Iowa) | Macular edema, reserved for people who do not improve first with anti-VEGF injections (Iowa) | Usually needs fewer sessions than injections, and can be repeated (Iowa) | Used as a second step for many patients (Iowa) |
| Scatter (panretinal) laser | Shrinks blood vessels that cause vision problems (NEI); the Iowa column says it seals and destroys diseased retina to preserve healthy retina | Advanced diabetic retinopathy (NEI) | Done at an eye doctor’s office; may take more than one session. Your vision is blurry for the rest of the day, so you need someone to drive you home (NEI) | Can cause loss of peripheral (side), color and night vision (NEI); the effect is permanent (Iowa) |
| Vitrectomy (surgery) | Removes blood, fluid and sometimes scar tissue from the back of the eye (MU Health) | Heavy bleeding or many scars (NEI); vitreous hemorrhage or tractional retinal detachment (Iowa) | Done in an operating room (Iowa) | Surgery, so talk through its risks with your retina specialist |
| Blood sugar, blood pressure and cholesterol control | The NEI says meeting your A1C goal can help prevent or manage diabetic retinopathy; controlling blood pressure and cholesterol can also lower the risk | Everyone with diabetes (NEI) | Daily habits and any medicines your doctor prescribes; costs vary | Works alongside treatment; the NEI says treatment will not undo vision damage |
| Fenofibrate (investigational for this use) | The NEI says an NIH-funded team is studying whether this cholesterol medicine can stop diabetic retinopathy from getting worse | Ask your doctor whether it is relevant to you | The NEI says an NIH-funded team is studying whether this cholesterol medicine can stop diabetic retinopathy from getting worse | Still under research |
Laser treatment
The NEI’s laser treatment page for diabetic retinopathy describes scatter laser surgery, also called panretinal photocoagulation. Your doctor uses a medical laser to shrink the blood vessels causing vision problems. You get numbing medicine in your eye, and you may see flashes of light and feel stinging or discomfort. The NEI says this treatment has risks, including loss of peripheral, color and night vision, and that for many people the benefits outweigh the risks. The Iowa column says focal laser can reduce macular edema by sealing leaking vessels, and that panretinal laser can cause some tenderness during or just after the procedure.
Injections
The Iowa column describes intravitreal injections as office procedures. The eye is cleaned and numbed, and the medicine is injected through the white of the eye into the vitreous gel. The Iowa column says you usually feel pressure but often not pain. The MU Health page lists anti-VEGF medicines and steroid medicines among its treatments for swelling of the macula. Injections are a repeated treatment, so ask your retina specialist how many to expect and how follow-up will be scheduled.
Surgery
The NEI says that if your retina is bleeding a lot or has a lot of scars, your eye doctor may recommend a vitrectomy. The MU Health page describes it as surgery that removes blood and fluid leaking from the vessels in the back of the eye, and sometimes scar tissue on the retina, so the retina can focus properly again. The Iowa column says this surgery is done in an operating room.
What new treatments are being studied?
Other approaches are in development. The NEI describes an NIH-funded fenofibrate study, and a 2022 review in Frontiers in Endocrinology, “Diabetic retinopathy: Looking forward to 2030”, says new agents and gene therapy are being developed for diabetic retinopathy.
If you want to see what studies are open, the NIDDK says ClinicalTrials.gov lists federally funded, open, recruiting studies. The NIDDK also notes that the NIH does not review every listed study and cannot ensure they are safe, so ask your eye doctor before you join one.
On the legal side, the FDA page on illegally sold diabetes treatments, as captured in October 2026, says FDA issued warning letters to 15 companies. The letters say that selling their products to treat diabetes and its complications violates federal law. That page covers diabetes products generally, not retinopathy. This is general information, not legal advice.
Could I just do the routine myself?
The routine is something you can run yourself every day, and it matters. The NEI says managing your diabetes is the best way to lower your risk of diabetic retinopathy. That means keeping your blood sugar in a healthy range, getting regular physical activity, eating healthy, and following your doctor’s instructions for insulin or other diabetes medicines. The NIDDK A1C page says health care professionals may check your A1C more often if you aren’t meeting your treatment goals.
The MU Health page lists poor blood sugar management, smoking, obesity, high blood pressure and high cholesterol as risk factors you can work on. The routine lowers your risk and supports treatment. It does not replace the eye exam or a retina specialist’s care for an advanced stage.
How do I stop diabetic retinopathy from getting worse?
Four things come up across these pages. First, keep the dilated eye exams going. The NEI says some people need one as often as every 2 to 4 months. Second, keep blood sugar, blood pressure and cholesterol in your target ranges, with your doctor’s help setting targets. The Iowa column says patients with diabetes should control their blood glucose and blood pressure to prevent or slow vision-threatening retinopathy. Third, if you have diabetes and are pregnant, the NEI says to have a comprehensive dilated eye exam as soon as possible. Fourth, if your retinopathy reaches a serious stage, the Iowa column says you should be referred to a retina specialist.
Are supplements or products for diabetic eye health worth it?
The NCCIH’s fact sheet on diabetes and dietary supplements says that for most supplements there isn’t evidence to support a beneficial effect on diabetes or its complications.
One example is alpha-lipoic acid. The NCCIH describes a 2011 study of 467 people with type 2 diabetes who took either alpha-lipoic acid or a placebo for 2 years. There was no statistically significant difference between the groups in developing clinically significant diabetic macular edema. The NCCIH also says some supplements may have side effects, and that kidney damage can be serious.
The FDA’s warning is also worth reading. The FDA says it is warning consumers about products claiming to be a “natural diabetes cure,” and it describes these products as marketed illegally. The NCCIH adds that it is very important not to replace medical treatment for diabetes with an unproven health product or practice. If a supplement or product is part of your plan, bring the label to your appointment so your clinician can check it against your medicines.
How much does diabetic retinopathy treatment cost?
None of these pages give a price for laser, injections or surgery, and prices change by clinic and by insurance plan. What the pages do describe is how each treatment is delivered, which affects the bill. The Iowa column says laser and injections are outpatient, office-based procedures in the US, while vitrectomy is done in an operating room. Because injections are repeated over months, the total can add up.
Ask the clinic for an itemized estimate before treatment. Include the exam, any imaging such as optical coherence tomography (OCT) or fluorescein angiography (the MU Health page lists both), each injection or laser session, and the follow-up schedule. Check with your insurer about what it covers.
A lower price does not tell you which treatment is better for your eyes; our low price does not prove treatment value guide explains why. If a diabetes medicine is part of your plan, our ozempic cost guide covers the price of one such medicine.
Where do I find diabetic retinopathy treatment near me?
Start with your primary care clinician or endocrinologist. The MU Health page says its eye specialists work with your primary doctor or endocrinologist, and the Iowa column says patients with proliferative retinopathy or macular edema should be referred to a retina specialist. Ask for that referral directly.
When you call a retina practice, ask whether they treat macular edema and proliferative retinopathy, whether they use OCT and fluorescein angiography, who handles follow-up visits, and whether they can give you a cost estimate. Your insurer’s directory can help you find in-network clinics nearby.
What can be mistaken for diabetic retinopathy?
The NEI says a dilated eye exam checks your eyes for diabetic retinopathy and other eye problems. Diabetes can also lead to cataracts, open-angle glaucoma, neovascular glaucoma and retinal detachment, according to the NEI page. Each one has its own treatment, so a clinician needs to check for them.
Floaters and blur are signs of retinopathy too, so the way to tell them apart is an eye exam, not a guess.
Why is my vision blurry after eating if I don’t have diabetes?
That question needs a clinician.
Two checks are worth asking about. First, the CDC’s prediabetes page says you can have prediabetes for years with no clear symptoms, and that a simple blood sugar test can show whether you have it. Second, the NCCIH says about one in four adults who have diabetes don’t know it. Ask your primary care clinician for a blood sugar test, such as the A1C. Ask an eye doctor for a dilated exam at the same time.
Before you book: a checklist
Bring:
- Your most recent A1C result and your blood pressure and cholesterol numbers
- The date of your last dilated eye exam and any eye reports
- A list of every medicine and supplement you take, since the NCCIH says supplements can interact with medicines
- Notes on any vision changes, including floaters, blur, color changes or spots
Track:
- Changes in your vision, especially new dark floating spots or streaks, which the NEI says need treatment right away
- Blood sugar readings and A1C results, and whether they are in your target range
- Dates of eye exams, injections, laser sessions and follow-up visits
Ask:
- What stage my retinopathy is in, and whether I have macular edema or bleeding
- Which treatment you recommend first, and why, and what the alternatives are
- How many visits and injections to expect, and how follow-up is scheduled
- What the risks and side effects of the treatment are
- An itemized cost estimate, and what my insurance covers
- Whether any study I could join is appropriate for me
Compare: laser, injections and surgery each suit different stages. Put the cost estimate, visit schedule and side effects for each next to the others before you decide.
Next step: book a dilated eye exam this month if you have diabetes and have not had one in the past year. Bring the checklist above.
By the Integrative Health Evidence Guide Team