Last updated on
11 November 2025
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Diabetes is one of the most common diseases in Singapore, with an 11.4% prevalence in adults as of 2024. As such, understanding its complications is a public health priority.
One of the possible complications of diabetes affects the eyes and is a leading cause of vision loss among diabetics today. This is diabetic retinopathy.
Often symptomless in its early stages, it may go unnoticed without regular screening. By the time vision is affected, the disease is usually more advanced and can have profound and lasting effects on a person’s quality of life.
In this article, we explain what diabetic retinopathy is, how it develops, and more.
Diabetic retinopathy is an eye condition caused by damage to tiny blood vessels in the retina.
The retina is the light-sensitive tissue found at the back of the eye. Persistently high blood sugar can injure the capillaries in that area, weakening them and causing them to leak.
Once this happens, it can set off a cycle of the blood vessels leaking, getting blocked, and then being replaced by abnormal new blood vessels as the body tries to compensate.
Diabetic retinopathy progresses in two main stages:
This is the early stage, when retinal vessels may only be leaking small amounts of fluid or blood.
It is possible for there to be no change in the patient’s vision yet. Macular swelling (swelling of the central part of the retina) can occur here as well as in the latter stage.
This is the advanced stage, when new and fragile blood vessels have already grown on the retinal surface.
These bleed easily and may cause other problems, including scarring, traction, or even retinal detachment. This can lead to severe sight loss if not treated promptly.
High glucose levels in the body damage small blood vessels in several ways.
These include narrowing the vessels and reducing their flexibility through glycation, or the binding of excess glucose in the blood to molecules in the walls of the blood vessels.
High blood sugar levels can also lead to inflammation and oxidative stress in the vessels. This damages the walls of the capillaries in the retina and can lead to leaks.
The risk of vision impairment as an outcome of this rises with a longer duration of diabetes and poor management of the condition. Other factors may also compound the problem.
For instance, high blood pressure and high cholesterol are considered further risk factors. The same is true for pregnancy in women, which can accelerate the progression of the issue.
Early diabetic retinopathy is generally asymptomatic (without symptoms). This can complicate the matter of diagnosing it early, which is preferred because it often leads to better outcomes.
This is one of the reasons people with diabetes should consider getting routine eye examinations. This applies even to diabetics whose vision appears to be normal.
It is entirely possible for a diabetic to already have the beginnings of diabetic retinopathy but simply not realise it. Fortunately, tests like dilated eye exams and assessments by eye doctors can detect the disease even before symptoms arise.
Once symptoms do present, they often include the following signs:
Abrupt and noticeable changes should prompt a patient to seek professional help immediately. A quick assessment can help lead to timely interventions.
As is largely true of the approach to managing diabetes, daily habits matter when living with diabetic retinopathy. Among other things, those with the condition should follow these steps:
The condition may also cause anxiety, as fear of losing one’s vision is a genuine concern for most people. This too should be addressed when living with diabetic retinopathy.
Aside from taking comfort in the idea that proactive management can help reduce the risk of the worst outcomes, patients can also seek support from friends and family. Regular check-ins with an eye doctor can also provide further assurance and aid.
There is no cure for diabetic retinopathy. However, modern treatments can prevent or slow its progression.
The preferred option depends on the stage of the disease and whether the macula is involved.
Monitoring and imaging are often paired with these treatments. OCT or Optical Coherence Tomography can be used to create cross-sectional images to better track the condition.
This and retinal photography are offered at ERS Suntec City. Such tests allow our ophthalmologists to better plan treatments and follow-ups. Most patients will require eye exams every 6 to 12 months as well, although it varies.
Prevention of the later-stage disease is key to managing diabetic retinopathy. It is most manageable when detected early, and becomes more complex to deal with in later stages.
Generally, diabetics should observe these rules:
This complication of diabetes may threaten sight, but early detection and proactive care can improve outcomes and reduce the risk of vision loss. Building screening into your healthcare routine offers a simple step for diabetics here.
Patients can visit ERS Suntec City to get their assessments done and get a consultation from our team of ophthalmologists. Book a consultation with us today for a comprehensive eye health evaluation and advice on protecting your vision from this complication of diabetes.
