If you have diabetes, your eyes are at risk — even if your vision feels fine right now. Diabetic retinopathy is the leading cause of vision loss in working-age adults, and it often develops silently for years before symptoms appear. The good news: caught early, it is highly treatable.
This guide walks you through exactly what diabetic retinopathy and diabetic macular edema (DME) are, how they’re detected, what treatment looks like, and what Oregon patients need to know to protect their sight.
What Is Diabetic Retinopathy?
The retina is the light-sensitive tissue lining the back of your eye — essentially the camera film that makes vision possible. It depends on a vast network of tiny blood vessels to stay healthy. When blood sugar is elevated over time, as it is in both Type 1 and Type 2 diabetes, those vessels begin to break down.
Diabetic retinopathy is the result: damaged, leaky, or abnormal blood vessels in the retina. It progresses through two main stages.
Non-Proliferative Diabetic Retinopathy (NPDR)
In the early stage, small blood vessels in the retina weaken and begin to leak fluid or blood. Tiny bulges called microaneurysms form in the vessel walls. You may have no symptoms at all, or you may notice mild blurring. NPDR ranges from mild to severe depending on how many vessels are affected.
Proliferative Diabetic Retinopathy (PDR)
In advanced disease, the retina becomes starved of oxygen and signals the body to grow new blood vessels. Unfortunately, these new vessels are fragile and abnormal — they bleed easily, can pull on the retina, and may cause a vitreous hemorrhage (bleeding into the gel of the eye) or even a retinal detachment. This is the stage where vision loss can become sudden and severe.
What Is Diabetic Macular Edema (DME)?
Diabetic macular edema can occur at any stage of diabetic retinopathy — even early on. The macula is the central part of your retina responsible for sharp, detailed vision — the part you use for reading, driving, and recognizing faces.
When the damaged blood vessels leak fluid into the macula, it swells. That swelling is DME, and it’s the most common cause of diabetes-related vision loss. Symptoms include blurry or wavy central vision, faded colors, and difficulty reading fine print.
Many patients in Eugene, Salem, Roseburg, and across the Oregon Coast are surprised to learn they have DME — because it can develop without any noticeable pain or dramatic vision change until it becomes significant.
How Is Diabetic Retinopathy Diagnosed?
A dilated eye exam is the cornerstone of diagnosis — this is why annual eye exams are so important for anyone with diabetes. But at a retinal specialist’s practice, the evaluation goes significantly deeper.
Optical Coherence Tomography (OCT) creates high-resolution cross-sectional images of the retina, revealing even subtle fluid accumulation in the macula long before it’s visible on a standard exam. Think of it as a CT scan for your retina — except it’s non-invasive, takes only a few minutes, and is painless.
Fundus Photography captures detailed photos of the retina and optic nerve, creating a baseline that allows your doctor to track changes over time.
Fluorescein Angiography involves injecting a harmless dye into a vein and photographing how it travels through the retinal blood vessels. This reveals leakage, blockages, and areas of abnormal vessel growth with remarkable precision. This test has some risk, so its should be minimized.
Electroretinogram is a test…
Together, these imaging tools give Dr. Peter Karth and the team at Retina Care a complete picture of what’s happening inside your eye — and what needs to be done about it.
Treatment Options for Diabetic Retinopathy and DME
Anti-VEGF Injections (the Frontline Treatment for DME)
The most significant advance in treating diabetic eye disease in the past two decades is anti-VEGF therapy. VEGF stands for vascular endothelial growth factor — the protein that drives the growth of those leaky, abnormal blood vessels.
Drugs like Vabysmo (faricimab), Eylea (aflibercept), and Lucentis (ranibizumab) are injected directly into the eye in a quick, well-tolerated office procedure. They block VEGF, reducing leakage, shrinking abnormal vessels, and in many cases improving vision.
Patients often worry about eye injections — understandably. But the procedure is carefully performed with numbing drops, and the needle is far smaller than most people imagine. The vast majority of patients find it manageable, and the results can be remarkable: many people with DME regain meaningful vision after a course of treatment.
Laser Treatment
Laser photocoagulation has been used for decades to treat diabetic retinopathy. Focal laser is applied directly to leaking blood vessels in the macula to reduce swelling. Scatter (panretinal) laser treats the peripheral retina in cases of proliferative retinopathy, reducing the drive for abnormal vessel growth.
While anti-VEGF injections have largely replaced laser as the primary DME treatment, laser remains an important tool — particularly for stabilizing proliferative diabetic retinopathy.
Corticosteroid Implants
For patients who don’t respond well to anti-VEGF or who have certain other risk factors, sustained-release corticosteroid implants (such as Ozurdex or Iluvien) can be injected into the eye and slowly release medication over months. These are particularly helpful for patients who have had cataract surgery.
Vitrectomy Surgery
In advanced proliferative retinopathy — when there is significant vitreous hemorrhage (blood in the gel of the eye) or a tractional retinal detachment — surgery may be necessary. Vitrectomy removes the blood-filled gel and repairs the retina. While this is a more involved procedure, outcomes at experienced retinal surgery centers are generally very good.
The Importance of Systemic Control
No eye treatment works as well as it should if blood sugar remains poorly controlled. Retinal care and diabetes management go hand in hand. Patients who keep their HbA1c well-controlled, manage blood pressure, and follow up with their primary care provider or endocrinologist consistently do better — they need fewer injections, progress more slowly, and retain more vision long-term.
Dr. Peter Karth works closely with referring physicians throughout Oregon — from Eugene and Springfield to Roseburg, Bandon, and Coos Bay — to ensure a coordinated approach to your diabetes and your eye health.
Who Is at Risk?
Anyone with diabetes is at risk. But risk is higher if you:
- Have had diabetes for 10 or more years
- Have poorly controlled blood sugar (high HbA1c)
- Also have high blood pressure or high cholesterol
- Are pregnant and have diabetes
- Are of Hispanic, Black, or Native American descent (statistically higher rates of diabetic eye disease)
- Already have early retinopathy that has been documented
The American Academy of Ophthalmology recommends annual dilated eye exams for all people with Type 2 diabetes and within five years of diagnosis for Type 1. If you have any retinopathy, your specialist will recommend more frequent follow-up.
Why See a Retinal Specialist for Diabetic Eye Disease?
Dr. Peter Karth completed his vitreoretinal fellowship training at Stanford University and focuses exclusively on the retina. That means every procedure, every injection, every clinical decision is performed by someone who does this work every single day. Patients throughout the Willamette Valley and Oregon Coast travel to Retina Care’s clinics specifically because they want that level of focused expertise.
At Retina Care, every employee is focused on your retina and your vision.
Protecting Your Vision Starts Now
Diabetic retinopathy doesn’t have to mean vision loss. With regular monitoring, timely treatment, and good systemic diabetes management, most people with diabetic eye disease can maintain their vision for life. The key is not waiting until symptoms appear — because by then, the disease has often advanced further than it needed to and may be too late.
If you have diabetes and haven’t had a dilated eye exam in the past year, now is the time to get a dialated eye exam. If you have been diagnosed with diabetic retinopathy or have vision loss in the presence of diabetes, its time to see Dr. Peter Karth.
At Retina Care, retinal specialist Peter Karth, MD, MBA, FASRS, FACS is happy to help you with your retina concerns. Please call 541-873-8462 to schedule an appointment at a location near you.