Stages - Diabetic retinopathy

Diabetic retinopathy develops in stages.

There are 3 main stages of diabetic retinopathy. You may not experience all of these.

Stage 1: background retinopathy

Tiny bulges have appeared in the blood vessels in the back of your eyes (retina). These may leak small amounts of blood. This is very common in people with diabetes.

At this stage:

  • your sight is not affected but you're at a higher risk of developing vision problems in the future
  • you do not need treatment, but you'll need to take care to prevent the problem getting worse
  • there is a 1 in 4 chance of it progressing to stage 2 or 3 within three years if both of your eyes are affected

Stage 2: pre-proliferative retinopathy

More severe and widespread changes are seen in the retina. These could include bleeding into the retina.

At this stage:

  • there's a high risk that your vision could eventually be affected
  • you'll usually have more frequent screening appointments (every 3 to 6 months) to check your eyes

Stage 3: proliferative retinopathy

This means that new blood vessels and scar tissue have formed on your retina. This can cause significant bleeding and lead to retinal detachment. This is where the retina pulls away from the back of the eye.

At this stage:

  • there's a very high risk you could lose your vision
  • treatment will be offered to stabilise your vision as much as possible. But it may not be possible to restore any vision you've lost

Diabetic maculopathy

In some cases, the blood vessels in the central area of the retina (macula) can also become leaky or blocked. This is known as diabetic maculopathy.

If this is detected:

  • there's a high risk that your vision could eventually be affected
  • you may need more frequent specialised testing to check your eyes
  • you will be referred to a hospital specialist. They will discuss treatments that can help stop the problem getting worse

Read more about treating diabetic retinopathy

Results of your screening test

If you've had a diabetic eye screening test, you'll be sent a letter stating that you have one of the following:

No retinopathy

This means no signs of retinopathy were found.

You are at very low risk of developing any vision problems in the next 12 months. You should attend your next screening appointment in 12 months.

If you have a 'no retinopathy' result in 2 consecutive years it means you have a very low risk of developing vision problems in 24 months.

You will be called for your next screening appointment in 24 months.

Background retinopathy

This means you have minor signs of retinopathy. You do not need treatment, but you'll need to take care to prevent the problem getting worse.

Information:

It's important that you go to your usual screening appointment next year.

Pre-proliferative retinopathy

This means you have changes to your retina due to diabetes. You will be referred to an eye specialist in a diabetic retinopathy clinic. They will send you an appointment letter so you can be closely monitored.

Proliferative retinopathy

This means you have significant changes to your retina which may result in loss of vision.

An urgent referral, usually within 2 to 4 weeks, will be made on your behalf to an ophthalmology clinic. It is important that you attend this appointment for treatment.

Diabetic macular oedema

Blood vessels have leaked fluid into the centre of your retina causing swelling.

A referral will be made on your behalf to an ophthalmology clinic. It is important that you attend this appointment for treatment.


Content supplied by the NHS and adapted for Ireland by the HSE

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This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 123.

Page last reviewed: 17 November 2020
Next review due: 17 November 2023

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