Stages - Diabetic retinopathy

Diabetic retinopathy develops in stages over time.

If you're diagnosed with diabetic retinopathy after diabetic eye screening, lifestyle changes and treatment can reduce the chance of the problem progressing.

The main stages of diabetic retinopathy are described below. You will not necessarily experience all of these.

Stage 1: background retinopathy

This means that tiny bulges (microaneurysms) have appeared in the blood vessels in the back of your eyes (retina), which may leak small amounts of blood. This is very common in people with diabetes.

At this stage:

• your sight is not affected, although you have 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 – read more about preventing diabetic retinopathy
• the chances of your sight getting worse are higher if both of your eyes are affected

Stage 2: pre-proliferative retinopathy

This means that more severe and widespread changes are seen in the retina, including bleeding into the retina.

At this stage:

• there's a high risk that your vision could eventually be affected
• you'll usually be advised to have more frequent screening appointments every 3, 6, 9 or 12 months to monitor your eyes

Stage 3: proliferative retinopathy

This means that new blood vessels and scar tissue have formed on your retina, which can cause significant bleeding and lead to retinal detachment, 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, although it will not be possible to restore any vision you've lost

Diabetic maculopathy

In some cases, the blood vessels in the part of the eye called the macula (the central area of the retina) 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 testing
• we may do a more detailed check of your eyes using a different type of camera which is sometimes called an optical coherence tomography (OCT) scan
• you may be referred to a hospital specialist to discuss treatments that can help stop the problem getting worse

Read more about treating diabetic retinopathy.

Which stage am I at?

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 and you should attend your next screening appointment when invited
• background retinopathy – this means you have stage 1 retinopathy and should attend your next screening appointment in 12 months; you may be seen sooner if your diabetes is not well controlled
• degrees of referable retinopathy – this means you have stage 2 or 3 retinopathy, or diabetic maculopathy, and should have more frequent tests or be referred to a specialist about possible treatments