Diabetic retinopathy and diabetic eye disease in San Antonio
Protect your vision with regular dilated eye exams, and know what to watch for
If you have diabetes, your eyes need regular check-ups, even when your vision seems fine. Diabetic retinopathy, damage to the blood vessels of the retina, is the most common diabetic eye disease and a leading cause of vision loss in working-age adults. It often has no symptoms in the early stages, but it can be found with a dilated eye exam and treated, and early care greatly reduces the risk of serious vision loss. At San Antonio Eye & Face Institute, Dr. Maria Isabel Triana and Dr. Relief Jones, III perform comprehensive diabetic eye exams, monitor your retina, treat related problems such as cataracts and glaucoma, and coordinate with retina specialists when you need injections or laser. Se habla español.
Get care right away if you notice sudden vision loss, a sudden shower of new floaters, flashes of light, or a curtain or shadow over part of your vision. These can be signs of bleeding in the eye or a retinal detachment. Call us at (210) 485-1488.
Reviewed by Dr. Maria Isabel Triana, M.D. · Last updated: November 1, 2026
At a glance
| What it is | Damage to the retina’s blood vessels caused by high blood sugar over time |
| Who’s at risk | Anyone with type 1 or type 2 diabetes. Risk rises the longer you have diabetes |
| Symptoms | Often none early. Later: floaters, blurry or fluctuating vision, dark areas, vision loss |
| How it’s found | A dilated eye exam, often with imaging (OCT and retinal photos) |
| How often to be checked | At diagnosis (type 2) or within about 5 years (type 1), then at least yearly, or as advised |
| Treatment | Blood sugar, blood pressure, and cholesterol control; and for more advanced disease, eye injections, laser, or surgery |
| At our practice | Diabetic eye exams and monitoring; cataract and glaucoma care; coordinated retina care |
| Spanish | Se habla español (Dr. Jones and Dr. Triana both speak Spanish) |
What is diabetic eye disease?
Diabetic eye disease is a group of eye conditions that can affect people with diabetes:
- Diabetic retinopathy: damage to the blood vessels of the retina. This is the most common type, and the terms are sometimes used interchangeably.
- Diabetic macular edema (DME): swelling in the center of the retina (the macula), which can blur your central vision
- Cataracts: clouding of the lens, which tends to develop earlier in people with diabetes
- Glaucoma: including neovascular glaucoma, a severe type caused by abnormal blood vessels in the eye
How diabetic retinopathy develops
The retina is the light-sensing tissue at the back of your eye, and it depends on tiny blood vessels. When blood sugar stays high, these vessels are damaged over time:
- Leaking. The vessel walls weaken and form small bulges called microaneurysms, which can leak fluid and blood into the retina.
- Blocked vessels. Some vessels close off, depriving areas of the retina of oxygen.
- A growth signal. The oxygen-starved retina releases a protein called vascular endothelial growth factor (VEGF).
- Abnormal new vessels. VEGF stimulates the growth of new, fragile blood vessels that bleed easily.
- Complications. These vessels can cause bleeding inside the eye (vitreous hemorrhage), scar tissue that can pull on and detach the retina, and swelling in the macula, which can lead to serious vision loss or blindness if untreated.
Diabetic retinopathy usually affects both eyes.
Stages of diabetic retinopathy
| Stage | What’s happening | Symptoms |
|---|---|---|
| Mild nonproliferative (NPDR) | A few microaneurysms | Usually none |
| Moderate NPDR | More vessel blockage and leaking | Often none |
| Severe NPDR | Many blocked vessels; high risk of progression | Possibly some blurring |
| Proliferative (PDR) | Abnormal new vessels grow and can bleed | Floaters, sudden vision loss |
| Diabetic macular edema | Swelling in the macula (can occur at any stage) | Blurry or distorted central vision |
Symptoms
Early diabetic retinopathy often has no symptoms. There’s no pain, and your vision may seem normal, which is why you can’t tell whether you have it by how you see. As it progresses, you may notice:
- Floaters or dark spots
- Blurry or fluctuating vision
- Dark or empty areas in your vision
- Trouble seeing colors, or difficulty seeing at night
- Sudden loss of vision (from bleeding in the eye)
Who is at risk?
Anyone with type 1 or type 2 diabetes can develop diabetic retinopathy. Risk is higher with:
- Longer duration of diabetes
- Poorly controlled blood sugar (a high A1C)
- High blood pressure and high cholesterol
- Kidney disease
- Smoking
- Pregnancy in women who already have diabetes
Roughly 1 in 3 people with diabetes has some degree of diabetic retinopathy, and diabetic retinopathy is more common among Hispanic/Latino and Black adults in the United States.Diabetic retinopathy is a leading cause of blindness in working-age adults, but it’s largely preventable with good care.
How often should you be checked?
- Type 2 diabetes: a dilated eye exam at diagnosis, then at least once a year
- Type 1 diabetes: a dilated eye exam within about 5 years of diagnosis (for children, around puberty or age 10), then at least once a year
- If retinopathy is found: more often, as your doctor advises
- Pregnancy: see below
Even with a normal exam, don’t skip yearly check-ups, since changes can start before you notice them.
Diabetes and pregnancy
Women with type 1 or type 2 diabetes who are pregnant or planning to become pregnant should have a dilated eye exam before or early in pregnancy, with follow-up as advised, because retinopathy can progress during pregnancy. Gestational diabetes (diabetes that begins during pregnancy) by itself doesn’t usually increase the risk of diabetic retinopathy, but tell your doctor, who will decide whether you need an exam.
How we diagnose diabetic eye disease
A diabetic eye exam is a complete, dilated exam:
- Vision and eye pressure check
- A dilated retina exam, with drops that widen your pupils so the doctor can see the whole retina
- Imaging. We offer optical coherence tomography (OCT) to look for swelling in the macula, and retinal photos to document changes and track them over time
- Additional testing, such as fluorescein angiography, may be done by a retina specialist when needed
Your vision will be blurry and sensitive to light for a few hours after dilation, so bring sunglasses and consider having someone drive you. Bring a list of your medications, your most recent A1C if you have it, and the name of your primary care doctor or endocrinologist so we can share the results.
Treatment
Controlling your diabetes is the foundation. Keeping blood sugar, blood pressure, and cholesterol in your target range slows diabetic retinopathy. Work with your primary care doctor or endocrinologist on this, and don’t stop or change medicines on your own. Treatment of the eyes depends on the stage:
| Treatment | What it does | Used for |
|---|---|---|
| Monitoring | Regular dilated exams and imaging | Mild or moderate disease without swelling |
| Anti-VEGF injections | Medicine injected into the eye blocks VEGF, reducing leaking and abnormal vessels | Diabetic macular edema and proliferative disease |
| Laser treatment | Seals leaking vessels or treats areas of the retina that produce VEGF | Macular edema and proliferative disease |
| Steroid medicine | Injected or implanted to reduce swelling | Some cases of macular edema |
| Vitrectomy (surgery) | Removes blood and scar tissue from the eye | Bleeding in the eye or retinal detachment |
Treatment doesn’t restore vision that’s already lost, but it can protect what you have, and timely treatment greatly reduces the risk of severe vision loss. At our practice, we perform your diabetic eye exams and monitoring, and we coordinate with trusted retina specialists for injections, retinal laser, and retinal surgery.
Diabetes and your other eye health
- Cataracts. People with diabetes tend to develop cataracts earlier. Dr. Jones performs cataract surgery, and we’ll examine your retina first and coordinate care if you have retinopathy or macular edema, which can affect your timing and your lens choice.
- Glaucoma. Diabetes raises the risk of open-angle glaucoma, and advanced retinopathy can cause neovascular glaucoma, a serious type that needs prompt treatment. Dr. Jones is a glaucoma fellowship-trained specialist who treats complex glaucoma, including tube shunts and laser treatment.
- Dry eye. Diabetes can affect the nerves of the cornea and tear production, which can cause dry eye.
- Blurry vision from blood sugar swings. Changes in blood sugar can temporarily change the lens and blur your vision. Don’t assume it’s only your sugar, and have it checked.
Protecting your vision
- Get a dilated eye exam at least once a year, and more often if your doctor advises.
- Keep your A1C, blood pressure, and cholesterol in your target range.
- Take your diabetes medicines as prescribed.
- Don’t smoke.
- Be active and eat well, with your doctor’s guidance.
- Know the warning signs (sudden vision loss, a shower of floaters, flashes, a curtain over your vision), and call right away if they occur.
- Tell every eye doctor you have diabetes, and share your results with your primary care doctor.
Cost and insurance
A medical eye exam to check for diabetic eye disease is generally covered by Medicare and most insurance plans. Call us and we’ll check your benefits. CareCredit can be used for medical procedures at our office (terms can vary). See insurance we accept
Why choose San Antonio Eye & Face Institute
- Diabetic retinopathy research background. Dr. Triana worked as a research coordinator at the Texas Diabetes Institute at UT Health San Antonio, on a project studying the development of diabetic retinopathy in children. Read Dr. Triana’s bio
- Experience with the eye problems that come with diabetes, including cataracts, glaucoma (including complex and neovascular glaucoma), and dry eye
- Coordinated care. We share results with your primary care doctor or endocrinologist, and we work with trusted retina specialists when you need injections, laser, or surgery.
- Spanish-speaking doctors and staff. Dr. Jones and Dr. Triana both speak Spanish.
- Physician-owned, so you see your doctors from your first exam to your last follow-up.
Schedule a Diabetic Eye Exam
Call (210) 485-1488
Frequently asked questions
What is diabetic retinopathy? Diabetic retinopathy is damage to the tiny blood vessels of the retina, the light-sensing tissue at the back of the eye, caused by high blood sugar over time. The vessels can leak fluid and blood, close off, or grow abnormal new vessels, which can lead to vision loss if untreated.
What is diabetic eye disease? Diabetic eye disease is a group of eye problems that people with diabetes can develop, including diabetic retinopathy, diabetic macular edema, cataracts, and glaucoma, including a severe type called neovascular glaucoma. Diabetic retinopathy is the most common.
What are the symptoms of diabetic retinopathy? Early diabetic retinopathy often has no symptoms, and vision can seem normal. As it progresses, you may notice floaters or dark spots, blurry or fluctuating vision, dark areas in your vision, or trouble seeing colors, and sudden vision loss can occur if there is bleeding in the eye.
Can diabetic retinopathy be prevented? It cannot always be prevented, but you can lower your risk and protect your vision by keeping your blood sugar, blood pressure, and cholesterol under control, not smoking, and having regular dilated eye exams so any changes are found and treated early.
How often should I have an eye exam if I have diabetes? Adults with type 2 diabetes should have a dilated eye exam when they are diagnosed, and people with type 1 diabetes within about 5 years of diagnosis, then at least once a year, or more often if retinopathy is found. Your doctor will set the right schedule for you.
Why do I need my eyes dilated for a diabetic eye exam? Dilating drops widen your pupils so your doctor can see the whole retina, where early diabetic changes begin. Your vision may be blurry and light-sensitive for a few hours, so bring sunglasses and consider having someone drive you.
Will I go blind from diabetic retinopathy? Most people with diabetes do not go blind. Severe vision loss can usually be prevented or reduced when diabetic eye disease is found early and treated, which is why regular exams matter even when your vision seems fine.
What is diabetic macular edema? Diabetic macular edema is swelling in the macula, the central part of the retina that you use for reading and seeing detail, caused by leaking blood vessels. It can happen at any stage of diabetic retinopathy and causes blurry or distorted central vision, and it is treatable.
How is diabetic retinopathy treated? Treatment starts with controlling blood sugar, blood pressure, and cholesterol. Mild disease may only need monitoring, while more advanced disease can be treated with eye injections, laser treatment, steroid medicine, or surgery, depending on the type and severity.
Are eye injections for diabetic eye disease painful? The eye is numbed first, and most patients feel pressure or brief discomfort rather than pain. The injections are quick, and your doctor will explain what to expect.
Can diabetes cause cataracts? Yes. People with diabetes tend to develop cataracts earlier and more often. Cataract surgery can restore clear vision, but your retina should be examined first, and any diabetic retinopathy or macular edema should be evaluated and treated before or around surgery.
Can diabetes cause glaucoma? Diabetes is linked to a higher risk of open-angle glaucoma, and advanced diabetic retinopathy can cause neovascular glaucoma, a severe type caused by abnormal blood vessels growing in the eye. Regular exams that include eye pressure checks help catch both.
Can high or low blood sugar make my vision blurry? Yes. Swings in blood sugar can temporarily change the shape of the lens and blur your vision. But blurry vision can also be a sign of retinopathy or macular edema, so do not assume it is only your blood sugar, and have it checked.
I am pregnant and have diabetes. Do I need an eye exam? Yes. Women with type 1 or type 2 diabetes who are pregnant or planning to become pregnant should have a dilated eye exam before or early in pregnancy and follow-up as advised, because retinopathy can progress during pregnancy. Gestational diabetes by itself does not usually increase the risk of retinopathy, but tell your doctor.
Does insurance cover diabetic eye exams? A medical eye exam to check for diabetic eye disease is generally covered by Medicare and most insurance plans, though coverage for routine vision exams and glasses can differ. Call our office and we will check your benefits.
Does your practice treat diabetic eye disease? Our ophthalmologists perform comprehensive dilated eye exams for people with diabetes, monitor diabetic eye disease, and treat related conditions such as cataracts and glaucoma. For treatments such as eye injections or retinal laser, we coordinate your care with trusted retina specialists.
Do you speak Spanish? Yes. Both Dr. Jones and Dr. Triana speak Spanish, and se habla español at our office.
This page is for general education and isn’t medical advice. Only an eye doctor can tell whether you have diabetic eye disease and recommend treatment. Never stop or change your diabetes medicines without talking to your doctor