Skip to main content
Home » What’s New » The 4 Stages of Diabetic Retinopathy

The 4 Stages of Diabetic Retinopathy

close up old man with brown eyes 23 2148783564

061022 1568×1045

Diabetes is a widely recognized disease, with its most common subsequent health risks well known to the public. However, diabetic retinopathy, an eye disease diabetics are vulnerable to, is not as well-recognized as other diabetic complications, often leading to many cases of preventable blindness.  Nearly all patients with type 1 diabetes and >60% of patients with type 2 diabetes have some form of retinopathy. The disease has four main stages that are more easily treatable when detected early on, especially through preventative measures.

According to the American Academy of Ophthalmology, diabetic retinopathy is an eye disease that occurs when high blood sugar levels cause damage to blood vessels in the retina. The affected blood vessels can sometimes swell and leak, or they can close, which causes a blockage and prevents blood from passing through.

Early detection is vital to a patient’s eye health and to avoid the most severe stages of diabetic retinopathy. The ability to efficiently and effectively detect the disease makes an immense difference. Below is a look at the risks that come with diabetic retinopathy stages, how each stage manifests itself, and what medical solutions exist to prevent this from occurring.


Who is at risk for diabetic retinopathy?

Anyone with diabetes, either type 1, type 2, or gestational, can develop diabetic retinopathy. The better a patient controls their blood sugar, the less risk there is. But, the longer a patient has diabetes, the more likely it is to occur. The early diabetic retinopathy stages are the best time to detect and treat the disease, which means that both diabetic patients and doctors alike should take advantage of retinal imaging.

Researchers have found that nonproliferative diabetic retinopathy (NPDR) was present in 25% of patients 5 years after they were diagnosed with diabetes, 60% at 10 years, and 80% at 15 years. These studies also found that the incidence of proliferative diabetic retinopathy (PDR) varied from 2% in those who had diabetes for less than 5 years to 15.5% in those who had diabetes for 15 or more years.

While diabetic retinopathy is a common risk all diabetic patients face, technological advancements in the medical field have now made retinal screenings more accessible, which in turn will help to shorten diagnoses timelines and help provide better quality care.  Taking precautionary measures to put an end to preventable blindness should be top-of-mind for both providers and patients.


The Four Stages of Diabetic Retinopathy

The four diabetic retinopathy stages are classified as mild, moderate, and severe nonproliferative and proliferative.

Baseline – No Diabetic Retinopathy is found: Non-proliferative diabetic retinopathy (NPDR)

normal fundus

Normal Fundus

  1. Mild NPDR



In the first of the diabetic retinopathy stages, patients will experience balloon-like swelling in certain areas of the blood vessels in the retina called microaneurysms. This stage rarely affects vision or needs treatment, but does signal diabetes damage has occurred and that there is increased risk of progression that can decrease vision.

At this stage, it is the patient’s responsibility to get educated on the possible ramifications of diabetes, while taking steps to better control their blood sugar and diet.

  1. Moderate NPDR

Moderate NPDR

Moderate NPDR

The second diabetic retinopathy stage is marked by damage to some of the blood vessels in the retina where there is leakage of blood and fluid into the retina tissue. This fluid can cause a loss of vision.

The use of fundus photography can allow patients to receive a quick evaluation. Referral to a specialist for further evaluation and possible treatment may be appropriate and recommended. Better control of blood sugar and obtaining further evaluation are key to potentially improving your sight.

  1. Severe NPDR

Severe NPDR

Severe NPDR

If there is inadequate control of your diabetes, more blood vessels are blocked with even more leakage of blood and fluid into the retina and the resulting much greater impact on vision. At this stage, a timely referral to an eye specialist is nearly always needed. The good news is that often the lost vision can be improved with appropriate treatment

  1. Proliferative Diabetic Retinopathy

Proliferative Diabetic Retinopathy

Proliferative Diabetic Retinopathy

The fourth and final stage of Diabetic Retinopathy is called Proliferative Diabetic Retinopathy. At this point, the disease has advanced significantly and is very threatening to one’s vision. Due to the damage to the eye’s normal blood vessels, there is poor circulation inside the eye. The retina then grows new blood vessels, however, they are abnormal and can cause severe damage possibly resulting in vision loss and potentially blindness.

At this stage, patients require immediate referral to a retina specialist for further examination and treatment.


How do you ensure early detection of diabetic retinopathy?

Taking proactive steps to prioritize one’s eye care by scheduling annual diabetic retinal evaluations is vital to both detect and treat diabetic retinopathy at its early stages.

These crucial retinal evaluations can detect harmful conditions prior to any major deterioration in a patient’s vision, while also providing time to develop a treatment plan of action. This action plan can then provide a guideline for both patients and providers, ensuring a holistic understanding and treatment of how a patient’s diabetes is affecting their overall health.


Click HERE for our updated COVID-19 Policy