Protecting Vision for Patients with Diabetes
Diabetic Retinopathy Treatment in Singapore
Medically reviewed by Dr Bobby Cheng
Senior Consultant Ophthalmologist
MBBS (Singapore) | MMed (Ophthalmology, Gold Medal) | FRCS (Edinburgh) | FAMS
What is Diabetic Retinopathy?
Diabetic retinopathy is a serious eye complication that affects people living with Type 1 or Type 2 diabetes. It develops when high blood sugar levels damage the blood vessels in the retina – the light-sensitive tissue at the back of the eye that transmits visual information to the brain. Over time, these vessels can leak, swell, or stimulate the growth of abnormal new vessels, gradually impairing vision.
Diabetic retinopathy progresses in two main stages:
Non-proliferative diabetic retinopathy (NPDR) – Early Stage
Blood vessels in the retina become weakened and begin to leak fluid, leading to retinal swelling. This includes macular oedema, where fluid accumulates at the centre of the retina and causes blurred or distorted vision.
Proliferative diabetic retinopathy (PDR) – Advanced Stage
New, abnormal blood vessels grow across the retina in response to poor circulation. These fragile vessels are prone to bleeding and scarring, significantly increasing the risk of retinal detachment and severe, permanent vision loss.
Who is at Risk of Diabetic Retinopathy?
Diabetic retinopathy can affect anyone diagnosed with Type 1 or Type 2 diabetes. The risk increases significantly with the duration of the condition — the longer a person has lived with diabetes, the greater the likelihood of developing some degree of retinal damage.
- Type 1 Diabetes – Individuals with Type 1 diabetes tend to be at greater risk of developing diabetic retinopathy compared to those with Type 2 diabetes.
- Poor Blood Sugar Control – Persistently high or unstable blood glucose levels are among the strongest accelerators of retinal vessel damage and disease progression.
- High Blood Pressure (Hypertension) – Uncontrolled blood pressure placed added stress on the already-vulnerable blood vessels in the retina.
- High Cholesterol – Elevated lipid levels can cause plaque buildup that narrows blood vessels, reducing the supply of oxygen and nutrients to the retina.
- Kidney Disease (Diabetic Nephropathy) – Kidney complications and retinopathy often share the same underlying microvascular pathology, making co-occurrence common.
- Pregnancy – Women with pre-existing diabetes or those who develop gestational diabetes may experience accelerated retinopathy progression, particularly during the second and third trimesters.
- Genetics – A hereditary predisposition may increase susceptibility to diabetic retinopathy, independent of other risk factors.
- Gender – Emerging research suggests that men may face a statistically higher risk of developing diabetic retinopathy than women, though the condition remains significant across all genders.
Managing your risk starts with awareness. Controlling blood sugar, blood pressure, and cholesterol — alongside regular eye screenings — remains the most effective strategy for reducing the risk of diabetic retinopathy.
Symptoms of Diabetic Retinopathy
One of the most challenging aspects of diabetic retinopathy is that it often develops without any noticeable symptoms in its early stages. As diabetic retinopathy advances, patients may experience:
Blurred or fluctuating vision
Vision that shifts in sharpness, particularly after meals or with changes in blood sugar
Dark spots, floaters, or empty areas in vision
Caused by blood or fluid leaking into the eye
Having difficulty seeing at night
Reduced contrast sensitivity and night vision
Sudden vision loss in severe cases
A potential sign of advanced proliferative diabetic retinopathy or retinal detachment requiring urgent attention.
How Diabetic Retinopathy is Diagnosed
Diagnosing diabetic retinopathy requires more than a standard eye test. Because the condition can progress silently — without noticeable symptoms — a thorough clinical assessment using advanced retinal imaging is essential for accurate staging and timely treatment planning.
Evaluates how clearly and sharply you can see at various distances.
The pupils are widened using eye drops to allow direct visualisation of the retinal blood vessels, enabling detection of leakage, swelling, or abnormal vessel growth.
A specialised camera captures high-resolution photographs of the retina, optic disc, and blood vessels to document your retinal health. These images allow your specialist to detect early changes and track disease progression accurately across follow-up visits.
A non-invasive imaging technique that produces detailed, high-resolution cross-sectional images of the retina to identify and measure macular swelling.
A specialised dye is administered to highlight the retinal blood vessels, revealing areas of leakage, blockage, or abnormal new vessel growth with precision.
Diabetic retinopathy is one of the most common causes of vision loss in people with diabetes. Early detection and treatment make a critical difference.
If you have diabetes, even without symptoms, routine eye checks are essential. We provide personalised care for patients seeking Diabetic Retinopathy treatment in Singapore, with support across all stages of the disease.
Treatment Options for Diabetic Retinopathy
Treatment for diabetic retinopathy is tailored to the stage of the disease and the extent of macular involvement. While early-stage retinopathy may be managed through careful monitoring and diabetes control, moderate to advanced stages typically require targeted medical or surgical intervention.
Intravitreal injections are among the most commonly used treatments for diabetic macular oedema and proliferative diabetic retinopathy. Anti-VEGF agents — including Lucentis, Eylea and Vabysmo or steroid medication such as Ozurdex are delivered directly into the eye to reduce swelling and inhibit abnormal blood vessel growth. The procedure is performed in-clinic under anaesthetic eye drops and is generally quick and well tolerated. Treatment begins monthly, with intervals extended as the condition responds. Regular OCT scans are used to monitor progress and guide ongoing care.
Laser therapy remains a proven and effective treatment for diabetic retinopathy. Focal or grid laser is used to seal leaking vessels in the macula and reduce swelling. For more advanced proliferative disease, panretinal photocoagulation (PRP) targets the peripheral retina to suppress abnormal vessel growth and minimise bleeding risk. Delivered in planned stages, laser treatment may cause a mild reduction in night or peripheral vision — however, its effectiveness in preventing serious vision loss is well established.
When fragile new vessels bleed into the vitreous gel, patients may experience sudden or severe vision loss. In cases where scar tissue forms and exerts traction on the retina, retinal detachment becomes a real risk. Vitrectomy surgery addresses these complications by removing the blood-laden vitreous, relieving retinal traction, and enabling direct treatment of the underlying retinal disease. This procedure is considered when vision is significantly compromised and other treatments have not been sufficient.
Treating the eye alone is not enough. Long-term outcomes are best achieved through a coordinated approach involving your eye specialist and primary care or endocrinology team. Optimising blood glucose, blood pressure, and cholesterol levels is essential to slowing disease progression. Complementary lifestyle measures — including a balanced diet, regular exercise, and smoking cessation — play a vital role in preserving vision over time.
Frequently Asked Questions About Diabetic Retinopathy
No. While it cannot be reversed, treatments can slow progression and preserve vision, especially when detected early.
At least once a year, or more frequently if retinopathy has already been detected. Your ophthalmologist will advise on the appropriate interval based on your condition.
Intravitreal injections are performed with anaesthetic eye drops. Most patients experience minimal discomfort during the procedure.
With timely diagnosis and treatment, severe vision loss can often be prevented. Early detection and consistent follow-up make a critical difference.