Why Diabetic Retinopathy Often Goes Undiagnosed
Submitted by Michael J. Elman, M.D. on November 15, 2025
Diabetic retinopathy is one of the most common and serious complications of diabetes, yet it frequently goes undetected until significant vision loss occurs. At Elman Retina Group in Baltimore, our board-certified retina specialists see many patients who had no idea they had retinal damage until advanced changes were discovered during an eye exam. Understanding why diabetic retinopathy often progresses silently is crucial for protecting your eyesight before permanent damage occurs.
A Silent Disease in Its Early Stages
In its earliest stages, diabetic retinopathy causes no pain or noticeable vision changes. High blood sugar damages the tiny blood vessels in the retina gradually, leading to small leaks or blockages that the patient cannot feel. Since central vision often remains clear until the disease advances, many individuals assume their eyes are healthy, particularly if they are not experiencing symptoms such as blurry vision or floaters. By the time vision changes occur, significant retinal damage may have already developed.
Why Routine Eye Exams Matter
The only way to detect diabetic retinopathy early is through a comprehensive dilated eye exam performed by a retina specialist. Advanced imaging technologies, such as optical coherence tomography (OCT) and fluorescein angiography, allow our doctors to see subtle changes in retinal blood vessels that can’t be seen with the naked eye. Unfortunately, many people with diabetes skip these annual exams, believing that a regular vision check is sufficient. Routine screenings for glasses or contacts do not evaluate the retina thoroughly and cannot diagnose diabetic retinopathy.
The Role of Systemic Health and Risk Factors
Certain factors increase the likelihood of undiagnosed retinal disease. Patients who have had diabetes for many years, or who have poorly controlled blood sugar, blood pressure, or cholesterol, face a higher risk. Even with good diabetes management, small fluctuations in glucose levels over time can still damage retinal blood vessels. Pregnant women with diabetes also require more frequent monitoring, as hormonal changes can accelerate retinopathy.
Why Early Detection Makes a Difference
When caught early, diabetic retinopathy can often be managed effectively with medications, laser treatments, or injections that help stabilize or even improve vision. However, untreated advanced disease can lead to irreversible blindness. The sooner treatment begins, the greater the chance of preserving vision and maintaining independence.
Protect Your Eyes with Expert Retinal Care
Diabetic retinopathy may not announce itself with pain or symptoms, but the consequences of waiting can be severe. At Elman Retina Group, our retina specialists in Baltimore, Pikesville, and Glen Burnie, Maryland use the most advanced diagnostic imaging and treatment methods to detect early damage and prevent vision loss. If you have diabetes, schedule a comprehensive eye exam today by contacting us at (410) 686-3000. Early diagnosis is the best defense for your vision.
