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Stages of Diabetic Retinopathy

Stages of Diabetic Retinopathy: Where Green Laser Treatment Is Required

Diabetic retinopathy is a progressive eye disease caused by long-term diabetes and is one of the leading causes of preventable blindness worldwide. Many patients lose vision not because treatment is unavailable, but because they do not understand the stages of diabetic retinopathy and delay care until the disease becomes advanced.

Knowing what are the stages of diabetic retinopathy, how symptoms change at each stage, and where green laser treatment is required can make the difference between preserved vision and permanent vision loss. At Dr Harsh Inder Retina Center, patients are educated about each stage so they can seek timely, sight-saving treatment.

What Is Diabetic Retinopathy and Why Does It Occur?

Diabetic retinopathy occurs when persistently high blood sugar damages the tiny blood vessels of the retina. Over time, these vessels may leak fluid, become blocked, or grow abnormally, reducing oxygen supply to the retina.

Key risk factors include:

  • Long duration of diabetes
  • Poor blood sugar control
  • High blood pressure or cholesterol
  • Pregnancy and kidney disease

Early diagnosis through regular eye screening at specialized centers like Dr Harsh Inder Retina Center can prevent severe vision loss in most cases.

What Are the Stages of Diabetic Retinopathy?

The different stages of diabetic retinopathy are classified based on the severity of retinal blood vessel damage. Each stage has specific signs, symptoms, and treatment requirements.

Stages and Treatment Needs

Stage

Retinal Changes

Common Symptoms

Laser Treatment

Mild NPDR

Microaneurysms

None

❌ No

Moderate NPDR

Vessel leakage, swelling

Mild blur

❌ Usually No

Severe NPDR

Blocked vessels, ischemia

Vision fluctuation

⚠️ Sometimes

Proliferative DR (PDR)

Abnormal new vessels

Severe vision loss

✅ Yes

Stage 1: Mild Non-Proliferative Diabetic Retinopathy

What happens at this stage?

  • Small balloon-like swellings (microaneurysms) appear
  • Minimal leakage of blood or fluid

Symptoms

  • Usually asymptomatic
  • Vision often remains completely normal

Treatment approach

  • No laser treatment required
  • Focus on diabetes control and annual retinal exams

👉 Tip: Even without symptoms, skipping eye exams can allow silent progression.

Stage 2: Moderate Non-Proliferative Diabetic Retinopathy

How does the disease progress?

  • Blood vessels weaken and leak more fluid
  • Retinal swelling may increase

Symptoms of diabetic retinopathy by stage

  • Mild blurred vision
  • Difficulty reading or focusing

Is green laser treatment needed?

  • Not routinely
  • May be advised only if diabetic macular edema develops

Most patients are managed with close monitoring, OCT scans, and angiography, as practiced at Dr Harsh Inder Retina Center.

Stage 3: Severe Non-Proliferative Diabetic Retinopathy

Why is this stage dangerous?

  • Many blood vessels become blocked
  • Retina receives insufficient oxygen (ischemia)
  • High risk of progression to advanced disease

Symptoms

  • Fluctuating or worsening vision
  • Dark spots or shadows

Role of green laser treatment

  • May be recommended selectively
  • Used to treat ischemic retinal areas and prevent progression

At this stage, retina specialists carefully evaluate angiography results before deciding laser treatment.

Stage 4: Proliferative Diabetic Retinopathy (PDR)

What defines proliferative diabetic retinopathy?
This is the most advanced and sight-threatening stage.

  • Abnormal new blood vessels grow on the retina
  • These vessels are fragile and bleed easily
  • High risk of vitreous hemorrhage and retinal detachment

Symptoms

  • Sudden vision loss
  • Multiple floaters
  • Severe blurring or black patches

Who Needs Green Laser Treatment?

Green laser treatment is required for:

  • Patients with proliferative diabetic retinopathy (PDR)
  • Selected cases of severe NPDR with retinal ischemia
  • Patients at high risk of retinal bleeding or vision loss

Early intervention at advanced retina centers such as Dr Harsh Inder Retina Center significantly reduces the risk of permanent blindness.

Where Is Green Laser Treatment Required in Diabetic Retinopathy?

What is green laser treatment?

Green laser treatment, medically known as pan-retinal photocoagulation (PRP), uses focused laser burns to treat damaged peripheral retina.

Why is it used?

  • Shrinks abnormal blood vessels
  • Reduces oxygen demand of the retina
  • Prevents severe vision-threatening complications

Retina specialists worldwide consider PRP the gold standard treatment for proliferative diabetic retinopathy.

How Does Green Laser Treatment Work? (Before vs After)

Before Laser

After Laser

Abnormal vessels continue growing

Vessel growth regresses

High bleeding risk

Reduced bleeding risk

Progressive vision loss

Vision stabilized

High chance of blindness

Blindness risk significantly reduced

Procedure overview:

  • Eye is numbed with drops
  • Laser applied to peripheral retina
  • Outpatient procedure (15–30 minutes)
  • Minimal downtime

Green Laser vs Anti-VEGF Injections: What’s the Difference?

Feature

Green Laser

Anti-VEGF Injections

Purpose

Prevents vessel growth

Reduces swelling & leakage

Duration

Long-term effect

Temporary

Frequency

Usually 1–2 sessions

Repeated injections

Best for

Proliferative DR

Macular edema

Many patients benefit from combination therapy, depending on disease severity.

Latest Advancements in Laser Treatment for Diabetic Retinopathy

Recent developments have improved patient comfort and outcomes:

  • Pattern scan laser for faster treatment
  • Reduced pain laser protocols
  • Better imaging-guided laser accuracy

Conclusion

Understanding the stages of diabetic retinopathy helps patients take action before irreversible damage occurs. While early stages require monitoring and diabetes control, green laser treatment becomes essential in advanced stages to preserve vision.

👉 If you have diabetes, don’t wait for symptoms. Book a retinal screening with a qualified retina specialist today and protect your eyesight early.

Frequently Asked Questions (FAQs)

1. What are the stages of diabetic retinopathy?

They include Mild NPDR, Moderate NPDR, Severe NPDR, and Proliferative Diabetic Retinopathy.

2. At which stage is green laser treatment required?

Green laser treatment is mainly required in proliferative diabetic retinopathy.

3. Can green laser treatment restore vision?

It prevents further vision loss but usually does not restore lost vision.

4. Is green laser treatment safe?

Yes, it is a proven, safe procedure when performed by trained retina specialists.

5. How often should diabetic patients get eye checkups?

At least once a year, or more frequently if retinopathy is detected.

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