Diabetic retinopathy actually occurs as a result of changes in the microvascular environment of the retina in the eye.  Although diabetic retinopathy is mostly asymptomatic, some noticeable features of this disease include microaneurysms, hemorrhages, soft exudates or microinfarctions, hard exudates or macular edema, intra-retinal microvascular abnormalities (IRMA) and dilation, constriction and tortuosity of blood vessels.

Depending on the severity of the disease, diabetic retinopathy can be divided into three categories.

1. Pre-proliferative or non proliferative diabetic retinopathy: In this, the smaller blood vessels or capillaries present inside the eye cannot tolerate excess concentrations of sugar in the blood. This results in over accumulation of glucose in the eye. Important features of this condition include vascular obstruction, infarctions of the retinal nerve fiber ending and presence of cotton wool spots.
2. Proliferative retinopathy: As the disease progresses, severe non proliferative condition gets transformed into an advanced or proliferative stage. This stage is characterized by neovascularization or formation of new blood vessels inside the vitreous humor that can lead to hemorrhage and retinal detachment. Another condition that occurs in this stage is the neovascular glaucoma.
3. Maculopathy: Also known as macular edema, this condition occurs when damaged blood vessels in the eye cause leaking of fluids and lipids into the macula that makes the region swell, thereby resulting in blurred vision

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