Diabetic Eye Disease

Diabetic Retinopathy

What is Diabetic Retinopathy?

Diabetic retinopathy is an eye problem caused by diabetes mellitus (sugar diabetes).  It affects the retina, which is the light sensitive tissue at the back of the eye, like the film of the camera.  Retinopathy occurs when high blood sugar levels damage the tiny blood vessels in the retina.  This damage can lead to problems with your vision, including blindness.

However, you may be able to prevent severe vision problems if:

  • You keep you diabetes under control.
  • You have regular eye exams
  • You get early treatment for retinopathy

How does it occur?

High blood sugar levels damage the small blood vessels in the retina as well as the heart, kidneys, brain and nerve cells.  The weakened blood vessels become leaky and leak fluid into the retina. Some of the blood vessels break and bleed into the retina.  As he disease becomes more advanced, new abnormal blood vessels may grow. (Proliferative diabetic retinopathy) These new blood vessels can bleed, cause cloudy vision, and destroy the retina.

The longer you have had diabetes, the more likely you are to have retinopathy.

What are the symptoms?

Diabetic retinopathy begins before you have any symptoms.  Often people present with severe vision threatening retinopathy and no symptoms at all. As the problem gets worse you may have:

  • Blurred vision
  • Distortion of vision, where straight lines look bent or wavy
  • Floaters, which are black spots or cobweb-like shapes
  • Temporary of permanent blindness

How is it diagnosed?

The only way to diagnose diabetic retinopathy is to have someone look inside your eyes. This can be your GP, endocrinologist or optometrist. He or she will be able to see inside your eyes look for signs of retinopathy.  The best way to look for retinopathy is with colour retinal photography, which is now widely available in many optometry practices. If the photograph shows any signs of retinal bleeding or fluid leakage, they may then need to refer you to an ophthalmologist.

How is it treated?

Early treatment before the retina has been badly damaged is the most successful in reducing vision loss from the disease.

Your ophthalmologist may use a laser to seal leaking blood vessels or destroy abnormal blood vessels.

If there is fluid leaking into the macula, the centre of the retina, injections of medicine such as Avastin, Lucentis, Eylea, Ozurdex or Triamcinolone may be required. These injections have revolutionized the treatment of diabetic retinopathy since 2007 and the visual outcomes of diabetic retinopathy are now excellent if the disease is detected early.

If you have had the bleeding into the clear gel (vitreous) that fills the inside of the eye, the ophthalmologist may need to remove the blood and the gel.  The gel will be replaced with a clear fluid.  This procedure is called a vitrectomy.

How can I take care of myself?

Follow your GP’s recommendations and these guidelines:

  • Make sure you have eye exams.

Ask your GP how often your eyes should be checked.

  • Immediately tell your GP if you have any changes in your vision.

What can be done to help prevent diabetic retinopathy?

To help prevent diabetic retinopathy, follow these guidelines:

  • Control your blood sugar
  • Learn your HbA1c (your three monthly blood test)
  • Control your blood pressure
  • Stop Smoking (Smoking may speed up the development of retinopathy)

Follow your diet and health care plan for your diabetes so you have fewer complications.

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