Diabetes & Your Eyes: A Cheat Sheet
Take away points:
Most people with diabetes will eventually develop diabetic retinopathy
Vision loss and blindness can be prevented with early detection and timely treatment
Controlling diabetes and having eye exams every year can catch retinopathy early and prevent vision loss.
It is important to take action before you notice any eye problems- prevention is better than a cure!
Diabetes can affect all parts of the body, including the eyes. If you suffer from diabetes, or have it in your family history, make sure you mention it to your optometrist. This will help them be on the look out for any tell tale symptoms or changes to your vision that may be related to diabetes.
More than 1.5 million Australians live with diabetes. Just like other parts of the body, diabetes can also affect your eyes. The most common eye condition related to diabetes is called diabetic retinopathy- a leading cause of vision impairment and blindness in Australia.
About 75% of people with diabetes eventually develop diabetic retinopathy. Symptoms usually occur within five-20 years of being diagnosed with diabetes.
Regular diabetic eye exams are essential in the management of this disease- the earlier diabetic retinopathy is diagnosed, the higher the chances of successful treatment and maintaining good vision.
How can diabetes affect my eyes?
Diabetes affects your blood circulation and fluid balance throughout your body- your eyes included. Altered circulation or fluid balance in the eyes can lead to the development of cataracts, glaucoma and diabetic retinopathy. If blood sugar levels aren't correctly controlled, or diabetes has been present for a number of years, the risk of developing a diabetic eye condition is greater.
Diabetic retinopathy occurs when high blood sugar damages the fine blood vessels in the retina, the light-sensitive lining at the back of the eye. Over time the blood vessels weaken and are blocked more easily, which causes blood leakage, swelling and inflammation in the retina.
What are the symptoms of Diabetic Retinopathy?
Often people with diabetic retinopathy are asymptomatic in the early stages- this means they don't have any obvious symptoms. This is why it is so important to have regular eye exams- we recommend yearly reviews if you are diabetic- because your optometrist can often detect minor changes before you notice any changes to your vision.
Diabetes Eye Symptoms can include:
Floaters and spots
Blank or missing areas in your vision
Difficulty seeing well at night
If you notice any of these symptoms, you should be examined by an optometrist, regardless of whether you have been diagnosed with diabetes.
The Two Stages of Diabetic Retinopathy
1. Background Retinopathy
This is the earlier stage of the condition. Weaker blood vessels have begun to leak and cause nerve fibres to swell and small internal bleeding. Detecting background retinopathy in this early stage is crucial so that appropriate measures can be taken to minimise disease progression to the next stage.
2. Proliferative Retinopathy
This is the more advanced stage of diabetic retinopathy. It is referred to as 'proliferative' because new blood vessels have grown in the retina or extended towards the middle of the eye. They are abnormally fragile, causing more bleeding and clouding of vision. Scarring may occur and lead to other serious complications such as retinal detachment.
Proliferative Retinopathy is sight-threatening and requires early intervention to prevent vision loss.
How is Diabetic Retinopathy diagnosed?
Diabetic Retinopathy can be detected during a full eye examination with dilation- where the optometrist uses special eye drops to dilate your pupils. This enables them to thoroughly examine the back of the eye and detect even minor signs of tell-tale changes or damage.
Digital retinal images (also known as fundus photos) can also help assess and monitor the health of the eye. Specialised equipment is used to take a high resolution image of the back of the eye to monitor for subtle changes not detectable by traditional methods. Not all optometrists have this type of equipment, but at Optometrist Parramatta digital retinal images are standard during every comprehensive eye examination
The Australian Government recommends that all diabetics have an eye examination at least every two years. Under Medicare, you are eligible for a rebate whenever an optometrist needs to conduct a diabetic eye examination.
Because of the seriousness of proliferative diabetic retinopathy, we recommend a visit to the optometrist every year- it doesn't cost anything and it may well save your sight.
What are my treatment options?
Managing diabetes is a life-long commitment. If you are diagnosed with proliferative diabetic retinopathy, your optometrist will refer you to an eye surgeon for laser treatment. This treatment is preventative as opposed to restorative, meaning that the earlier that proliferative diabetic retinopathy is diagnosed and treated, the higher the chances of success.
Diabetes can be hereditary so it is important to keep up to date with your eye examinations and medical check-ups if diabetes runs in the family.