What is it?
About a million Australians have diabetes mellitus and within 15 years of onset, more than 70% of these will develop a diabetic eye disease. Diabetic eye disease refers to a group of eye problems that people with diabetes may face as a complication of diabetes. All can cause severe vision loss or even blindness.
Diabetic eye disease may include:
- Diabetic retinopathy – damage to the blood vessels in the retina.
What is diabetic retinopathy?
Diabetic retinopathy is the most common diabetic eye disease. It is caused by changes in the blood vessels of the retina. In some people with diabetic retinopathy, blood vessels may swell and leak fluid. In other people, abnormal new blood vessels grow on the surface of the retina, the light-sensitive tissue at the back of the eye. A healthy retina is necessary for good vision.
Early diabetic retinopathy does not always cause symptoms to the sufferer and so early threats to vision may go undetected. However, over time diabetic retinopathy can get worse and cause damage and irreversible vision loss making regular eye examinations so important.
What are the risk factors?
All people with diabetes, both type 1 and type 2 are at risk. That’s why everyone with diabetes should get a comprehensive dilated eye exam at least once a year. The longer someone has diabetes, the more likely he or she will get diabetic retinopathy.
During pregnancy, diabetic retinopathy may be a problem for women with diabetes. To protect vision, every pregnant woman with diabetes should have a comprehensive dilated eye exam as soon as possible.
Good control of blood sugar, blood pressure, and cholesterol lowers the risk of diabetic retinopathy.
What are the symptoms?
Vision can fluctuate from day to day due to fluctuations in blood glucose levels, but often there are no symptoms in the early stages of the disease, nor is there any pain. Don’t wait for symptoms; if you have been diagnosed with a form of diabetes, have regular yearly examinations with your optometrist.
How is diabetic retinopathy detected?
Diabetic retinopathy is detected during a comprehensive eye exam that includes;
- Visual Acuity Test – this eye chart test measures how well you see at various distances.
- Dilated Eye Exam – drops are placed in your eyes to widen, or dilate, the pupils. This allows the optometrist to see more of the inside of your eyes to check for early signs of the disease.
- Digital Fundus Photography – a digital fundus photo of the retinal blood vessels inside the eye are taken each year, and then the photos are compared to photos taken in previous years to detect early changes in the retinal blood vessels.
- OCT – Ocular Coherence Tomography – scans the layers of the retina and enbales your optometrist to pick up early changes like oedema (fluid) in the retina which could indicate future problems.
What treatments are available?
During the early stages of diabetic retinopathy, close monitoring of the retinal blood vessels is essential. To prevent progression of diabetic retinopathy, people with diabetes should control their levels of blood sugar, blood pressure, and blood cholesterol.
If new weak diabetic retinopathy blood vessels are detected, laser surgery can be used to slow the leakage of fluid from these abnormal blood vessels. Although laser treatment has a high success rate, it does not cure diabetic retinopathy. There is always a risk for new leaky blood vessels to form.
Doctors are starting to use injections into the eye which have been very successful in controlling haemorrhages in other conditions like Macular Degeneration to manage some of the signs of diabetic retinopathy.
Most importantly, managing your diabetes well and early detection through regular eye examinations are the best way to protect your sight.
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