What is Diabetic Eye Disease?
Diabetes is a chronic disease in which your blood glucose or sugar levels are too high.
Uncontrolled glucose levels can affect every organ in your body, with the most dangerous being heart disease, kidney disease and eye disease.
People with diabetes may develop a number of eye disorders including:
- Damage to retinal blood vessels (retinopathy)
- Vitreous haemorrhage
- Retinal detachment
- Retinal vascular occlusion
- Neovascular glaucoma
- Cataract
High blood sugar causes swelling of the lens in the eye, distorting the ability to focus clearly. The early symptom of all these disorders is blurred vision.
About Diabetic Retinopathy
Diabetic retinopathy is a disease that damages the tiny blood vessels in the retina (the light-sensitive tissue at the back of the eye). It is the most common eye disease associated with diabetes and is one of the leading causes of blindness in adults.
Your chance of developing diabetic retinopathy increases with the following factors:
- Long duration and poor control of diabetes
- High cholesterol
- High blood pressure
- Pregnancy
- Smoking
What are the Types of Diabetic Eye Disease?
There are three main types of retinopathy in diabetes, including:
- Non-proliferative retinopathy where the retinal blood vessels leak fluid or bleed.
- Macular oedema where there is swelling of the macula, caused by the leakage of fluid from retinal blood vessels. It can damage central vision.
- Proliferative retinopathy where new blood vessels may grow from the damaged retina when the eye is deprived of oxygen. These abnormal new vessels are fragile and can bleed easily.
What are the Symptoms of Diabetic Eye Disease?
The early stages of the disease do not show any symptoms; but as the condition worsens you may have blurred vision, spots or dark shapes floating in your vision (floaters), lowered night vision, or temporary or permanent blindness.
It is very important for all diabetics to have a regular eye examination since the early disease can already be present without any warning sign or symptom.
How is Diabetic Eye Disease Diagnosed?
Your doctor will diagnose diabetic retinopathy using the following methods:
- A dilated eye exam is a good diagnostic tool for retinopathy. Drops will be placed in your eye to dilate your pupils. This will help your doctor look for the presence of cataracts, abnormal blood vessels, swelling and bleeding in the retina, scar tissue and retinal detachment
- Tests for vision and eye pressure
- Fluorescein angiography may be performed, in which a special dye is injected into your arm and images of the blood vessels are taken as the dye circulates into the eye. This will show the blood vessels that are broken, leaking or blocked
- Optical Coherence Tomography (OCT) takes sectional images of the retina to determine leakage into the retinal tissue
Diagnosis is critical as if it is not detected and treated early, diabetic retinopathy can eventually lead to blindness.
What are the Treatment Options for Diabetic Eye Disease?
Treatment is decided based on the type and severity of the disease, and your response to prior treatment. Mild non-proliferative (background) diabetic retinopathy may not require immediate treatment except for regular monitoring with a thorough eye exam every 6-12 months.
Maintenance and control of blood sugar levels can prevent progression to more serious stages of retinopathy. Your eye specialist will work as a team with your family doctor (and diabetes specialist if you have one) to make sure that your diabetes is being well-managed.
In more severe cases of diabetic retinopathy, treatment may be needed:
- Injections: Medicines called anti-VEGF drugs can be given directly into the eye to reduce leaking and bleeding from damaged blood vessels in the retina. These are the same drugs used to treat macular degeneration
- Laser treatment: A laser can sometimes be used to stop abnormal vessels in the retina from leaking and bleeding
- Vitrectomy: In advanced cases, surgery may be needed to remove blood and scar tissue from the eye and repair the retinal detachment
Treatment can slow down the progression of the disease but is not a cure, as the underlying diabetes is a lifelong condition.
Regular monitoring of eye health and good diabetic management is paramount.
