Diabetic Eye Disease

Currently there are approximately 3.5 million people in the UK who are diagnosed with diabetes. It is also estimated that over half a million are undiagnosed. Therefore current estimates are nearer to 4 million which represents approximately 6% of the population. Type 1 diabetes accounts for approximately 10% of all cases and type 2 diabetes 90%.

People with diabetes are at risk of having problems with their eyes. At the back of the eye there is a network of tiny blood vessels which supply oxygen and nutrients to the seeing part of the eye, which we call the retina. Over time diabetes can affect the wall of the blood vessels which can cause them to leak and bleed, and can also lead to blockages of the tiny vessels which reduces the circulation to the retina. When this starts to occur it can affect how the retina works. We refer to this as diabetic retinopathy. The type and grade of the retinopathy depends on how much damage there is to the blood vessels, and is a common complication of both type I and type 2 diabetes. It is the leading cause of preventable sight loss in the UK.

It is important for diabetics to have regular retinal screening normally performed with digital retinal imaging. This is part of a national diabetic screening program, and allows detection of any changes that become sight threatening. The earlier these changes can be treated, the better outcome for preserving your eyesight. Mild diabetic retinopathy is usually monitored without treatment. If it progresses to a stage where it is sight threatening, then you will be referred to an ophthalmologist where some cases require laser treatment or injections to prevent any further damage to the eye.

Good diabetic control is important to keeping your eyes healthy for as long as possible. Maintaining good glucose and blood pressure control is really crucial. Also keeping to a healthy diet with regular exercise and not smoking.

Diabetes can also affect other parts of the eye. It can affect the lens inside the eye and sometimes this can cause a change in your prescription, or a clouding of the lens which leads to cataract. Diabetics are more at risk of glaucoma, and other conditions such as retinal vein occlusions.

As well as retinal screening it is therefore important to visit your optometrist on a regular basis. During a normal eye examination you will undergo a thorough examination to check the health of the eye as well as checking your vision. We recommend enhanced tests with wide field imaging (Optomap) and OCT (Optical Coherence Tomography). This allows a more detailed examination of the retina and particularly with OCT allows us to view the deeper structures within the retina to detect changes much earlier on.

Luckily only a small number of people develop severe diabetic retinopathy. The risks increase the longer you have had it, and how well the diabetes has been controlled. The good news is that the earlier the sight threatening changes are detected and treated the better overall outcome. This is why regular checks are essential.