Diabetic Retinopathy: A Guide

Do you or someone you know have diabetes? Are you aware of diabetic retinopathy? Do you know the steps to take for prevention?

In this guide we’re going to cover everything you need to know about diabetic retinopathy, and your eyes and diabetes.

What is Diabetic Retinopathy?

Diabetic retinopathy is a complication of diabetes caused by high blood sugar levels damaging the retina at the back of your eye. It can cause blindness if left undiagnosed and untreated.

How Diabetes Affects The Eyes

The retina is the light-sensitive layer of cells at the back of your eyes that converts light into electrical signals. The signals are sent to the brain which turns them into the images that you see.

To function properly, the retina needs a constant supply of blood, which it receives through a network of tiny blood vessels.

Over time, a consistently high blood sugar level can damage the blood vessels in 3 main stages:

• Background retinopathy: Tiny bulges develop in the blood vessels which may bleed slightly but do not usually affect your vision.
• Pre-proliferative retinopathy: More severe and widespread changes affect the blood vessels, including more significant bleeding into the eye.
• Proliferative retinopathy: Scar tissue and new blood vessels, which are weak and bleed easily, develop on the retina. This can result in some loss of vision.

In some cases, the blood vessels in the macula, the central area of the retina, can become leaky or blocked. This is called diabetic maculopathy.

Who Is At Risk Of Diabetic Retinopathy?

Anyone with type 1 or type 2 diabetes is potentially at risk of developing diabetic retinopathy.

However, you’re at greater risk if you:

• Have had diabetes for a long time
• Have a consistently high blood sugar level
• Have high blood pressure
• Have high cholesterol
• Are pregnant
• Are of Asian or Afro-Caribbean background

Symptoms Of Diabetic Retinopathy

Unfortunately, it is difficult to notice diabetic retinopathy in the early stages as it does not tend to have any obvious symptoms until it’s more advanced.

In later stages, blood vessels in the retina start to bleed into the vitreous (gel-like fluid that fills your eye). If this happens, you may see dark, floating spots or streaks that look like cobwebs.

However, early signs of the condition can be picked up during diabetic eye screenings.

To minimise the risk of diabetic retinopathy symptoms developing, people with diabetes should:

• Ensure they control their blood sugar levels, blood pressure, and cholesterol.
• Take diabetes medicine as prescribed.
• Seek medical advice quickly if you notice changes to your vision.
• Maintain a healthy weight, eat a healthy, balanced diet, exercise regularly, and stop smoking.
• Attend diabetic eye screening appointments. Screening is offered to all people with diabetes aged 12 and over to pick up on, and treat, any problems as soon as possible.

Diabetic retinopathy can also lead to problems such as:

• Diabetic Macular Oedema (DMO): DMO happens when blood vessels in the retina leak fluid into the macula. This causes blurry vision.
• Neovascular Glaucoma: Diabetic retinopathy can cause abnormal blood vessels to grow out of the retina and block fluid from draining out of the eye.
• Retinal Detachment: Diabetic retinopathy can cause scars to form in the back of your eye. When the scars pull your retina away from the back of your eye, it’s called tractional retinal detachment.

Diabetic Eye Screening

If you have diabetes and are aged 12 or over, you’ll get a letter every 1 or 2 years asking you to have a diabetic eye screening.

CAUTION: You will NOT be able to drive after a diabetic eye screening as your eyesight might be blurry for a few hours due to the drops that are instilled into your eyes. Make sure you are able to get a lift to and from the screening.

The screening involves taking photos of the back of your eyes that then get sent off for a professional to examine and review.

Treatment For Diabetic Retinopathy

For diabetic retinopathy cases where your sight is being threatened or affected, the main treatments available are:

• Laser Treatment: To treat the growth of new blood vessels in the retina in cases of proliferative diabetic retinopathy and to stabilise some cases of maculopathy.
• Eye Injections: To treat severe maculopathy that’s threatening your sight.
• Steroid Eye Implants: To treat severe maculopathy if eye injections are not suitable or have not worked for you.
• Eye Surgery: To remove blood or scar tissue from the eye if laser treatment is not possible because the retinopathy is too advanced.

Here at Opticare, we offer specialised diabetic eye screening at our Newark practice. If you or your child are worried about diabetic retinopathy, or the effects of diabetes on your eyes, we encourage you to book in with us at Opticare today.