This article answers the most frequently asked questions concerning diabetic eye disease and diabetic retinopathy and includes questions such as "How does diabetes affect the eyes?" and "What treatment is available?"
- How does diabetes affect the eyes?
- What are the symptoms of diabetic retinopathy?
- How can I prevent diabetic eye disease?
- What treatment is available?
- What risks are involved in treatment?
Diabetes can lead to damage in the eye called Diabetic Retinopathy. High blood sugar levels cause damage to the blood vessels in the retina, resulting in bleeding, and leakage of exudates. In advanced disease this leads to the formation of abnormal new blood vessels. Diabetic retinopathy is the most common cause of blindness in the working population in the western world.
Other common diabetic eye problems include dry eyes and cataracts.
- Fluctuating or changing vision.
- A reduction or loss of sight.
- Bleeding in the eye.
- Increased pressure in the eye.
Annual screening for diabetic eye disease is offered to all diabetic patients over the age of twelve in the UK. The screening is conducted through digital photography of your eyes and the images will be checked to see if you have any treatable diabetic eye diseases.
By maintaining good blood pressure, blood sugar levels and cholesterol levels patients are able to reduce their risk of developing diabetic eye disease. Even in those patients who have already developed diabetic retinopathy, the symptoms can be improved through controlling blood pressure and cholesterol levels.
You will need treatment when diabetic macular oedema has led to a swelling and a decrease in vision or when you have Proliferative Diabetic Retinopathy leading to the development of new retinal blood vessels.
Laser treatment is the standard treatment for diabetic retinopathy. For maculopathy a focal laser/grid laser are applied to the centre of the retina to decrease thickening. In Proliferative Diabetic Retinopathy peripheral laser treatment is used to reduce newly developed blood vessels in the retina.
Anti-VEGF intravitreal injections are used to treat maculopathy by stopping the leakage from current blood vessels and preventing the development of new blood vessels. In Proliferative Diabetic Retinopathy these injections temporarily close the new blood vessels.
Vitrectomy is a surgical operation whereby the gel in the eye is removed. Vitrectomies can be used both in the treatment of Proliferative Diabetic Retinopathy and macular oedema.
All treatments, except for vitrectomy, are carried out during an outpatient visit. Laser treatments will not require follow-up treatment whilst Anti-VEGF injections will be followed by administering antibiotic eye drops. Vitrectomy is a Day Surgery procedure with patients allowed to go home the same day and with follow-up to include eye drops.
Side effects of laser treatment include reduced vision and an increase in swelling of the macular oedema.
Side effects of the Anti-VEGF injections and vitrectomy include increased pressure, inflammation, bleeding and pain in the eye; retinal detachment; and endophthalmitis very rarely.