For Eye Care - assisting those with eye problems

DIABETES AND THE EYE

Diabetes is a common disease and has important implications for the short term and long term health of sufferers. This section will tell you more about diabetes and how it affects the eye.

Effects of diabetes

Fluctuations in blood sugar can cause changes in the focussing of the crystalline lens within the eye and cause temporary visual blurring, particularly if diabetic control is poor. Diabetes can also cause cataracts in young people, or accelerate the development of cataract in older people.

Diabetic retinopathy is one of the commonest causes of blindness in the UK in people between the ages of 30-65, and 12% of people who are registered blind and partially sighted each year have diabetic eye disease. At any one time up to 10% of people with diabetes will have retinopathy requiring medical follow up or treatment.

Diabetes can also affect other organs, and the presence and severity of retinopathy may be an indicator of increased risk of other complications of diabetes such as ischaemic heart disease, kidney disease, or diabetic neuropathy (which contributes to male impotence, and diabetic foot disease).

Can I prevent the development of retinopathy?
Tight control of diabetes can reduce the risk of retinopathy by 60% in type I (insulin dependent) and 40% in type II (non-insulin dependent) diabetes, and will also reduce the risk of other diabetic complications.

Although the majority of people with diabetes who have had diabetes for long enough will have some degree of retinopathy, eye checks will enable early diagnosis and early treatment. When people first develop diabetic retinopathy they have no symptoms, but, if diagnosed at this early stage, it is a treatable condition, which is why it is important for diabetics to have regular eye tests.

When should I have my eyes examined?
People with insulin dependent diabetes need to have their eyes examined at diagnosis and after they have had diabetes for 4 years and then regularly. People with non-insulin dependent diabetes should have an eye examination at diagnosis and yearly thereafter by their diabetic specialist, GP, ophthalmologist or optician. Sight tests are free for people with diabetes.

What Is Diabetic Retinopathy?

Diabetic retinopathy is a potentially vision threatening condition in which the blood vessels inside the retina become damaged from the high blood sugar levels associated with diabetes. The longer you have diabetes, the greater your chance of developing diabetic retinopathy.

Recommended Care

Once diagnosed with diabetes, make sure you receive a comprehensive dilated eye evaluation at least once a year.

Women with diabetes also should be examined if considering pregnancy, early in the first trimester, and every one to three months during pregnancy because diabetic retinopathy can progress much more rapidly during pregnancy.

Recent studies show that intensive control of diabetes with self-monitoring of blood sugar levels and multiple daily insulin injections or an insulin pump can significantly slow the development of diabetic retinopathy and other complications from diabetes. As always, early diagnosis of diabetes and the effective control of blood sugar levels and hypertension through diet and exercise can help control eye diseases associated with diabetes.

Treatment

An effective partnership between you, your primary care physician and your opthalmologist is essential to ensure proper eye care and treatment.

The current primary treatment option for diabetic retinopathy is laser photocoagulation. This helps to stop or prevent growth of abnormal blood vessels that cause vitreous hemorrhage and retinal detachment. The "focal" laser helps to close leaking blood vessels, which lead to macular edema. When performed promptly, laser photocoagulation helps reduce the risk of severe vision loss by up to 90 percent.

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