Diabetes eye disease can affect vision and if severe can lead to blindness
It is preventable
It is treatable
It may be present at diagnosis in Type 2 diabetes
Eventually 70-100% of people with Type 1 diabetes will develop retinopathy
Your annual Retinal Screening can help detect eye problems
Diabetic eye disease how much do you know?
Have a look at this interactive quiz to help you find out more. (National Eye Institute)
Diabetes can affect the blood circulation throughout the body. This can cause changes to the blood vessels within the eye, which is known as Diabetic Retinopathy. This may lead to bleeding or scarring in the centre of the retina and stop light rays reaching part of the back of the eye. These changes are more frequent in people with high blood glucose, high blood pressure or high cholesterol, but can affect anyone with diabetes.
High blood glucose levels
High blood pressure (hypertensions)
Your diabetes care team can help you manage this and address issues of diet, exercise and weight reduction. They will help you manage self adjustment of insulin and advise on changes needed to diabetes and blood pressure medication (tablets). A service is available if you want to stop smoking.
You will be offered an annual eye check, (retinal screening) at your GP surgery where photographs of the eye are taken- read more.
Blurred vision at diagnosis or after significant changes in blood glucose control are probably temporary. It is advisable not to buy or change glasses for 8-10 weeks after starting or changing treatment. If you are concerned about your vision, please consultant your doctor.
Diabetic retinopathy is usually graded according to how severe it is. The three main stages are described below.
1. Background Diabetic Retinopathy This condition is very common in people who have had diabetes for a long time. Your vision will be normal with no threat to your sight.
2. Maculopathy With time if the background diabetic retinopathy becomes more severe, the macula area may become involved. This is called “maculopathy”. If this happens, your central vision will gradually get worse. You may find it difficult to recognise people’s faces in the distance or to see detail such as small print. Maculopathy is the main cause of loss of vision and may occur gradually but progressively. It is rare for someone with maculopathy to lose all their sight
3. Proliferative Diabetic Retinopathy As the eye condition progresses, it can sometimes cause the blood vessels in the retina to become blocked. If this happens then new blood vessels from in the eye. This is called “Proliferative Diabetic Retinopathy”, and is nature’s way of trying to repair the damage so that the retina has a new blood supply.
Unfortunately, these new blood vessels are weak. They are also in the wrong place. As a result, these blood vessels can bleed very easily and cause scar tissue to from in the eye. The scarring pulls and distorts the retina. Proliferative retinopathy is rarer than background retinopathy. Without treatment, total loss of vision may happen in proliferative retinopathy
With treatment, sight threatening diabetic problems can be prevented if caught early enough. However laser treatment will not restore vision already lost.
Is the name given to a number of conditions in which the “optic nerve” is damaged where it leaves the eye. This is caused by raised pressure within the eye, but the nerve may be subject to damage for other reasons, such as poor blood supply, weakness of structure or destruction of nerve cells.
This may occur as one of the first symptoms of diabetes although it may occur at any time when your diabetes is not well controlled. It is due to a swelling of the lens of the eye and will clear without treatment soon after the diabetes is brought under control again.
A cataract is a clouding of the lens of the eye, which causes the vision to become blurred or dim because light cannot pass through the clouded lens back to the eye. This is a very common eye condition that develops as people get older but someone with diabetes may develop cataracts at an earlier age than someone without diabetes.
To preserve your vision for longer, you need good control of your blood glucose level, blood pressure and cholesterol and not smoke.
If problems are discovered our Multidisciplinary team will manage and treat your complication. The University Hospitals of Leicester NHS Trusts, Diabetes Team have a dedicated, Retinopathy Team which consist of multidisciplinary backgrounds of expertise to find and help you take care of your eyes. We also have the services of the the Diabetes Specialist eye nurse.
Most sight- threatening diabetic problems can be managed by laser treatment. Most sight loss from diabetes can be prevented if detected early. Early eye disease may be delayed by improved treatment of diabetes and by laser treatment at the eye clinic if necessary. Laser treatment aims to preserve the sight, not to improve it, so early detection before symptoms is important.
If you have had laser treatment for diabetic retinopathy you are required to inform the DVLA
The treatment for cataracts involves an operation to remove the cloudy lens, which is lens replaced by a plastic lens, helping the eye to focus properly once again.