Diabetes Eye Problems (Retinopathy and Maculopathy)

Diabetic complications can affect the eyes, causing potentially serious conditions that can lead to loss of vision.

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What is Diabetic Retinopathy?

Diabetic retinopathy is a disease of the retina (the nerve layer lining the back of the eye), resulting from the effects of diabetes on its blood vessels. It is the leading cause of blindness in people between the ages of 20 to 60 years of age. There are mainly three types of diabetic retinopathy: 

Background Diabetic Retinopathy 

This type is very common in people who have had diabetes for a long time. At this stage, the vessels of the retina are mildly affected, with tiny blood spots or fatty deposits appearing on the retina, but the vision is still normal. 

Diabetic Maculopathy 

The macula is the central part of the retina which is used for central (straight-ahead) vision. Diabetic patients whose glucose control is not optimal may suffer from swelling (oedema) of the macula. This leads to decreased or distorted vision, where objects look wavy or crooked. In such cases, the disease may not be curable, but treatment is aimed at preventing the sight from worsening. 

Proliferative Diabetic Retinopathy 

As the condition progresses, the retinal blood vessels become blocked and this can lead to the development of new vessels. These new vessels are abnormal and fragile; they may rupture and bleed in the eye. This is called vitreous haemorrhage and causes sudden loss of vision. In more advanced cases, scar tissue develops. This scarring pulls and distorts the retina and may even cause retinal detachment and a more severe loss of vision. 

Diabetes Eye Symptoms and Diagnosis

The first signs of diabetic retinopathy are a gradual blurring of vision. However, this may not be noticeable at first. Your ophthalmologist may recommend fundus flourescein angiography (FFA), which is a special photographic process that can detect early signs of the disease.

Diabetic Retinopathy Treatment

Laser Treatment

Laser treatment to the points of leakage for diabetic maculopathy can decrease the swelling and stabilise vision. More extensive laser treatment in the early stages of proliferative retinopathy can cause the abnormal blood vessels to regress, preventing more severe complications from developing. However laser treatment is not without side effects. Some patients may experience a decrease in vision to the sides (peripheral vision). Night and colour vision may also be affected.

Surgery

In some diabetic patients, the disease progresses despite laser treatment, leading to persistent bleeding in the eye or retinal detachment. Vision then continues to deteriorate. In such severe cases, surgery such as vitrectomy (removing vitreous gel from the eye) may be required.

Injection of Medication Inside the Eye

Recent studies have shown that injecting some medication (e.g. Triamcinolone, anti-vascular endothelial growth factor or anti-VEGF) inside the eye may help to maintain or improve vision in some people with diabetic retinopathy.

Preventing or Delaying Diabetic Retinopathy

Many studies show that tight control of your blood sugar and keeping your blood pressure and blood cholesterol within normal limits have a major positive effect on diabetic retinopathy.

The Importance of Annual Eye Examinations
People diagnosed with diabetes are recommended to have eye screenings early in order to detect diabetic retinopathy. Even if it is not detected, or treatment is not needed after the initial examination, it is still important to follow up with regular eye tests as the disease may appear or progress with time.

Without treatment, there is a high risk of blindness. The good news, however, is that early treatment gives a good chance of maintaining vision throughout life. 



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Diabetes Eye Problems (Retinopathy and Maculopathy)

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