DIABETES

I have diabetes, why do I need an eye examination?

It is very important that you have your eyes reviewed by an ophthalmologist.  Most diabetics are unaware of the importance of having their eyes examined.  Diabetics are at risk of developing eye problems such as cataracts and glaucoma, but the disease’s effect on the retina is the main threat to vision.  Most patients develop diabetic changes in the retina which leads to vision loss, retinal artery hemorrhages, swelling and weakening.  The effect of diabetes on the eye is called diabetic retinopathy. 

What is diabetic retinopathy?

Diabetic retinopathy is the most common diabetic eye disease.  It is caused by changes in the blood vessels of the retina (the innermost lining of the inside of your eye where all of the images that you see are focused).  Over time, diabetes affects the circulatory system of the retina.  The earliest phase of the disease is known as background diabetic retinopathy.  Here, the retinal arteries become weakened and leak, forming small, dot-like hemorrhages.  These leaking vessels often lead to swelling or oedema in the retina and decreased vision.

The next stage is known as proliferative diabetic retinopathy.  Here, circulation problems cause areas of the retina to become oxygen-deprived or ischaemic.   New, fragile, vessels develop as the circulatory system of the retina.  This is called neovascularization.  Unfortunately, these delicate vessels haemorrhage easily.  Blood may leak into the retina and vitreous, causing spots or floaters, along with decreased vision. 

In the later phases of the disease, continued abnormal vessel growth and scar tissue may cause serious problems such as retinal detachment and glaucoma.  The affect of diabetic retinopathy on vision varies widely, depending on the stage of the disease.  Some common symptoms of diabetic retinopathy are blurred vision, flashes and floaters and/or sudden loss in vision.

Therefore, anyone with diabetes - type 1 and 2, needs to have their eyes examined and continue to have them reviewed regularly by an ophthalmologist.

What does a diabetes eye assessment involve?

Vision examination:  Our orthoptist will measure how well you see at various distances to detect any early loss in visual acuity.  Dilated eye examination: Drops are placed in the eye to dilate your pupils.  This allows the ophthalmologist to view the inside and back of your eyes.  Our ophthalmologist will use a special magnifying lens to examine your retina and optic nerve for signs of damage, leakage and early blood vessel changes, all of which will aid with the diagnosis of diabetic retinopathy.  After the examination your vision will be blurred and may take a few hours to recover.

How is diabetic retinopathy managed?

If diabetic retinopathy is diagnosed our ophthalmologist will treat your eyes according to the stage of the disease and the specific problem that requires attention.  Tests to monitor the progression of the disease and to make decisions for the appropriate treatment include:  fluorescein angiography, retinal photography, and ultrasound imaging of the eye.

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