This week we recognise Diabetes Awareness Week, which is the perfect time to share some useful information with you all about how diabetes can affect your eyes. We see a lot of patients at Envision who have Diabetes - a serious chronic health condition which occurs when there is too much glucose in the blood. Unfortunately, over time high glucose levels can damage the body’s blood vessels and nerves, leading to long term health complications such as heart, kidney and eye disease including diabetic retinopathy.
The main types of diabetes are:
- Type 1 diabetes - is associated with an autoimmune response and usually develops early in life.
- Type 2 diabetes - may develop over the course of many years and is commonly related to lifestyle factors.
- Pre-diabetes - a condition where blood glucose levels are higher than normal, but not high enough to be diabetes
If you have diabetes (Type 1 or 2), you may develop eye changes at some point in time. These changes can range from simple visual fluctuations to more complex conditions such as diabetic retinopathy. Fluctuating vision in diabetic patients can vary from day to day and can be best alleviated through good blood sugar control. Diabetic retinopathy is a more serious issue and can potentially cause vision loss. This condition develops when there is damage to the delicate blood vessels at the back of your eye.
What is diabetic retinopathy?
Almost 1.9 million Australians have diabetes, and of these, between 25% and 35% exhibit some form of diabetic retinopathy. The risk of developing diabetic retinopathy is dependent on the duration of the disease and glycemic control. The longer a person has had diabetes (along with poorly controlled blood sugar) the higher the risk of developing diabetic retinopathy in some form. The most effective way to protect yourself from premature diabetic retinopathy is to monitor and control blood sugar levels consistently. It is also essential to have regular eye testing so that any changes can be detected early addressed.
How does diabetic retinopathy affect vision?
Vision is most severely affected when diabetic retinopathy causes macular oedema (simply known as diabetic macular oedema). Diabetic macular oedema is caused by damaged blood vessels, which leak fluid underneath the macula. This then leads to swelling in the macular region, resulting in blurred and distorted vision.
How can I prevent diabetic retinopathy?
- Controlled and stable blood sugar levels (4-7mmol/L on average). Regular visits to your GP or self-monitoring your blood sugar levels is essential.
- HbA1c of under 7%.
- Controlled blood pressure and cholesterol levels.
- Awareness of benefits of a good diet and physical activity.
Your GP will be able to provide further information on what monitoring will work best for you.
What are the symptoms of diabetic retinopathy?
If you notice any changes in your vision, consult your optometrist. Here are some things to look out for:
- Blurred or distorted vision that does not improve with glasses or contact lenses.
- Issues driving (day or night), watching TV, or recognising people’s faces.
- Extreme sensitivity to glare (photophobia).
How do you treat diabetic retinopathy?
Treatment options may include:
- Observation and blood sugar stabilisation for mild retinopathy.
- Laser to seal any leaky blood vessels to prevent them from additional leaking.
- An injection if there is any diabetic macular oedema to reduce macular swelling.
- Steroid implants can also reduce the swelling in diabetic macular oedema.
Should any specialist treatment above be required, you we will refer you to an ophthalmologist.
What other side effects on the eyes does diabetes have?
Cataract: people who have diabetes are 2-5 times more likely to develop a significant cataract. Additionally, the cataract may develop at a younger age for a person with diabetes compared to a non-diabetic.
Glaucoma: uncontrolled diabetes can have the capacity to cause a form of glaucoma, known as neovascular glaucoma.
Double vision: this is a less common complication from diabetes which occurs when the eye muscles are damaged.
How do we check your eyes for diabetes?
Here at Envision Optical, we recommend those with diabetes to visit us every 12 months for a diabetic eye examination - which involves putting dilating drops in your eyes to get a better view of the back of the eye. We can then accurately assess the health of your eyes and use retinal photography to identify if any complications are arising from your diabetes. Regular testing means that any issues will be found early, resulting in quicker referral or treatment times and better visual outcomes.
Please reach out to the team at Burleigh Waters or Tweed Heads if you have any concerns and click here if you're due to book your routine exam. We look forward to seeing you soon!