Diabetes is one of the fastest-growing health challenges of the 21st century. Currently, more than 460 million people worldwide are living with diabetes. If not well-controlled, diabetes can damage many organs in the body, including the eyes. Diabetic eye disease includes diabetic retinopathy, glaucoma, and cataract. The most common eye disease associated with diabetes is diabetic retinopathy. It is the leading cause of blindness in persons with diabetes.
Poorly controlled diabetes damages the blood vessels in the retina - the light-sensitive tissue at the back of the eye. This results in bleeding as well as leakage of fluid into the retina. If the fluid leakage involves the macula - the central part of the retina, central vision is impaired. This is a condition called diabetic maculopathy.
Diabetes can also cause the blood vessels to be blocked, cutting off the oxygen supply to parts of the retina and damaging the retinal cells. This results in the growth of abnormal new blood vessels, which are delicate and bleed easily. In severe cases, bleeding and scarring of the retina can result in retinal detachment. Abnormal new blood vessels can also grow on the iris, and cause glaucoma.
Once the diabetic retinopathy progresses to this severe stage, the risk of vision loss and blindness is high despite treatment.
If you have diabetes, it is vital to get regular eye examinations. Most people with early and moderate diabetic retinopathy do not have any symptoms or vision loss. You do not require treatment at this stage, but it is important to improve your diabetes control.
Treatment is required if the diabetic retinopathy is severe or if abnormal new blood vessels are seen.
The mainstay of treatment is a laser to the unhealthy peripheral retina, which prevents further new blood vessels from forming.
Injections of medications into the eye is an alternative to laser treatment, especially if there is macula swelling. Most patients require multiple and regular injections, and it is important not to skip any.
Rarely, surgery may be required to remove blood or scar tissue that may be causing the retina to detach.
With early detection and treatment, we can improve the outcomes of diabetic retinopathy, so undergo regular eye examinations if you have diabetes.
To reduce the risk of diabetic retinopathy and vision loss, it is important to optimise your blood sugar levels. In addition, work with your doctor to control your blood pressure and cholesterol levels. Smoking may make diabetic retinopathy worse, so stop smoking if you do. Lead a healthy lifestyle with a healthy diet and regular exercise to achieve a healthy weight. Taking an active role in managing your diabetes means that most patients with diabetes are able to retain good vision.