Diabetic Eye Disorder
About Diabetic Eye Disorder
People with diabetes are 25 times more likely to suffer blindness than the general population.
They have a higher incidence of -
Cataract – in a person with diabetes the increased sugar level causes the lens to cloud more quickly, making it like looking through a dirty window.
Glaucoma – diabetes is linked with an increased pressure in the eye, associated with optic & cranial neuropathies.
People with diabetes have a unique disease called diabetic retinopathy that affects the retina, which is like the camera film of the eye. This is a disease of the small blood vessels supplying the retina. The vessels close prematurely, leak blood or fat or grow abnormally. These vascular changes are occurring within all the body's organs in a diabetic patient and may lead to high blood pressure, numbness in the feet, kidney failure, strokes and heart attacks.
Fortunately, an ophthalmologist can view these vessels directly and painlessly within the eye and can predict the health of the other organs. Once diabetes is diagnosed it is important for the eyes to be examined regularly for diabetic retinopathy. This is useful not only in preventing blindness, but also to help your doctors keep your general health at its best.
When to have your eyes examined?
At first diagnosis - this is important to determine your baseline health, as you may not know how long your sugars have been high.
Children with diabetes are usually examined at 10 years old, or 5 years after diagnosis (which ever is later).
Pregnant women should be seen in the first trimester.
Frequency of examination- If all is well, your ophthalmologist will see you every 12 to 18 months.
If there are changes occurring within the eye or if there is a deterioration of your general health, your GP or ophthalmologist may ask to see you more often.
If laser therapy is needed your eye doctor will follow you more closely.
Most often there will be no symptoms noticed by the patient despite the diabetic changes slowly occurring at the back of the eye.
However WARNING SIGNS -
- Black smudges in the vision
- Showers of floaters or "flies"
- Distorted or fluctuating blurry vision If these occur, you should see your eye doctor as soon as possible.
DIABETIC EYE DISORDER TREATMENT
The Examination -
You will have your vision checked, as well as the pressure in your eye measured (see glaucoma).
The pupils will then be enlarged (dilated) with drops so the ophthalmologist can view the retina.
Warning - These drops will cause your vision to be blurry and bright, and this can last 4 hours or even longer. It is wise to come with a friend to assist you if your vision is severely affected, especially another driver if you normally come to the doctor by car. A pair of sunglasses is also recommended if you find yourself affected by glare.
This is a test in which the doctor injects a dye (Fluorescein) into your arm to find out if any of the blood vessels in the retina are leaking, and whereabouts they are. After injecting the dye the photographs of the retina are taken which help diagnose diabetic retinopathy and guide the doctor as to what treatment to use.
You do not need to fast before this test, though some people feel queasy during the injection. Your skin will tinged yellow by the dye, but this will only last 24 - 48 hours as you pass the dye from your urine (which will be bright yellow).
The laser is used to treat the leakage of the retinal vessels and prevent the growth of abnormal vessels within the eye. This therapy has been tried and tested for over 20 years and it is the most successful technique used by eye doctors to control retinopathy.
Of course, good control of blood sugars, cholesterol, weight and blood pressure are essential to slow the development of retinopathy and to help treat it once it has occurred.
Should laser therapy be prescribed, the pupils will be dilated. The therapy is definitely dazzling but rarely painful. Because your vision will be blurry from the drops, and dazzled by the laser, we advise you to bring a friend to help you get home.
Laser therapy may need to be divided over several appointments. It may need repeat fluorescein angiography to guide its completion. It may need to be repeated from time to time as your retinopathy waxes and wanes.
FAQ's About Diabetic Eye Disorder
- I have had diabetes for 15 years and had my eyes screened 3 times. Each time the doctor told me everything was OK. Do I still need to continue with screening?
- Yes. The likelihood of retinopathy increases with the duration of your diabetes.
80% of diabetic patients have some changes within their eyes by 15 years of disease. It may not require laser therapy but the examination may give your doctors useful information about your general health.
- I am a diabetic and the sole carer of my invalid husband. I really depend on my eyes for driving and reading his medications. What can I do to look after my vision?
- Good control of your sugars has been shown to delay the development of retinopathy. Your local doctor and dietitian can help you with this as well as giving attention to your weight, blood pressure, dietary fats and cholesterol. All these factors maintain your general health as well as your vision.
Regular eye review will detect retinopathy early and allow for timely application of laser therapy, thus minimising the risk of severe visual loss.
- Can I have eye disease without any symptoms?
- Yes. Retinopathy may be present at the diagnosis of your diabetes, particularly in late-onset diabetes where the blood sugars gradually rise and it is difficult to pick the exact time when the diabetes started.
- Are there any symptoms I should watch out for?
- If any of the following symptoms occur you should see your eye doctor immediately.
1. A shower of floaters - like a cloud of mosquitoes drifting in and out of your vision.
2. Distorted vision - the bending of a line of print on a page or the lines of a picket fence or wood panelling
3. Black smudges - noticeable when looking a plain background or printed page where the print goes missing in patches