Diabetic eye disease refers to a group of conditions that can develop in people with diabetes and may lead to vision loss if left untreated. These include diabetic retinopathy, where high blood sugar damages the fine blood vessels in the retina; diabetic macular oedema, which causes fluid to build up at the macula; and cataracts, which cloud the eye’s natural lens. Keep reading to learn more about the causes, symptoms and diagnosis of diabetic eye disease, and explore the treatment options available.
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Diabetic eye disease symptoms
Diabetic eye disease can cause a range of symptoms and ultimately lead to vision loss and blindness. The exact symptoms you may experience, however, will depend on the specific condition you’re diagnosed with.
Diabetic retinopathy
Diabetic retinopathy has several stages. During the mild stages, you might not experience any symptoms. As the condition progresses, you may develop:
- blurred vision
- fluctuating vision
- loss of vision
- spots or dark strings floating in your vision
Diabetic macular oedema
Similarly to diabetic retinopathy, during the early stages of diabetic macular oedema, you may not notice any symptoms at all. However, if the condition worsens, you may experience:
- blurred vision
- dark spots in your vision
- faded colour vision
- sensitivity to bright light or glare
- difficulty reading
- visual distortions (straight lines, such as door frames, may appear distorted or bent)
Cataracts
When cataracts are mild, you may not notice them. More symptoms tend to develop as the cataract progresses, including:
- cloudy or blurry vision
- seeing double in one eye
- seeing halos around lights
- sensitivity to bright lights and glare
- colours seem altered
What causes diabetic eye disease?
The cause of diabetic eye disease is poorly controlled diabetes, often with an overlay from high blood pressure and high cholesterol. Blood glucose or blood sugar levels which are too high, cause damage to the blood vessels in the retina. This poor blood supply affects both the function and structure of the retina.
Diabetic eye disease treatments
In the early stages of diabetic eye disease, managing your diabetes and keeping your blood glucose levels in range can help manage your condition.
Your diabetes care team should be able to support you in this by recommending lifestyle changes and drug therapy as needed. They may also suggest ways to help you control your blood pressure and blood cholesterol.
However, if abnormal blood vessels start to develop in the retina, or there is a risk of bleeding, you may need laser treatment, injections or even surgery.
- intravitreal injections, or anti-vascular endothelial growth factor (anti-VEGF) therapy, or steroid treatments are used to treat vision loss due to diabetic macular oedema
- laser treatment can be used to control diabetic macular oedema, or to stabilise new blood vessels that develop as a result of diabetic retinopathy
- vitrectomy (vitreo-retinal) surgery may be recommended if diabetic retinopathy can progress to a more advanced degree of diabetic retinopathy. This surgery is utilised for many reasons, including clearance of persistent blood in the vitreous gel, treating scarring and detachment of the retina or undertaking laser if not possible by other means
- cataract surgery might be suggested if you have cataracts that are interfering with vision. This surgery removes the cloudy lens in your eye and replaces it with an artificial lens to improve your vision. The decision for cataract surgery in diabetic patients needs careful discussion and monitoring for potential complications
You can find out more about diabetic eye disease treatments here.
When to see a consultant?
When you’ve been diagnosed with diabetes, it’s important to have annual eye examinations. In particular, if you experience any rapid changes to your vision, you should see a consultant as a matter of urgency.
Diabetic eye disease diagnosis
Diabetic eye disease is diagnosed through a comprehensive dilated eye examination. During the exam, your doctor will consider:
- your medical history – to assess your overall health, any eye symptoms you’re experiencing, and when they began
- your visual acuity – to measure how well each eye is seeing
- your eye health – by undertaking a full examination of all the structures of your eye and the surrounding tissue
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