Patient Information

Diabetic Retinopathy

What is Diabetic Retinopathy? 

If you have diabetes you are at risk of developing Diabetic Retinopathy.  Diabetic Retinopathy is an eye condition that causes damage to the blood vessels at the back of your eye (the Retina). These blood vessels can become blocked, leak fluid or bleed, which often leads to vision loss or blindness. It usually affects both eyes. When left untreated, Diabetic Retinopathy can scar and irreversibly damage your retina.

What are the Symptoms of Diabetic Retinopathy?

You might not have any symptoms of Diabetic Retinopathy until the late stages. When you do have symptoms, you might notice:

• sudden loss of vision
• Blurry vision or distorted vision
• Holes or black spots in your vision
• Floaters or moving black spots in your vision caused by bleeding

What causes Diabetic Retinopathy?

If your blood glucose level (blood sugar) is too high for too long, it damages the small blood vessels that keep your retina healthy. These damaged blood vessels are weaker than normal blood vessels & can then leak blood and fluid into your retina. This can cause another condition called macular oedema - which causes blurry vision or distorted vision.

If more retinal blood vessels become blocked, the ischemic retina can cause development of abnormal blood vessels called proliferative diabetic retinopathy. These abnormal new blood vessels can rupture causing a sudden loss of vision due to a haemorrhage in the jelly of the eye (vitreous haemorrhage). There is also a risk of developing a retinal detachment.

Diabetic patients are more likely to develop eye conditions like Glaucoma or Cataracts.

What are the risk factors for Diabetic Retinopathy?

Any form of diabetes: Type 1, Type 2, or Gestational can result in diabetic retinopathy. Your chances of developing Diabetic Retinopathy increases the longer you have had diabetes & if your diabetes is not adequately controlled.

Other things which can contribute to development or worsening of diabetic retinopathy include:

• High blood pressure
• High cholesterol
• Smoking

All diabetic patients are advised to have a regular eye check up to screen for early signs of Diabetic retinopathy.

Stages

Diabetic retinopathy tends to go through these four stages:

How is Diabetic Retinopathy Diagnosed?

At Hills Eye Surgery, your eyes will be thoroughly examined to determine if there is any sign of Diabetic Retinopathy. 

Pupil dilation will enable the view of your Retina, where changes in your eye’s blood vessels or the formation of any new blood vessels can be seen. Any retinal swelling or detachment can also be detected

An OCT scan of your macula can help in early diagnoses of Diabetic macular oedema. Some patients may require a Fluorescein angiogram in which a dye is injected in the vein in the arm and then pictures taken of the retina to check for any signs of leakage of the dye.

Treatment

Treatments for diabetic retinopathy include:

• Anti-VEGF injection therapy: These injections are given inside the jelly of the eye (Vitreous) and block vascular endothelial growth factor (VEGF), a protein that makes abnormal blood vessels grow in your eye, it can reverse the blood vessel growths and lower fluid build up in your retina. 
• Focal/grid macular laser: Lasers make tiny burns on the leaky areas of vessels in your macula to stop the leakage.
• Steroids implanted or injected into your eye. There are both short-term and long-term acting types and help by reducing the leakage from damaged blood vessels.  Steroids can increase your chance of Glaucoma or Cataracts. ¥our eye pressure in your eye will need to be monitored if you take them.
• Pan Retinal Photocoagulation (PRP) laser: This treatment is used for patients who have Proliferative diabetic eye disease. 2,000 to 3000 laser spots are scattered over the ischemic retina to shrink abnormal blood vessels. You may need two or more sessions. Laser surgery can save your central vision, but it may reduce your side, colour, or night vision. It works best if you get it before those new vessels start to bleed.
• Vitrectomy: If blood vessels leak into the vitreous humour and your vision becomes cloudy, you may need to have this procedure. It removes the leaked blood so you can see better.

At Hills Eye Surgery the best treatment for Diabetic Retinopathy will be discussed with you. 

What are the complications of Diabetic Retinopathy?

Within your Retina (the back of your eye) is a spot called the Macula. A healthy macula gives you sharp vision straight in front of you. This is what you need to drive, read, and see other people’s faces. If your diabetic retinopathy causes fluid build up and swelling in your macula, it is called Diabetic macular oedema (DME) - which  is a serious complication of diabetic retinopathy. 

DME is the most common reason people with diabetic retinopathy lose their vision, and about half of people with diabetic retinopathy get DME. Sometimes, vision loss from DME can’t be reversed.

Can Diabetic Retinopathy be prevented?

It is very important to keep your blood sugar and blood pressure at adequate levels. This will slow down progression of diabetic retinopathy and maybe even stop it from happening.

More tips to prevent diabetic retinopathy include:

• Make sure you see you visit Hills Eye Surgery at least once a year for a full eye examination. Depending on your eyes you may be advised to visit every 6 months for a routine check. Ensure to follow the advice of regular full examinations at the advised times to ensure any signs of Diabetic Retinopathy are picked up at its earliest.
• If you have diabetes and are pregnant, have a thorough eye exam during your first trimester &/or if  diabetes develops later.
• Do not smoke if you have diabetes.