Original caption: Interior view showing retinal changes associated with the early stages of diabetic retinopathy. Microaneurysms, dot blot hemorrhages, hard exudates, and dilation of retinal veins are seen. --- Image by © Barbara Galati/Science Faction/Corbis

July 9-16 is National Diabetes Awareness Week 2017, and in our Gold Coast and Tweed Heads optometry practices we see many patients each week with diabetes. It is very important that patients are aware of the potential sight threatening changes that occur with diabetes and the importance of eye exams to prevent complications from diabetes.

Diabetic retinopathy (DR) is a common complication of diabetes. It is a series of changes in the blood vessels of the retina at the back of the eye that can cause bleeding and fluid leakage/swelling. This can cause sight threatening complications. Both Type 1 and 2 diabetics are at risk of developing DR. About 700 000 Australians have diabetes. Between 40-45% of all diagnosed diabetics have some degree of DR.

So What Causes Diabetic Retinopathy?

Diabetic retinopathy occurs due to the damaging effects of diabetes on the integrity of the sealed walls of the blood vessels in the retina at the back of the eye. Vision loss results in two ways:

  • Fragile, abnormal blood vessels can develop and leak blood into the central vision area, the macula. This is proliferative retinopathy and is the fourth and most advanced stage of the disease.
  • Fluid can leak into the centre of the macula, making the macula swell and causing blurred vision. This is called macular oedema. Its likelihood increases with more advanced disease.

Most people with diabetes have background retinopathy. They are only minor changes that act as warning signs that diabetic control is inadequate and more serious complications are being risked if control does not improve. Usually you will not notice any vision changes other than perhaps blurred areas in your vision with fine detail tasks.

How do we check for diabetic retinopathy?

Your Envision Optical optometrist will carefully examine the retina through dilated pupils to check for any blood vessel changes and areas of bleeding or fluid accumulation. This should be done at least annually. We recommend routine digital retinal photography at every visit to enable accurate monitoring for any changes. OCT retinal and macular scans will be performed if any swelling of the retina or macula is suspected.

Treatment of diabetic retinopathy?

If any changes are detected close to the central vision area or any fluid swelling is detected at the macula, referral to a retinal specialist will be recommended. If the retinopathy is more serious, then treatment options including laser therapy and injections may be recommended by the specialist. They will also work closely with your GP and diabetic team to ensure your control is maximized.

If you are diabetic, ensure you have at least annual eye health exams. If your vision changes or you experience any blurring or spots in your vision have a check up as a matter of urgency.