Diabetic eye disease – everything you need to know

Diabetes affects up to 1.7 million Australian adults and this staggering number is only set to rise in the coming years, as is the prevalence of people affected by diabetic eye diseases. In fact, it’s estimated that almost all those with type 1 diabetes and more than 60% of those with type 2 diabetes will develop some form of diabetic eye disease within 20 years of diagnosis.

When it comes to eye disease, early detection is key

Diabetic eye disease is the leading cause of irreversible blindness in Australian adults under 74. Many eye diseases have no signs or symptoms in their earliest stages, and it can be difficult to know if you have diabetic eye disease unless you get an eye test with an optometrist. By the time people do notice changes to their sight, the damage can already be quite severe. Fortunately, with regular eye health tests, these eye diseases can be detected and treated early, and this can help to minimise the risk of blindness.

What is Diabetic Eye Disease?

Diabetic Eye Disease refers to a group of serious eye health conditions that affects people with diabetes, including Diabetic Retinopathy and Diabetic Macular Oedema. People with diabetes are also at higher risk of developing Glaucoma and cataracts, and the risk of developing these increases the longer an individual has had diabetes. For this reason, regular eye tests are a must.

Diabetic Retinopathy

Of the people that have diabetes in Australia, it is estimated that 25 to 35% have some degree of Diabetic Retinopathy . Retinopathy occurs when spikes in blood sugar levels cause damage to the small blood vessels in the retina, which is located at the back of the eye. This damage can affect vision and may eventually cause blindness.

There are two stages of Diabetic Retinopathy:

1. Non-proliferative
Non-proliferative is the early stage of Diabetic Retinopathy. Depending on the number of blood vessels that are affected, it usually causes little to no issues to your vision. However, in this early stage, blood vessels may start to leak or become blocked, restricting vital oxygen and nutrients to the eye. Whilst not usually sight-threatening at this stage, non-proliferative retinopathy should be monitored to make sure it doesn’t progress into the far more dangerous Proliferative Retinopathy.

2. Proliferative
Proliferative is the advanced stage of Diabetic Retinopathy. As damaged blood vessels struggle to supply oxygen and nutrients to the eye, new abnormal blood vessels often grow. These are fragile and can leak easily, which can cause scar tissue to form. When these bleed other complications such as retinal detachment may occur. If not treated, it can cause severe and irreversible damage and blindness. Seek help immediately if you experience a sudden loss of sight.

Diabetic Macular Oedema

Diabetic Macular Oedema is the most common cause of vision loss for people with diabetes. This happens when swelling and leakage from the damaged vessels extends to the central part of the retina (the macula). The macula is responsible for central, straight-ahead vision, which we use for important everyday tasks such as reading, recognising faces and driving a car. It affects up to 30% of people who have had diabetes for 20 years or more, and if untreated, 20 to 30% of people who have it will experience moderate visual loss.

Cataracts & Glaucoma

Adults with diabetes are also at a higher risk of developing Glaucoma and Cataracts. Glaucoma is the name of the disease when the optic nerve between the eye and the brain is damaged. To read more about glaucoma, click here (glaucoma article) or visit Glaucoma Australia.

Cataracts are a clouding of the eye’s natural lens. It is one of the world’s leading causes of preventable blindness and can happen to people of any age, although age is the most common risk factor. Cataracts can be treated with eye drops once diagnosed. For more serious cases, surgery may be required. If you or your loved one have diabetes, speak to an optometrist or your GP to find out more about your risk of cataracts and other eye conditions.

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Can I prevent eye disease if I have diabetes?

The good news is that there are several steps you can take that may reduce your risk of Diabetic Eye Disease or minimise the damage caused by certain conditions. As always, consult with your doctor before making any changes or undertaking any new activities.

  • Prevention is essential and it is for this reason regular eye tests are so important. Maintain regular eye health tests at least every two years (or as advised by your GP or optometrist). These allows your optometrist to monitor your eye health and detect any issues early so the right course of treatment can commence. If possible, see the same optometrist each time, so that he/she can begin to learn what is (and isn’t) normal for your eyes.
  • Keep your blood sugar, blood pressure and cholesterol under control.
  • Quit smoking - smokers with diabetes have a much higher risk of losing their sight.
  • Exercise regularly.
  • Maintain a healthy diet - advice from your GP or a dietician can be very helpful.
  • If you notice a difference in your vision, seek treatment immediately to stop it from getting worse.

If you have diabetes and haven’t had an eye health test recently, you can find and book a local optometrist via MyHealth1st.

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