Good Vision for Life - Diabetic Eye Disease

Good Vision for Life - Diabetic Eye Disease

Posted by Dr Leisa Schmid PhD Optometrist on the 26th of July, 2016

People with diabetes can develop any or all of a group of eye conditions. These conditions include cataract, glaucoma, diabetic retinopathy, and diabetic macular oedema (DME). People with diabetes can have blurred vision and difficulty focusing when their blood glucose levels are high. 

1. Cataract - cataract develops at a younger age in people with diabetes. A cataract is a clouding of the lens inside the eye (see Part 2 of this series).

2. Glaucoma – the incidence of glaucoma is higher in people with diabetes. Glaucoma causes damage to the eye’s optic nerve (Glaucoma will be discussed in Part 4 of this series).

3. Diabetic retinopathy – the blood vessels inside the eye are damaged. This is the most common cause of vision loss among people with diabetes.

4. Diabetic macular oedema (DME) - DME is swelling of the central area of the retina. The prevalence of DME is reported to be 10-15%.

Diabetic Retinopathy
Diabetic retinopathy progresses through a number of stages. Blood vessels in the retina become weak and leaky or blocked. This stage is called non-proliferative diabetic retinopathy. The drug Fenofibrate reduces the risk of diabetic retinopathy progression by about 30%. If more blockages occur then the retina becomes hypoxic (has a lack of oxygen) causing cotton wool spots. This leads to new blood vessel formation; a condition known as proliferative diabetic retinopathy. These new blood vessels are very fragile and often leak and bleed resulting in retinal fibrosis (scar formation), retinal tears and detachment, and ultimately vision loss. Once the retinopathy has progressed to being proliferative then laser treatment to large areas of the retina (pan-retinal photocoagulation) becomes necessary to halt progression.

Diabetic Macular Oedema (DME)
DME can be either caused by leakage from microaneurysms in retinal blood vessels (swelling in a blood vessel wall) (focal DME) or by leakage of blood vessels under the retina (diffuse DME). This leakage causes retinal thickening and swelling which damages retinal cells and affects vision. The benchmark treatment for DME is laser retinal photocoagulation. However, it is less successful in diffuse DME and new treatments such as intravitreal pharmacotherapy (eye injections) with steroids (such as triamcinolone) and anti-vascular endothelial growth factor (VEGF) are evolving.

It is important to control diabetes. Taking prescribed medications, maintaining a healthy diet and staying physically active can all help to delay or prevent vision loss. Diabetic retinopathy often goes unnoticed. Early detection and timely treatment is essential, so it is advised that people with diabetes get a comprehensive eye exam at least once a year.

Dr Leisa Schmid is an Optometrist at LensPro Brisbane City. She undertook her Optometry training in Brisbane, graduating with First Class Honours.  She then completed a PhD in visual neuroscience at the University of Queensland.  She has presented research and optometry related seminars to both other optometrists and the general public. She is therapeutically qualified and can treat some eye conditions.

This is general advice only and does not replace having regular eye examinations.

Dr Leisa Schmid PhD Optometrist
LensPro Brisbane City
Shop 106A, Level E
The Myer Centre
91 Queen Street
Brisbane Qld 4000
Tel: 07 3012 9099 Fax: 07 3012 9466

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