Diabetic Eye Disease – Stages, Symptoms, and Treatment
Having diabetes is about more than keeping your blood sugar level in the target range: Even if you can put the disease in reverse, you’ll always be living with it, monitoring it, and being mindful of potential complications, particularly those that can affect your eyes. What is diabetic eye disease? It’s a term used to describe a collection of eye problems that are the result of long-term high blood sugar, which could potentially result in vision loss if left unaddressed. These include diabetic retinopathy, diabetic macular oedema (DME), cataract and glaucoma. High glucose over time is toxic to the delicate blood vessels in the retina, which swell, leak and tissue suffers damage as a result. Early detection and treatment are very important, and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) states that blindness may be avoided if prompt treatments begin soon enough.
Common Types of Diabetic Eye Disease
Several eye diseases are considered part of the spectrum of diabetic eye disease, with their own course of development, and risk factors:
- The most common form is Diabetic Retinopathy, caused by injury to blood vessels of the retina. If these vessels weaken, fluid or blood may leak out and vision loss can result.
- Diabetic Macular Oedema (DME) is when fluid accumulates in the macular, which plays a key role in providing our sharp, central vision. This swelling results in blurry or distorted vision.
- In people with diabetes, cataracts, or the clouding of the eye’s natural lens, often develop sooner and progress faster.
- Glaucoma is where pressure in the eye is raised, damaging the nerve over time. Diabetics are almost 2 times more likely to have glaucoma compared to non-diabetics.
Stages of Diabetic Eye Disease
Diabetic retinopathy is divided into several stages of diabetic eye disease, which are usually distinguished by the severity of the damage:
- Background/Significance Mild Non-Proliferative Retinopathy – small bulges (microaneurysms) occur in the blood vessels of the retina. Vision may be unaffected at this point.
- Moderate Non-Proliferative Retinopathy – Blood vessels start to distort more and small signs of change in vision may be present.
- Advanced Non-Proliferative Retinopathy – Blood vessels are severely blocked, some areas of the retina don’t get enough oxygen.
- Proliferative Retinopathy – The most advanced stage and defined as the stage where new, delicate blood vessels grow incorrectly within the eye and can fill with blood and bleed into the eye potentially causing retinal tearing and detachment and blindness.
Symptoms of Diabetic Eye Disease
In the early stages, diabetic eye disease has no symptoms, so it is important that you get your eyes screened regularly. In more advanced stages, symptoms include:
- Blurred or fluctuating vision
- Dark spots or floaters
- Difficulty seeing at night
- Sudden loss of vision (and sometimes blindness in one eye)
Signs such as these should not be ignored since early treatment can save eyesight.
Risk Factors for Diabetic Eye Disease
Just like anyone can get diabetic eye problems, the risk goes up with:
- Uncontrolled blood sugars
- Elevated blood pressure and cholesterol
- Duration of diabetes for more than 10 years
- Smoking and obesity
- Family history of diabetic complications, such as retinopathy, nephropathy or foot ulcers
Since patients can take steps to reduce these risk factors, the knowledge that they play a role makes them feel more in control over their recovery.
Diagnosis and Screening for Diabetic Eye Disease
Early diagnosis is crucial for optimal treatment. Multiple diagnostic weapons are employed:
- Concise dilated eye test – The pupils are opened wide to closely examine the retina.
- Optical Coherence Tomography (OCT) – Generates images of layers of the retina to identify swelling.
- Fluorescein Angiography – A dye is injected to detect leaking blood vessels in the retina.
According to NHS guidelines, all people with diabetes should have an annual diabetic eye screening undertaken, designed to identify any changes before symptoms occur.
Treatment for Diabetic Eye Disease
The treatment for the diabetic eye disease varies depending on the type and severity:
A. Early-Stage Management
“Maintaining target range of blood sugar, blood pressure, cholesterol is the other major thing. A healthy lifestyle, including a good diet, regular exercise and giving up smoking, can also restrict the progression of the disease.
B. Medical Treatments
- Anti-VEGF injections (such as Lucentis or Eylea) are a popular treatment option to halt abnormal blood vessels in the retina.
- Retinal swelling in DME is limited by treatment with steroid injections or implants.
C. Laser Treatment
- Focal laser seals any leaking vessel to decrease the accumulation of fluid.
- PRP (also called scatter laser treatment) is used to shrink the abnormal blood vessels in proliferative retinopathy.
D. Surgical Options
- Vitrectomy is also conducted in severe cases to eliminate blood and scarring for the eye.
- Cataract surgery swaps the fogged lens with an artificial one to recover sight.
Preventing Diabetic Eye Disease
It can be prevented with proper health care. Key steps include:
- Keeping HbA1c levels less than 7%
- Best to keep BP under 140/90 mm Hg.
- Preventing and lowering cholesterol
- Annual Eye Check-Ups
- Not smoking and keeping a healthy weight
These practices lower your chance of experiencing serious eye complications.
Conclusion: Early Action Saves Vision
Like we said earlier, the eye problems due to diabetes are serious…but they’re also some of the most preventable. With regular eye checks, good diabetic control, and prompt treatment for diabetic eye disease, most people can keep their vision throughout their lives. And if anything changes with your vision, or you have any concerns, don’t hesitate to find out what’s going on from a professional.
Protect your vision if you have diabetes, with an annual eye exam.
Chase Lodge Hospital
