14th Edition-Sept.2006
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For many years diabetes has been the leading cause of people
developing blindness. However, with new advances in how to prevent
or treat diabetes eye damage, the number of people developing
changes to their sight through diabetes is decreasing. Existing
damage can often also be halted or prevented from getting worse.
Diabetes eye damage must be picked up early for it to be successfully
stopped or treated. If damage is picked up late there is often not much
that can be done to save your sight.
Some people already have the early signs of diabetes eye damage
when they first find out they have diabetes. Therefore it is very
important that they have a full diabetes eye check when they first
know they have diabetes. From that time on they should have a full
eye check at least every two years.
Diabetes eye damage is sometimes called a "silent" disease. This is
because the damage can be happening a long time before they notice
any change at all in their sight. By the time their sight changes the
damage is often very bad. Don't wait until you notice your vision is
changing before you have your eyes properly checked.
So, it's really important to:
Get a full diabetes eye check when you first find out you have
diabetes.
Have regular diabetes eye checks every two years you have diabetes.
If you already have any diabetes eye damage have checks and
treatment as directed by an eye specialist.
HOW CAN DIABETES AFFECT MY EYES?
It is easier to understand this if you know about some of the parts of
your eye and how these parts work. The main parts of your eyes the
diabetes can affect are called the "lens" and the "retina" Damage to
your "retina" is usually more serious and also often more common in
those with diabetes.
WHAT ARE THE LENS AND THE RETINA?
Our eyeballs have a front and a back. The front of our eyes the part we
look out of is called the "lens". People who need to wear glasses
usually have some sort of problem with the lens of their eye. The
glasses act like an extra lens that corrects the problem in the eyeball's
lens underneath. You may have changes in your lens that have
nothing to do with your diabetes.
The back of your eyeball is call your "retina" This is a light sensitive
disc that picks up the picture that comes through your lens. The lens
and the retina of your eyes work a bit like a movie projector and a
screen. The projector is like your lens and the screen is like your
retina.
If the lens the picture goes through is wrongly focused or damaged,
the picture on the screen will not be right. This problem can usually be
fixed by refocusing the lens by:
Having glasses or putting a new lens onto the projector.
Having surgery to remove the old lens and implant a new lens into
your eye.
If the screen the picture is projected onto is twisted or has holes or
black spots in it the picture will also not be right. Your retina acts like
the screen the picture is projected onto. Unfortunately, if your retina is
damaged this is often harder to fix.
WHAT CAN GO WRONG WITH MY RETINA IF I HAVE DIABETES?
Unlike a movie screen that is usually a piece of vinyl, your retina is a
piece of living tissue. This means it needs a good blood supply to
keep it healthy. If things go wrong with this blood supply it can
damage pieces of the screen. If the damage is too bad the whole
screen can be wiped out. This results in total blindness.
In diabetes it is mainly damage to the blood vessels in the retina that
can cause problem. The blood vessels can become leaky, blocked or
too small to let through enough blood.
THERE ARE TWO TYPES OF DIABETIC RETINOPATHY:
Background Retinopathy:
This one is the most common form of Diabetic Retinopathy. It is
caused by different types of problems with existing blood vessels
within the eye. The problems involve bleeding from blood vessels
and leakage of the fats and fluids into the tissue of the eye. If these
problems occurs in one particular part of the eye (the macula) reduced
vision will result. Normally, though, this form has no effect on vision
and needs no treatment. Sometimes, though, it can lead to the more
serious form.
PROLIFERATIVE RETINOPATHY:
This is a more serious condition and starts out as Background
Retinopathy. It is caused by the growth of very fine and delicate blood
vessels that tend to bleed very easily. The bleeding itself can cause
problems with vision. Scar tissue may form at the point that bleeding
occurs.
WHO IS AT RISK OF RETINOPATHY?
Several factors influence whether you get retinopathy. These include
your blood glucose control, your blood pressure levels, how long you
have had diabetes, and your genes.
The longer you have had diabetes, the more likely you are to have
Retinopathy. Almost everyone with Type 1 diabetes will eventually
have Background Retinopathy. And most people with type 2 will also
get it. But Retinopathy that can destroy vision is Proliferative
Retinopathy and is far less common.
People who keep their blood glucose closer to normal are less likely
to have Retinopathy, or if they do it is likely to be the less sight
threatening Background Retinopathy.
WHAT CAN GO WROING WITH MY LENS IF I HAVE DIABETES?
People with diabetes are more at risk of getting "cataracts" and
Glaucoma.
Many people without diabetes get cataracts, but people with diabetes
are twice as likely to develop this eye condition. People with diabetes
also tend to get cataracts at a younger age and have them progress
faster. With cataracts, the eye's lens clouds are blocking light.
Cataracts can nearly always be successfully treated. For early
cataracts, you may need to wear sunglasses more often and use glare
control lenses in your glasses. For cataracts that interfere greatly with
vision, doctors usually remove the lens of the eye. Sometimes, the
patient gets a new implanted lens. This is usually a very simple
surgical procedure and most people only need to stay in hospital for 6
to 8 hours to have this done.
People with diabetes are almost twice as likely to develop glaucoma
than people with out diabetes. Glaucoma occurs when pressure builds
up in the eye. The pressure pinches the blood vessels that carry
blood to the retina and optic nerve. This damages the retina and the
nerve and it can cause gradual loss of vision. There are several
treatments for glaucoma. Some use drugs to reduce pressure in the
eye, while others involve surgery.
CAN I PREVENT DIABETIC EYE DAMAGE?
You may not be able to prevent eye damage entirely, but you can
certainly do a great deal to reduce your chance of getting it. You can
also stop it getting worse if you already have it. However to either
prevent it or stop it getting worse is best to take action early
WHAT CHANGES OF VISION SHOULD MAKE ME SEE MY DOCTOR?
Your vision becomes blurry.
You have trouble reading.
One or both of your eyes hurt.
You feel pressure in your eye.
You see spots or "floaters"
You can't see things at the side as you used to.
WHAT IS A DIABETES EYE CHECK?
A check for diabetic eye disease involves trained health professional
either looking at or photographing the backs of our eyes or retinas.
To see your retinas properly they shine a light through the pupils of
your eyes to look in the back of your eye. They usually need to dilate
the pupils of your eyes so the can see the whole of the retina. Putting
special drops in your eyes before doing the check does this.
Once your pupils are dilated the person can either shine a light into
your eyes to look at the retina themselves or take a photo of the back
of your eye. This photo is sent to an eye specialist to look at.
WHAT IF I ALREADY HAVE DIABETIC RETINOPATHY?
The usual treatment for damage to you retina is by laser therapy.
Laser treatment seals leaking or new blood vessels. It mainly works
by preventing and delaying further damage from occurring. Eye
specialists almost always do this type of treatment. You don't have to
be admitted to hospital to have laser therapy. It is usually done in eye
out patient services.
Surgical treatment (called vitrectomy) may be needed if bleeding from
the retina into the eyeball is causing persistent cloudy vision or if
scarring has occurred. Surgery is also available if the retina becomes
detached from its base, which sometimes happens if you have
Proliferative Retinopathy.
IN SUMMING UP HERE ARE SOME THINGS TO DELAY OR PREVENT
EYE DAMAGE
Have regular full diabetes eye checks.
Maintain healthy blood glucose levels, one US test showed that
people on standard diabetes treatment got retinopathy four times
more often as people who kept their blood glucose levels close to
normal.
Maintain a healthy blood pressure, high blood pressure has been
shown to make eye problems worse.
Quit smoking
Maintain healthy blood lipids, (cholesterol)
Report any changes in your sight urgently and immediately to you
doctor.
developing blindness. However, with new advances in how to prevent
or treat diabetes eye damage, the number of people developing
changes to their sight through diabetes is decreasing. Existing
damage can often also be halted or prevented from getting worse.
Diabetes eye damage must be picked up early for it to be successfully
stopped or treated. If damage is picked up late there is often not much
that can be done to save your sight.
Some people already have the early signs of diabetes eye damage
when they first find out they have diabetes. Therefore it is very
important that they have a full diabetes eye check when they first
know they have diabetes. From that time on they should have a full
eye check at least every two years.
Diabetes eye damage is sometimes called a "silent" disease. This is
because the damage can be happening a long time before they notice
any change at all in their sight. By the time their sight changes the
damage is often very bad. Don't wait until you notice your vision is
changing before you have your eyes properly checked.
So, it's really important to:
Get a full diabetes eye check when you first find out you have
diabetes.
Have regular diabetes eye checks every two years you have diabetes.
If you already have any diabetes eye damage have checks and
treatment as directed by an eye specialist.
HOW CAN DIABETES AFFECT MY EYES?
It is easier to understand this if you know about some of the parts of
your eye and how these parts work. The main parts of your eyes the
diabetes can affect are called the "lens" and the "retina" Damage to
your "retina" is usually more serious and also often more common in
those with diabetes.
WHAT ARE THE LENS AND THE RETINA?
Our eyeballs have a front and a back. The front of our eyes the part we
look out of is called the "lens". People who need to wear glasses
usually have some sort of problem with the lens of their eye. The
glasses act like an extra lens that corrects the problem in the eyeball's
lens underneath. You may have changes in your lens that have
nothing to do with your diabetes.
The back of your eyeball is call your "retina" This is a light sensitive
disc that picks up the picture that comes through your lens. The lens
and the retina of your eyes work a bit like a movie projector and a
screen. The projector is like your lens and the screen is like your
retina.
If the lens the picture goes through is wrongly focused or damaged,
the picture on the screen will not be right. This problem can usually be
fixed by refocusing the lens by:
Having glasses or putting a new lens onto the projector.
Having surgery to remove the old lens and implant a new lens into
your eye.
If the screen the picture is projected onto is twisted or has holes or
black spots in it the picture will also not be right. Your retina acts like
the screen the picture is projected onto. Unfortunately, if your retina is
damaged this is often harder to fix.
WHAT CAN GO WRONG WITH MY RETINA IF I HAVE DIABETES?
Unlike a movie screen that is usually a piece of vinyl, your retina is a
piece of living tissue. This means it needs a good blood supply to
keep it healthy. If things go wrong with this blood supply it can
damage pieces of the screen. If the damage is too bad the whole
screen can be wiped out. This results in total blindness.
In diabetes it is mainly damage to the blood vessels in the retina that
can cause problem. The blood vessels can become leaky, blocked or
too small to let through enough blood.
THERE ARE TWO TYPES OF DIABETIC RETINOPATHY:
Background Retinopathy:
This one is the most common form of Diabetic Retinopathy. It is
caused by different types of problems with existing blood vessels
within the eye. The problems involve bleeding from blood vessels
and leakage of the fats and fluids into the tissue of the eye. If these
problems occurs in one particular part of the eye (the macula) reduced
vision will result. Normally, though, this form has no effect on vision
and needs no treatment. Sometimes, though, it can lead to the more
serious form.
PROLIFERATIVE RETINOPATHY:
This is a more serious condition and starts out as Background
Retinopathy. It is caused by the growth of very fine and delicate blood
vessels that tend to bleed very easily. The bleeding itself can cause
problems with vision. Scar tissue may form at the point that bleeding
occurs.
WHO IS AT RISK OF RETINOPATHY?
Several factors influence whether you get retinopathy. These include
your blood glucose control, your blood pressure levels, how long you
have had diabetes, and your genes.
The longer you have had diabetes, the more likely you are to have
Retinopathy. Almost everyone with Type 1 diabetes will eventually
have Background Retinopathy. And most people with type 2 will also
get it. But Retinopathy that can destroy vision is Proliferative
Retinopathy and is far less common.
People who keep their blood glucose closer to normal are less likely
to have Retinopathy, or if they do it is likely to be the less sight
threatening Background Retinopathy.
WHAT CAN GO WROING WITH MY LENS IF I HAVE DIABETES?
People with diabetes are more at risk of getting "cataracts" and
Glaucoma.
Many people without diabetes get cataracts, but people with diabetes
are twice as likely to develop this eye condition. People with diabetes
also tend to get cataracts at a younger age and have them progress
faster. With cataracts, the eye's lens clouds are blocking light.
Cataracts can nearly always be successfully treated. For early
cataracts, you may need to wear sunglasses more often and use glare
control lenses in your glasses. For cataracts that interfere greatly with
vision, doctors usually remove the lens of the eye. Sometimes, the
patient gets a new implanted lens. This is usually a very simple
surgical procedure and most people only need to stay in hospital for 6
to 8 hours to have this done.
People with diabetes are almost twice as likely to develop glaucoma
than people with out diabetes. Glaucoma occurs when pressure builds
up in the eye. The pressure pinches the blood vessels that carry
blood to the retina and optic nerve. This damages the retina and the
nerve and it can cause gradual loss of vision. There are several
treatments for glaucoma. Some use drugs to reduce pressure in the
eye, while others involve surgery.
CAN I PREVENT DIABETIC EYE DAMAGE?
You may not be able to prevent eye damage entirely, but you can
certainly do a great deal to reduce your chance of getting it. You can
also stop it getting worse if you already have it. However to either
prevent it or stop it getting worse is best to take action early
WHAT CHANGES OF VISION SHOULD MAKE ME SEE MY DOCTOR?
Your vision becomes blurry.
You have trouble reading.
One or both of your eyes hurt.
You feel pressure in your eye.
You see spots or "floaters"
You can't see things at the side as you used to.
WHAT IS A DIABETES EYE CHECK?
A check for diabetic eye disease involves trained health professional
either looking at or photographing the backs of our eyes or retinas.
To see your retinas properly they shine a light through the pupils of
your eyes to look in the back of your eye. They usually need to dilate
the pupils of your eyes so the can see the whole of the retina. Putting
special drops in your eyes before doing the check does this.
Once your pupils are dilated the person can either shine a light into
your eyes to look at the retina themselves or take a photo of the back
of your eye. This photo is sent to an eye specialist to look at.
WHAT IF I ALREADY HAVE DIABETIC RETINOPATHY?
The usual treatment for damage to you retina is by laser therapy.
Laser treatment seals leaking or new blood vessels. It mainly works
by preventing and delaying further damage from occurring. Eye
specialists almost always do this type of treatment. You don't have to
be admitted to hospital to have laser therapy. It is usually done in eye
out patient services.
Surgical treatment (called vitrectomy) may be needed if bleeding from
the retina into the eyeball is causing persistent cloudy vision or if
scarring has occurred. Surgery is also available if the retina becomes
detached from its base, which sometimes happens if you have
Proliferative Retinopathy.
IN SUMMING UP HERE ARE SOME THINGS TO DELAY OR PREVENT
EYE DAMAGE
Have regular full diabetes eye checks.
Maintain healthy blood glucose levels, one US test showed that
people on standard diabetes treatment got retinopathy four times
more often as people who kept their blood glucose levels close to
normal.
Maintain a healthy blood pressure, high blood pressure has been
shown to make eye problems worse.
Quit smoking
Maintain healthy blood lipids, (cholesterol)
Report any changes in your sight urgently and immediately to you
doctor.
By: Nancy Brown
Damage to your retina through diabetes is
called "Diabetic Retinopathy". It is
important to remember that Diabetic
Retinopathy is a process. It has a
beginning, middle and an end. The end
point of Diabetic Retinopathy results in
total loss of vision or blindness.
Fortunately the beginning part and to
some extent the middle part can often be
successfully treated or at least stopped
from getting worse.
called "Diabetic Retinopathy". It is
important to remember that Diabetic
Retinopathy is a process. It has a
beginning, middle and an end. The end
point of Diabetic Retinopathy results in
total loss of vision or blindness.
Fortunately the beginning part and to
some extent the middle part can often be
successfully treated or at least stopped
from getting worse.