Diabetic Changes

About four per cent of the Australian population has diabetes. Of these, more than 70 per cent will develop some changes in their eyes within 15 years of diagnosis. Optometrists play an important role in diagnosing these conditions in their early stages, when they respond best to treatment.

Eye Changes in People with Diabetes

Diabetes can sometimes cause the focusing ability of the eye to weaken or fluctuate from day to day. This characteristic has often led to optometrists diagnosing diabetes in their patients. The problem usually eases when blood sugar levels are controlled by a doctor.

Diabetes can also cause more serious changes in the eyes, primarily through its effects on the blood vessels in the retina.

Diabetic Retinopathy

After diabetes has been present for some years, changes may occur at the back of the eye in the retina. Your optometrist uses an instrument called an ophthalmoscope to check for these changes.

These changes are known as diabetic retinopathy. There are two main types of this condition: non-proliferative, sometimes called background retinopathy, and proliferative retinopathy.

The risk of developing retinopathy increases with the length of time you have had diabetes. The risk is also increased when blood sugar levels are not well controlled.

Non-proliferative Retinopathy

This condition rarely causes vision loss and therefore does not usually require treatment. Occasionally, swelling of the retina may cause hazy vision or make straight lines appear bent. Your optometrist may instruct you in a simple procedure to carry out at home so that you can test your eyes for this condition. If vision is affected in this way, your optometrist can confirm the cause and refer you for appropriate treatment.

Proliferative Retinopathy

This condition is more serious and requires early treatment to help prevent serious vision loss. Your optometrist can recognise signs that this condition might develop, or detect it in its early stages. Once proliferative retinopathy has been diagnosed, your optometrist will refer you to an eye surgeon for further appraisal and likely laser treatment. Treatment of this condition has a better chance of success if it is applied very early.

Managing Diabetic Retinopathy

Not all of these complications can be prevented, so the best management is to have regular eye examinations so that changes can be detected and treated early.

It is advisable for all people with diabetes to have yearly eye examinations. People who have been diagnosed with retinopathy should have eye examinations more frequently than once a year. In addition, regular visits to a general medical practitioner and/or endocrinologist may help to control blood sugar levels.

Diabetes and Other Vision Conditions

Double Vision

This is a distressing but rare complication of diabetes. The condition is usually temporary, but it may last for a few months. An optometrist can help treat it while it is present. Diabetes is not the only cause of double vision.

Glaucoma

The eye disease glaucoma is slightly more common in people with diabetes than in the general community. Glaucoma is a condition in which the nerve cells that transmit information from the eye to the brain become damaged, often due to pressure caused by a build-up of fluid in the eye. If untreated, glaucoma can cause blindness.

Cataract

Cataracts are more likely to occur in people with diabetes at an earlier age than in people without diabetes. A cataract is a cloudiness that can form in the lens inside the eye. If present, glaucoma and cataract will be readily detected at your regular eye examination, when your optometrist will advise the best management strategy for the condition.

Read our article on Diabetes and Eye Health.

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