08 Aug What is diabetic eye disease?
Diabetic eye disease is formally known as diabetic retinopathy. This progressive disease process is driven by diabetes and attacks the tiny network of blood vessels in the retina at the back of the eye. It will affect to some extent the majority of individuals who have had diabetes for 20 years or more. It is one of the world’s leading causes of blindness and was responsible for 5% of world blindness, 5million cases in 2002. Sadly, the incidence and prevalence of this condition has been rising since.
How does diabetes damage the eye?
The uncontrolled regulation of blood sugar in diabetes leads to large variations in the levels of sugar in the blood. High levels of blood sugar act as a corrosive, damaging the delicate lining of blood vessels and causing lesions to develop. Intricate networks of blood vessels such as those in the eye are damaged, attempt to proliferate and become leaky and frankly bleed which eventually leads to a decrease in visual acuity and blindness.
Key risk factors for the development of diabetic retinopathy include:
- Length of time the patient has had diabetes
- Insulin dependence
- High serum lipid levels 
What are the symptoms of diabetic retinopathy?
Much of the damage to the retina by diabetes takes place without any symptoms. The appearance of symptoms of diabetic eye disease is a late feature in the disease process. The main symptoms are blurry vision, vision loss and blindness.
How is diabetic eye disease managed?
1- Treat the underlying diabetes: Bringing the diabetes under control with stringent blood sugar management is critical. Insulin may need to be started for this purpose. Patients should be educated to monitor serum blood sugar closely.
2- Screening and Monitoring: As diabetic retinopathy develops without symptoms screening provides a vital opportunity for detection of the disease process at the back of the eye. This examination of the retina is also used to monitor progress of the condition at regular intervals. Using an ophthalmoscope or modern digital imaging, the retina can be examined for characteristic lesions, fluid leakages and bleeding indicative of retinopathy. Visual acuity can also be routinely assessed.
3- Treatment: Laser photo-coagulation is a key treatment targeted at controlling the proliferation of friable new blood vessels and preventing leakage or haemorrhaging of vessels. Intervention must be timely if visual acuity and sight are to be preserved .Other ophthalmic operations
such as vitrectomy, removal of the vitreous with replacement with saline may save vision. A number of novel drugs which target the proliferative stage of the disease have limited used and availability.
This article is not a substitute for a consultation with your surgeon. Before choosing to proceed with laser eye surgery your surgeon will have a detailed discussion with you about the right procedure and about the potential complications.
A unique mix of expertise, experience and international reputation, Dr Ron Binetter is the figure behind the Binetter Eye Centre. With more than two decades of hands-on experience in eye surgery, Dr Binetter is a specialist in cataract, lens implantation and laser eye surgery. Learn more about Dr Ron Binetter’s background and qualifications.