Diabetic Retinopathy

Diabetes is a chronic condition that can have adverse effects on the eye and visual function. Diabetic Retinopathy (DR) is caused by complications of diabetes. It damages blood vessels that nourish the retina at the back of the eye. This progressively results in blurred vision. Severe vision loss may be preventable if the DR is detected and treated early and appropriately.

DR typically begins as small microaneurysms (ballooning of small blood vessels) in the retina. Intermediate signs are small dot haemorrhages in the retina, as well as small areas of blood vessel leakage (exudates) and small areas of reduced blood supply (cotton-wool spots). End-stage DR is characterised by internal eye (vitreous) haemorrhage, as well as retina scarring and detachment of the retina from the back of the eye (tractional retinal detachment).

DR is best minimised by maintaining good control of blood sugar levels and through early detection of disease progression. Early detection allows for intervention in the disease process, either through laser photocoagulation, or intravitreal injection of Anti-VEGF pharmaceutical agents or steroids to halt or delay progression of the ocular disease. Treatment may maintain vision, though it rarely restores it.

People with diabetes also have an increased risk of acquiring other vision conditions, such as glaucoma or cataracts. Regular eye examinations are essential to detect these vision conditions.

Functional implications of DR include:

  • Having difficulty with fine details (e.g. when reading or watching television)
  • Having difficulty with outdoor travel
  • Experiencing visual fluctuations from hour to hour or day to day
  • Seeing images as rippled (e.g. straight lines appear bent)
  • Experiencing blurred, hazy or double vision
  • Losing some field of vision
  • Having difficulty seeing at night or in low light
  • Being particularly sensitive to glare and light
  • Having difficulty focusing.

For further information on diabetes, visit Diabetes Australia or Optometrists Association Australia.

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