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Diabetic Eye Screening & Diabetic Retinopathy
Why is Diabetic Eye Screening Necessary?
Diabetic Eye Screening is an essential part of diabetic care.
If you have been diagnosed with diabetes, you are at risk for developing Diabetic Retinopathy - a condition that can lead to blindness if left untreated. Among Australians between the ages of 20 and 65 years, diabetic retinopathy is the leading cause of blindness.
Diabetic Eye Screening can detect changes in your eyes at an early stage when loss of vision can be prevented or even improved.
How often should Diabetic Eye Screening be performed?
It has been recommended that all Australians who have been diagnosed with diabetes undergo Diabetic Eye Screening every 1-2 years.
How do you prepare for Diabetic Eye Screening?
When coming for a Diabetic Eye Screening you must bring your glasses or contact lenses along with the lens solution. You should also bring sunglasses as your eyes may become temporarily sensitive to light following the Diabetic Eye Screening.
What happens during Diabetic Eye Screening?
During the diabetic screening, you may be given eye drops to dilate your pupils.
The drops may cause a stinging sensation and temporary blurring of vision. Once your pupils are sufficiently dilated, detailed photographs of your eyes will be taken.
The entire procedure will last no more than 30 minutes.
What precautions should be taken after Diabetic Eye Screening?
After the Diabetic Eye Screening exam, everything will appear bright and you may have to wear sunglasses for a few hours.
You should have someone drive you back home after a Diabetic Eye Screening.
What Could the Results of a Diabetic Eye Screening Exam Demonstrate?
A Diabetic Eye Screening exam has three outcomes:
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No signs of Diabetic Retinopathy
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Early signs of Diabetic Retinopathy that would require follow-up treatment
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Advanced signs of Diabetic Retinopathy that requires immediate treatment
How is Diabetic Retinopathy treated?
Treatment would depend on the type and severity of the diabetic retinopathy:
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Early stage Diabetic Retinopathy - Mild or moderate diabetic retinopathy may not require any specific eye treatment other than close monitoring and strict blood sugar control.
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Advanced stage Diabetic Retinopathy - Severe diabetic retinopathy will require prompt treatment. The various options include
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Focal Laser Treatment - The laser treatment is focussed on specific areas within the retina to stop or slow down the leakage of blood and fluid into the eye from abnormal blood vessels. The procedure is also known as photocoagulation.
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Scatter Laser Treatment - Abnormal blood vessels in regions away from the centre of the retina (macula) are treated with scattered laser burns. The treatment causes shrinkage of the abnormal blood vessels. The procedure is also known as Panretinal Photocoagulation.
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Vitrectomy - A very small incision is made in the centre of the eye to remove blood and scar tissue.
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Injections - Certain medications are known as vascular endothelial growth factor (VEGF) inhibitors may be injected into the eye to prevent the growth of abnormal blood vessels.
Of note, after treatment for Diabetic Retinopathy you must continue to have regular diabetic screening to effectively manage diabetes.
Diabetic Retinopathy & Diabetic Macular Oedema (DMO/DME)
Diabetic Eye Disease or Diabetic Retinopathy is a medical condition in which high levels of blood sugar cause damage to blood vessels within the retina.
Diabetic Retinopathy can lead to:
Vision Loss from swelling of the retina - Macular Oedema,
Bleeding or Vitreous Haemorrhage, and
Retinal Scarring - Proliferative Diabetic Retinopathy
Diabetic Retinopathy is a leading cause of blindness among working-age adults aged 25-74 in Australia.
All people with diabetes mellitus are at risk this includes both those with Type I diabetes and those with Type II diabetes. The longer a person has diabetes, the higher their risk of developing eye problems.
People who have persistently high blood glucose levels are at risk of serious vision loss and blindness.
People with diabetes whose blood glucose is not at target levels are almost eight times more likely to develop Diabetic Retinopathy.
Other general health factors causing Diabetic Retinopathy are patients with elevated:
blood pressure
blood lipids
weight
Good diabetes control is important for managing Diabetic Retinopathy.
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Diabetic Retinopathy results from damage to the small blood vessels and nerve cells of the retina as a side effect of diabetes.
The choroid is the underlying vascular (blood vessel) layer of the eye from which the Retina receives oxygen and nutrients.
These small blood vessels (capillaries) are especially vulnerable to high sugar levels in the blood, which damage the cells of the capillary wall, causing leakage and blockage of the capillaries.
Diabetic Retinopathy occurs when these blood vessels in the Retina are damaged.