Eye problems are among the most significant complications of diabetes, and eye problems from diabetes are the most common cause of blindness in people of working age.

Diabetes affects the eye in a number of ways. The most damaging condition occurs when the fine network of blood vessels in the retina – the light-sensitive inner lining of the back of the eye – leak fluid. This is known as diabetic retinopathy. If you are diabetic, it is very important that you have regular screening for retinopathy. Your local NHS will arrange this for you.

Cataracts also develop earlier and progress more rapidly in people with diabetes than in other people. Untreated diabetes may also make cause frequent or noticeable changes to your eyesight. If you notice any problems with your eyesight you should see your optometrist for advice.

Serious eye problems are less likely if the diabetes is well controlled or in its early stages. If problems are detected and treated early, most sight loss from diabetic eye disease can be prevented.

Remember, however, that if your vision is getting worse, this does not necessarily mean you have diabetic retinopathy. It may simply be a problem that can be corrected with glasses.

It is important to realise that retinopathy screening will not detect signs of other eye disease such as glaucoma, so it is also important to go for your regular eye examinations with your optometrist as well as having your retinopathy screening.

How can your optometrist help?

If the optometrist suspects you may have diabetes, they will refer you to a doctor for medical advice.

As well as yearly retinopathy screening, you should go to your optometrist for regular eye examinations, which are paid for by the NHS, to make sure you have no other signs of eye disease. You will usually have a test every two years – unless your optometrist advises otherwise, This is different from the retinopathy screening.

Diabetic retinopathy and your eyes

The video below should be viewed in conjunction with the text beneath it and preferably watched while your optometrist discusses it with you.

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  • Diabetes can have various effects on the eyes, most commonly the retina.
  • The walls of the blood vessels tend to become weakened.
  • Over time, the walls may bulge – known as an aneurysm.
  • This creates an ‘eddy’ in the blood flow which can eventually block.
  • Blood and other fluids also tend to leak from the blood vessels.
  • This results in a build up of lipids in the layers of the retina.
  • Because of the reduction in blood flow, new blood vessels tend to form.
  • However these blood vessels are fragile and bleed easily.
  • If the new blood vessels bleed into the jelly in the eye (the vitreous) there can be a sudden loss of vision. But this may clear somewhat over time.

What can be done?

Most sight-threatening diabetic problems can be prevented by laser treatment if it is carried out early enough. It is important to realise, however, that laser treatment aims to save the sight you have – not to make it better. The laser, a beam of high intensity light, can be focused with extreme precision to seal the blood vessels that are leaking fluid into the retina. If new blood vessels grow, more extensive laser treatment may be needed.

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