Diabetic Eye Disease (Retinopathy)

What is diabetic retinopathy?

Diabetic retinopathy or diabetic eye disease, occurs when high levels of sugar (glucose) in the blood damage the blood vessels which normally provide nutrients and oxygen to your retina.

The damage causes two problems with the blood vessels. Firstly, the damaged blood vessels can leak, causing your retina to become waterlogged, which compromises your ability to see clearly. This swelling commonly occurs in the macula, which controls your central vision. It is known as diabetic macular oedema (DMO).

Secondly, the damage can prevent blood from flowing through the blood vessels. The retina becomes starved of oxygen and ceases to function properly. This is called non-proliferative diabetic retinopathy (NPDR).

If the blood vessel damage is severe, the retina may produce new abnormal blood vessels in an attempt to provide oxygen again. This is called proliferative diabetic retinopathy (PDR). These new retinal blood vessels are fragile and can bleed easily or turn into scar tissue, which can detach your retina. New blood vessels can also grow at the iris, the coloured part of your eye, which can lead to glaucoma. Proliferative diabetic retinopathy poses a significant risk of permanent vision loss and requires prompt treatment.

What are the symptoms of diabetic retinopathy?

Diabetic retinopathy can affect the vision in two main ways: swelling of the macula (macular oedema) or bleeding into the vitreous jelly of the eye (vitreous haemorrhage).

In diabetic macular oedema, you may have blurred vision, a central black spot in your vision, distortion or difficulty with depth perception. Vitreous haemorrhage can cause a cloud of spots in your vision (floaters) or blurred vision.

How can I reduce the risks of getting diabetic retinopathy?

You can reduce your risk of developing or worsening diabetic retinopathy by:

• Keeping your blood sugar (glucose) level within normal limits

• Tightly controlling your blood pressure

• Controlling your cholesterol levels

• Keeping fit and maintaining a healthy weight

• Give up smoking

• Having regular retinal screening – the most effective thing you can do to prevent sight loss due to diabetic retinopathy is to attend your retinal screening appointments. Early detection and treatment can stop you from losing sight.

How do you treat diabetic retinopathy?

It is crucial to control your blood sugar levels, blood pressure and cholesterol. Dr Yun will liaise with your GP and endocrinologist to ensure optimal control is achieved.

Mild diabetic oedema does not need treatment and can be closely monitored. Moderate diabetic oedema may be suitable for localised laser treatment targeted at leaking blood vessels. Severe cases of diabetic oedema can be treated with a course of “anti-VEGF” injections into the affected eye. These medications stop the damaged blood vessels from leaking.

Non-proliferative diabetic retinopathy requires regular monitoring to ensure that no new abnormal blood vessels have formed. If proliferative diabetic retinopathy is present, a larger area of your retina may need to be treated by laser. Treating more of your retina stops it from producing the growth factors that make new blood vessels develop. Proliferative diabetic retinopathy may also require a course of injections into the affected eye.

Dr Yun provides both laser treatment and “anti-VEGF” injections in his rooms.