How can you tell if diabetes is affecting your eyes?
If you are diabetic, either on tablets or insulin, your eyes are at risk of developing cataracts, diabetic eye disease (DED) and dry eyes.
Diabetes causes changes to blood sugar levels. This can affect the lens in your eye, particularly if your diabetes is poorly controlled. As your blood sugar levels fluctuate during the day, this can cause blurred vision. Eventually, this can lead to a premature cataract. However, diabetic eye disease does not cause visual symptoms until late in the disease, hence, it is extremely important to have regular eye checks in order to make an early diagnosis.
Diabetes can also have an impact on the blood supply to the back of the eye, which can affect how the retina works. This can cause changes in vision resulting in shapes floating in your vision field (often referred to as “floaters”) and blurred vision, from proliferative diabetic retinopathy (PDR) with the risk of retinal vessel occlusion and retinal haemorrhages, and diabetic maculopathy, particularly diabetic macula oedema (DMO).
Dry eyes are also found to be common in diabetes, these often cause redness and eye pain.
What eye diseases are caused by diabetes?
When the blood vessels in the retina become damaged, this causes a condition called proliferative diabetic retinopathy (PDR). Blood vessels can become blocked, grow incorrectly, or start to leak. This in turn reduces blood supply to the retina, which then affects your vision.
The macula is the centre part of the retina, and very important for your best ‘straight-ahead’ vision – for seeing detail, reading, driving, and for colour vision.
When the macula of the eye becomes affected by retinopathy, this is known as diabetic maculopathy. This can then develop into diabetic macular oedema (DMO).
In some cases, diabetic retinopathy can progress further and new, abnormal blood vessels can start to develop inside the eye. These can cause many problems and require treatment with laser (pan-retinal photocoagulation) and/or injections into the eye. In some cases, surgery may be indicated, for instance, if there is a lot of bleeding in the eye that is not getting better by itself or if the retina becomes unstable and a retinal detachment develops.
See Diabetic Eye Disease Treatments here
Diabetic Macula Oedema (DMO)
What is diabetic macular oedema?
Diabetic macula oedema (DMO) is a disorder concerning the centre of the retina, which is used for sharp vision. Blood vessels damaged by diabetes become leaky, and fluid builds up around and in the retinal cells causing swelling in the retina. It is relatively common in diabetic patients, especially when diabetes is not well controlled. In comparison, proliferative diabetic retinopathy is less commonly seen, but when present can seriously threaten vision and subsequent complications such as cataract.
What are the symptoms of diabetic macular oedema?
The main symptom of diabetic macula oedema is blurred or wavy vision. This is usually experienced in the centre of the field of vision. Patients may also find that colours seem to appear faded or not as sharp.
People with macular oedema experience a range of vision loss, from only slightly blurry to a vision loss which is noticeable. It can take longer to notice these symptoms if only one eye is affected.
What causes diabetic macula oedema?
Macular oedema occurs when there is an accumulation of fluid in the macula, caused by leakage from damaged blood vessels in the retina. This is primarily caused by diabetic retinopathy. It can also be caused by age-related macular degeneration or inflammatory diseases which affect the eye.
Risk factors for DMO include high blood pressure, high cholesterol and smoking. The risk also increases with the length of time you’ve been diabetic and if your diabetes is poorly controlled. The condition is also more likely to occur in pregnancy.
It is very important to ensure that your diabetes, blood pressure and cholesterol are as well-controlled as possible and that you do not smoke. We will advise you to see your GP or diabetes specialist to check all of these factors.
Is diabetic macular oedema serious?
In the early stages, macular oedema can be reversible. But chronic oedema may lead to irreversible changes in the macular and retina, leading to permanent vision loss. Therefore, if untreated, macular oedema can be extremely serious.
Can diabetic macular oedema be cured?
There is no permanent cure, but various medications and procedures as advised by a specialist doctor can help to reverse or slow the damaged caused by this condition.
In mild cases which are not affecting vision, we would advise monitoring closely and ensuring that all the factors discussed above are well-controlled. In some cases, for example, if the patient has uncontrolled blood pressure, the DMO can resolve with improved control. This may require different medication and lifestyle changes.
What is the best treatment for diabetic macular oedema?
If a patient is experiencing vision changes, there are different treatments that we may suggest. These include laser treatment and injections of special drugs and steroid implants.
Clinica London Retina Care
We have five highly skilled medical and surgical retinal consultant specialists available to assess, diagnose, advise and carry out treatments and surgery for your diabetic eye disease.
See all Diabetic Eye Disease Treatments here
If you are interested in seeking treatment for diabetic eye disease, macular oedema or any other eye condition, find out more about our team of experts. We will be delighted to hear from you to discuss how we can help to improve your symptoms and long-term eye health.