If you have diabetes, you’re at risk of developing an eye condition known as diabetic retinopathy, a complication of diabetes that damages the light-sensitive layer at the back of the eye (retina). Left undiagnosed and untreated, diabetic retinopathy can lead to sight loss, but with ongoing diabetes management and regular screening, you can protect your vision.
What are the symptoms of diabetic retinopathy?
In its early stages, diabetic retinopathy does not usually cause any noticeable symptoms – so you may not even know you have it.
That’s why screening is such an important part of care for diabetics. Screening can detect the condition before you notice any changes to your vision, and if it is detected early enough, management of the condition can stop it getting worse. Otherwise, by the time symptoms become noticeable, it can be much more difficult to treat.
What causes diabetic retinopathy?
The retina is the light-sensitive layer that covers the back of our eyes and needs a constant supply of blood to keep it healthy. Diabetic retinopathy occurs when high blood sugar levels start to damage these blood vessels. The damage happens in three main stages (background, preproliferative and proliferative) and it’s in the advanced stages that the blood can leak out and cause vision loss.
How is diabetic retinopathy diagnosed?
Everyone with type 1 and type 2 diabetes will be invited to a diabetic eye screening programme from the age of 12. This is usually a yearly check to assess the health of the retina and keep an eye out for any signs of its development.
Diabetic eye screening is separate to your normal eye test, so you’ll still need to see an optician regularly. Along with testing your vision, your optician will also be able to check for any signs of diabetic retinopathy during your eye test. One way of doing this is with an OCT scan, a hospital-quality scan that allows us to see all the layers within the eye and helps our opticians to see any slight change in the retina that could signal diabetic retinopathy.
If you’re diabetic, you should already be part of a screening programme, if you are not, your GP can arrange this for you. In certain parts of the country, we provide this regular screening service on behalf of the NHS.
You should receive a letter from your local Diabetic Eye Screening Service inviting you to attend a screening appointment. The letter will include a leaflet about diabetic eye screening. The check takes about 30 minutes and involves examining the eyes and taking photographs of the retina to assess its health.
The photos from your check will be assessed by a number of specialists, including someone who is trained in identifying and grading retinopathy. Within six weeks, both you and your GP should receive a letter with your results.
You may need to have a further assessment if:
- The photographs are not clear enough to give an accurate result
- You have retinopathy that could affect your sight and follow-up treatment is needed
- You have retinopathy that needs to be checked more than once a year
- Other eye conditions are detected, such as glaucoma or cataracts
If your results show no retinopathy or background retinopathy, you will be invited back for another screening appointment a year later.
If you have sight problems in between screening appointments, such as sudden vision loss or deterioration in your vision, seek immediate advice by contacting your optician, GP or NHS 111. Do not wait until your next screening appointment.
Treatment and management of diabetic retinopathy
Treatment for diabetic retinopathy will depend on which stage of diabetic retinopathy is present and will only be necessary if your screening identifies that your vision is at risk.
Management in the meantime will usually involve maintaining a healthy lifestyle and keeping a close eye on your blood sugar levels.
For advanced stages of diabetic retinopathy, there are three main treatment options:
- Laser treatment
- Injections into the eye
Sir Steve Redgrave on diabetes
Sir Steve Redgrave CBE already won four Olympic gold medals in four consecutive games when he was diagnosed with type 2 diabetes in 1997.
Well into his preparation for the Sydney 2000 Olympics, it was a bombshell that could have made many give up. But three years later, at the age of 38, he collected his fifth gold medal in the coxless four.
The sporting legend, now 56, has teamed up with Specsavers and RNIB to raise awareness of the importance of eyecare, which he says plays a key role in helping him monitor his diabetes.