Diabetic retinopathy: How to prevent vision loss

Diabetic retinopathy is an eye condition that affects the blood vessels in the retina. It can cause vision loss/blindness for those who have diabetes. Signs and symptoms aren’t usually visible in the early stages. For this reason, it is crucial for those with diabetes to have regular eye tests where an optometrist will carry out checks that are designed to target early detection of eye diseases such as diabetic retinopathy.

What causes diabetic retinopathy?

Diabetic retinopathy is caused by having too much sugar in the blood (diabetes). This can affect the retina (the part of the eye that detects light) and eventually result in vision loss if left untreated.

There are two main stages of diabetic retinopathy:

Early diabetic retinopathy

Also known as non-proliferative diabetic retinopathy, this is when new blood vessels do not grow, and the walls of the blood vessels in your retina weaken. Tiny bulges form in the weakened blood vessels and may leak fluid into the retina which could cause swelling. This is the early stage of the condition.

Proliferative diabetic retinopathy

This is the later stage of the condition where new, fragile blood vessels begin to grow in the retina and vitreous (the gel-like fluid that fills the back of the eye). These new, abnormal blood vessels can leak blood into the vitreous and block vision.

What is the first symptom of diabetic retinopathy?

You may not experience any diabetic retinopathy symptoms in the early stages, which is why those with diabetes should ensure they are having their eyes tested at least once a year. As the condition progresses, you may experience:

• Spots and/or dark strings floating in your vision
• Pain in the eye
• Blurred or fluctuating vision
• Dark or empty areas in your vision
• Poor vision in dark or low-lit areas
• Vision loss

What is the most common treatment for diabetic retinopathy?

Diabetic retinopathy treatment largely depends on what stage the condition is at. Whilst there is no cure, treatment can prevent, delay or reduce vision loss. Here are some common treatments for diabetic retinopathy:

Laser treatment (photocoagulation)

Optic neuritis and nerve damage can occur unexpectedly without any specific reason. There are steps that you can take to reduce your risk of developing optic neuritis.

Laser treatment works by limiting the growth of new blood vessels across the back of your retina. It can also help seal leaking blood vessels. For this reason, it is most effective when used in the early stages of diabetic retinopathy. More aggressive forms of laser treatment may be used for diabetic retinopathy if it has severely developed.

Injections

Medicine may be directly injected into the eye to suppress retinal swelling and prevent new blood vessels from forming. The number of injections given varies depending on the severity of the condition.

Surgical removal (vitrectomy)

This treatment is mostly used for advanced diabetic retinopathy. It focuses on removing the vitreous gel as well as any leaking blood and scar tissue from the back of your eye. The aim of this surgery is to refocus light rays onto the retina.

As with any eye condition, personalised advice and treatment for diabetic retinopathy will be provided by an ophthalmologist.

How can diabetic retinopathy be avoided?

You cannot directly prevent diabetic retinopathy, but you can reduce your chance of developing it by managing your diabetes:

• Incorporate healthy eating and physical activity into your daily routine
• Monitor your blood sugar level as often as recommended by your doctor
• Take diabetes medication or insulin as directed by your doctor
• Keep your blood pressure and cholesterol under control by exercising regularly
• Quit smoking as this can cause various diabetes complications

If you have diabetes, you should be having an eye test every year. However, if you notice any vision changes, you should seek advice from an eye professional immediately.