Diabetic retinopathy is a complication of diabetes that affects the back of the eye. When someone has high and varying blood sugar levels, the blood vessels in the retina can become irreversibly damaged. This can lead to loss of vision and eventually blindness.
Diabetic retinopathy commonly occurs in both eyes and most often starts with no visual symptoms. In the early stages, the walls of the blood vessels in the retina weaken. This can cause fluid and blood to leak into the eye (called the non-proliferative stage), which sometimes results in blurred vision. It can progress, with fragile new blood vessels growing within the retina (the proliferative stage), which can rupture easily and bleed. This can cause a catastrophic drop in vision.
Diabetic retinopathy can cause blindness, yet in most cases blindness is largely avoidable. This can be done with effective diabetes management, regular eye screening and timely treatment. Developing diabetic retinopathy depends on a number of factors:
The duration of diabetes: the longer someone has had diabetes, the more likely they are to get diabetic retinopathy.
Blood sugar levels: when blood sugar levels are consistently high, the chances of diabetic retinopathy developing are high. Once diabetic retinopathy starts, tight control of blood sugars can slow down its progression to vision loss.
Controlling other risk factors: monitoring cholesterol and blood pressure is also important in delaying the progression of diabetic retinopathy. Behavioural change through lifestyle choices – access to and eating healthy food, weight control, regular exercise and quitting smoking – helps control these risk factors.
People with diabetes should have an eye examination at the time their diabetes is diagnosed. This should be followed by regular comprehensive eye examinations and treatment when required. Early detection of sight-threatening diabetic retinopathy is the most important and cost-effective way to enable effective and timely treatment of the disease and preventing blindness.
Most people with diabetic retinopathy do not have to go blind, however for early detection and treatment to be successful, regular screening for diabetic retinopathy must be integrated into diabetes care, where timely detection, management and referral of diabetic retinopathy are facilitated. Ensuring all people with diabetes have access to these important health care services requires a new approach in service provision and cross-sectoral collaboration.
We need to make eye health part of the comprehensive care received by every person with diabetes.