What is diabetes?
Diabetes is a long term condition, where the body does not produce enough insulin or cannot use insulin properly. Insulin is a hormone produced by the body to break down glucose (sugar) in so it can be used properly by the body as fuel.
Diabetes can cause problems with different parts of the body, including the eye. People with diabetes will not necessarily have complications with their sight. If diabetes is well controlled there is a lower risk of any problem and it might be less serious.
It is very important that people with diabetes have their eyes examined regularly.
There are two types of diabetes. In type 1 diabetes the body does not produce any insulin. People suffering from type 1 will need to use insulin for the rest of their life. Type 1 normally develops in people under the age of 40.
People with type 2 diabetes still produce insulin but not enough to function properly. Sometimes they can manage their condition by controlling their diet or exercising but in some cases they will need injections of insulin. The condition normally develops in people over the age of 45 and lifestyle can affect chances of developing the illness. It is the most common form – 95% of people with diabetes have type 2.
Diet and Exercise
You can reduce your risk of developing these conditions, which can lead to sight loss, by maintaining a healthy weight or by losing weight if you need to. Most people can get all the vitamins and minerals they need from eating a healthy and balanced diet.
Link to https://www.rnib.org.uk/eye-health/looking-after-your-eyes/nutrition-and-eye
Drink within the recommended limits
Heavy alcohol consumption may increase the risk of developing Age Related Macular Degeneration.
To keep health risks from alcohol to a low level:
- men and women are advised not to drink more than 14 units a week on a regular basis
- spread your drinking over 3 or more days if you regularly drink as much as 14 units a week
- if you want to cut down, try to have several drink-free days each week
Keep tabs on your drinking with the Drinkaware alcohol tracker.
Protect your eyes from the sun
Getting out in the sun is important for your general health, but you have to be sure to protect yourself.
Never look at the sun directly, even when something exciting such as an eclipse is happening. Doing so can cause irreversible damage to your eyesight and even lead to blindness. Several studies also suggest sunlight exposure is a risk factor for cataracts.
Wearing a wide-brimmed hat or sunglasses can help protect your eyes from UV rays. The College of Optometrists recommends buying good-quality dark sunglasses – these needn't be expensive.
Look for glasses carrying the CE mark or the British Standard BS EN ISO 12312-1:2013, which ensures they offer a safe level of ultraviolet protection.
The College of Optometrists' website has more information about how to look after your eyes
What are the symptoms and causes of diabetic retinopathy?
Diabetes can cause a number of problems with the eye. Diabetic retinopathy is the most serious complication as it involves the retina and blood vessels in the eye.
There are three main stages in the development of diabetic retinopathy.
Background diabetic retinopathy
People who have had diabetic retinopathy for a long time are likely to have this condition. The blood vessels in the retina are only mildly affected, when they swell they sometimes leak blood or fluid. The macula remains undamaged and vision will be normal.
People who have had background diabetic retinopathy are likely to develop maculopathy. When the blood vessels in the retina begin to leak, the macula becomes affected and central vision will become gradually worse. It is very rare for someone with maculopathy to lose all of their sight as peripheral vision will be preserved. It may become difficult to recognise people’s faces from a distance or see detail.
Proliferative diabetic retinopathy
People who have been dependent on insulin for a long period of time are more likely to develop proliferative diabetic retinopathy. Diabetes can cause blood vessels in the retina to become blocked. As a consequence new blood vessels will form in the eye, which is nature’s way of trying to correct the problem as the retina needs a new blood supply. These new blood vessels are weak and grow on the surface of the retina and the vitreous gel. They can scar very easily and cause scar tissue to form in the eye. The scarring pulls and distorts the retina out of position.
Eyesight may become blurred or patchy as retinal bleeding obscures vision. Retinal bleeding or detachment can cause sudden and severe sight loss. If proliferative retinopathy is not treated, total loss of vision might occur.
What should I do?
If you have diabetes make sure you have an eye examination every year. Do not wait until your eyesight deteriorates as early diagnosis is vital in preventing diabetic retinopathy. Sight tests are free for people with diabetes. Your doctor, diabetologist or optometrist can examine for diabetic retinopathy.
Complications with diabetic retinopathy can be reduced by having good control of diabetes. It is important to monitor your diabetes, and treat high blood pressure to prevent sight loss from diabetes. You can discuss with your doctor what is best for you.
Smoking can raise blood pressure and blood sugar levels and can increase chances of nerve damage, kidney and cardiovascular disease.
You can help reduce the risk of diabetic retinopathy by having your eyes checked regularly, not smoking, and controlling sugar levels, blood pressure and your cholesterol.
Can it be treated?
Treatment can prevent sight threatening diabetic retinopathy, if it is diagnosed early enough. It is crucial to have an eye examination once a year if you have diabetes.
Laser treatment can be used to manage most sight threatening problems with diabetes. The laser treatment can prevent further sight loss by sealing the blood vessels which might be leaking. This treatment can also be used to stop 80% of new blood vessels growing.
Is there a cure?
Laser treatment can save remaining sight, but it cannot make it better or repair damage. Once you have had laser treatment, the problem is mostly controlled. You should have regular eye checks to make sure you do not need more laser surgery.
How will I live with it?
Our low vision clinics can help you to learn how to use your remaining vision as fully as possible.
This document was created in partnership with RNIB and Action for the Blind.
Devon in Sight is a local charity providing practical help and advice to people affected by sight loss, to maximise independence, wellbeing and choice.
You can call the RNIB Helpline on 0303 123 9999 and coordinators will provide you with impartial support and advice on everything to do with visual impairment.
RNIB have information on eye conditions from the Royal College of Ophthalmologists.
Diabetes UK is the largest UK charity supporting people who have diabetes.
Moorfields Eye Hospital is one of the world’s largest centre for eye care and research.
Devon in Sight is not a medical organisation, therefore we can only provide general information that is not intended to be a substitute for a proper medical assessment. The information is also not intended to be used for individual cases. If you have a specific question about your eye condition, we recommend that you consult an eye care professional.
Devon in Sight has tried to ensure that the contents of these pages are accurate. However Devon in Sight will not accept liability for any loss or damage or inconvenience arising as a consequence of any use of or the inability to use any information on our website or in these fact sheets.
Visitors who use our website and use these factsheets and rely on any information do so at their own risk. Devon in Sight does not represent or warrant that the information accessible via the website or these fact sheets is accurate, complete or up to date.
The information contained on the website or these factsheets was correct at the time of writing. However, due to research and medical advances, the content may not be completely up to date.