Patient information: Diabetic retinopathy

What is diabetic retinopathy? Patients with diabetes have elevated sugar in their blood and this can affect the retina.  The retina is the lining in the inside of the back of the eye and it functions a bit like the film in the back of a camera, absorbing light and forming an image of the outside world.  The retina has very fine blood vessels that supply it with nutrients and oxygen.  In diabetic retinopathy these blood vessel are damaged, causing them to become blocked or to leak fluid. In more severe disease, fragile new vessels grow in the retina. These new vessels sometimes bleed and the blood in the eye can blur the vision.  Diabetics may also suffer from cataract, a clouding of the lens of the eye. The treatment of cataract is outlined on another webpage (click here to view)

What are the symptoms of diabetic retinopathy? Diabetic retinopathy varies from mild to severe, depending on the duration and severity of diabetes, as well as other factors such as high blood pressure.  Hence patients may notice nothing, mildly blurred vision, or severe loss of vision.

What is the treatment of diabetic retinopathy? Mild disease does not need treatment, but yearly review is very important. This may be by a photographic screening service, optician, GP, or diabetic specialist, depending on local arrangements.     Those with more severe disease may be referred to an eye doctor (ophthalmologist) who will undertake regular review, or sometimes laser treatment.  Laser treatment is usually done at an outpatient visit and  takes from about 5 to 30 minutes depending on the type of laser required.  For a small proportion of patients with severe disease surgery may be required, and this is often combined with laser treatment inside the eye.   

What can I do? There is strong evidence that improving control of diabetes has a longterm beneficial effect on the eyes, slowing the rate of progression of diabetic retinopathy.  Hence, making sure your blood sugar is well controlled is a cruicial part of looking after your eyes.  It is also important to ensure your blood pressure is regularly checked and treated if elevated.  The combination of smoking and diabetes has severe health effects throughout your body.  

Any further questions? The Royal College of Ophthalmologists provides a  patient information sheet for those with diabetes and it is available by clicking here.   You should feel free to put any questions you have to your doctor, nurse, or optician.  Those who are planning to get pregnant should be monitored closely for diabetic retinopathy and should ask their GP to arrange this.

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