Diabetic Retinopathy: From Diagnosis to Management

Navigating the complexities of diabetes can be challenging, especially when it comes to understanding and managing its complications, such as diabetic retinopathy. This condition, a leading cause of blindness among adults, requires early detection and ongoing care to preserve vision.

What is Diabetic Retinopathy?

Diabetic retinopathy is a serious condition that arises as a complication of diabetes, characterised by damage to the blood vessels of the retina, the light-sensitive tissue at the back of the eye. This condition is a leading cause of blindness among working-age adults in Australia and globally. It develops over time and can affect anyone with type 1 or type 2 diabetes. The longer a person lives with unmanaged diabetes, the higher the likelihood of developing diabetic retinopathy, emphasising the importance of regular monitoring and management of blood sugar levels.

In the early stages, diabetic retinopathy may not present noticeable symptoms. However, as the condition progresses, individuals may experience a range of symptoms including blurred vision, the appearance of dark, floating spots or streaks (“floaters”), fluctuating vision, dark or empty areas in the vision, and difficulty perceiving colours. These symptoms occur as a result of leaking or swelling blood vessels in the retina, or the growth of abnormal new vessels on the surface of the retina, which can bleed into the eye and affect vision.

According to the Centre for Eye Research Australia, an estimated 1.9 million Australians have diabetes, and up to one in three of these individuals will develop some form of diabetic eye disease, including retinopathy. (1,2)

Risk Factors for Diabetic Retinopathy

Anyone living with type 1, type 2 or gestational diabetes is at risk of developing the eye disease. However, several factors can increase the risk of developing diabetic retinopathy, including:

  • Duration of Diabetes: The longer you have diabetes, the greater your risk of developing diabetic retinopathy.
  • Poor Control of Blood Sugar Levels: Uncontrolled blood sugar can accelerate the onset and severity of diabetic retinopathy.
  • High Blood Pressure: High blood pressure can compound the damage to the retinal blood vessels.
  • Cholesterol Levels: High levels of cholesterol can lead to the accumulation of deposits in the blood vessels of the retina, further obstructing blood flow.

Understanding these risk factors is crucial for early intervention and prevention strategies. (3)

How is Diabetic Retinopathy Diagnosed?

Early diagnosis of diabetic retinopathy is vital for effective management and prevention of vision loss. Eye exams are the most effective way to detect retinopathy. They are simple and painless and they typically include examinations like:

  • Visual Acuity Testing: Measures the eye’s ability to focus and discern shapes and details.
  • Dilated Eye Exam: Drops are placed in the eyes to widen the pupils, allowing a better view of the retina.
  • Fluorescein Angiography: A dye is injected into the arm to highlight blood vessels in the eye during a special camera’s photographs.

Regular eye exams are recommended for individuals with diabetes, even if no vision problems are evident. If you do notice any changes to your vision like blurring, flashes, spots or distortion we recommend you book an appointment with an eye doctor for an examination. (4)

Treatment Options

Treatment for diabetic retinopathy depends on the stage of the disease and how it has progressed. Options may include:

  • Laser Treatment: To seal or shrink leaking blood vessels.
  • Medicines: VEGF inhibitors can slow or reverse the diabetic retinopathy.
  • Injection Therapy: Medications are injected into the eye to prevent new blood vessels from forming.
  • Vitrectomy: A surgical procedure to remove blood from the middle of the eye.

Early treatment can significantly reduce the risk of blindness. (5)

Tips on How to Prevent or Delay Diabetic Eye Diseases

Managing diabetic retinopathy involves both medical treatment and lifestyle adjustments. Here are some tips:

  • Maintain Optimal Blood Sugar Levels: Keeping blood sugar levels within a target range can slow the progression of retinopathy.

  • Monitor Blood Pressure and Cholesterol: High blood pressure and cholesterol can exacerbate eye damage.

  • Quit Smoking: Smoking increases the risk of diabetes complications, including eye issues.

  • Follow a Healthy Diet: A balanced diet rich in fruits, vegetables, legumes, lean proteins, low fat dairy and whole grains can help control diabetes and, by extension, diabetic retinopathy.

  • Exercise Regularly: Physical activity helps control blood sugar levels, reducing the risk of progression. (6)

Preventive measures, such as regular eye exams, are crucial for early detection and management of diabetic retinopathy.

Conclusion

Diabetic retinopathy poses a significant risk to individuals with diabetes, but with early diagnosis, effective treatment, and proactive management, its impact can be minimised. Embracing a healthy lifestyle and adhering to regular eye exams can help prevent or delay the onset of diabetic eye diseases, safeguarding your vision for the future. Remember, managing diabetic retinopathy is a crucial part of living well with diabetes.

How we reviewed this article:
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