Diabetic Eye Disease

Diabetic eye disease ends up affecting most people with diabetes. After 10 years of diabetes 80% of patients will have signs of diabetes that can be seen by an ophthalmologist. There are 2 common types of diabetic eye disease: diabetic retinopathy and diabetic macular oedema. Diabetic eye disease is the most common cause of blindness in the working population and affects 8% of Australian men and 6.5% of Australian women – and these numbers are increasing.

What is Diabetic Retinopathy

Diabetes affects the small blood vessels of the body.  The retina (the seeing layers at the back of the eye) are supplied with oxygen and nutrients by a rich network of small blood vessels.  These become damaged by high sugar levels in the blood and can become leaky or stop working altogether.  The early signs of diabetic retinopathy are patches of exudates (fats and other proteins that can leak out of the damaged blood vessels) and haemorrhages (blood spots) that can be seen by an ophthalmologist (eye doctor) or an optometrist (optician) when they examine the back of the eye.  As the condition progresses the small blood vessels stop working and the retina is no longer supplied with the blood that it needs.  This is called retinal ischaemia.  The area of the retina that is starved of oxygen releases powerful factors (angiogenic factors) that cause new vessels to grow within the jelly of the eye (the vitreous).  These vessels do not grow normally and tend to break, releasing blood into the normally clear vitreous jelly in the middle of the eye.  Left untreated this process leads to scar tissue and retinal detachment.  The end result can be untreatable blindness.

How is Diabetic Eye Disease treated?

There have been very exciting advances in the management of diabetic eye disease in recent years.  The traditional use of laser photocoagulation of the retina (small burns on the retina with a special laser) is now used with or even (in certain cases) replaced by special new drugs call Anti Vascular Endothelial Growth Factor (Anti VEG-F).  These drugs need to get to work directly on the retina (back of the eye) and are injected into the eye using a tiny needle – but fortunately the process is painless.