How does the condition of diabetes affect the eyes?

Diabetic retinopathy is another complication of the chronic disease, diabetes, affecting tiny blood vessels situated at the back of the eye (retina). Signs of this are not apparent at an early stage and can take some time to develop.

The composition of the retina is quite basic to understand. We know that this particular part of the eye consists of light-sensitive cells that change light into electric signals. The brain has the hard job of making sense of these signals by converting them to images. This is how you are able to see. However, the retina requires a steady flow of blood from a tiny network of blood vessels in this part of the eye to work. High blood pressure from diabetes can threaten the blood supply to the retina due to damage to the intricate blood supply network.

Damage can occur in three primary ways:

  • Tiny bulges develop within the blood vessels that may eventually bleed but do not affect your eyesight significantly.
  • The damage from pre-proliferative retinopathy is much more significant, causing more bleeding in the eye.
  • Proliferative retinopathy is severe, giving rise to the formation of scar tissue and blood vessels on the retina, causing bleeding and vision deterioration.

How do you screen for diabetic retinopathy?

People between 12 years and up are welcome to screen for eye diseases yearly. Screening is generally provided because there are no early signs of diabetic retinopathy. In addition, there are severe repercussions of untreated diabetic retinopathy, such as irreversible blindness.

A dilated eye exam is the best way to check for widened blood vessels and bleeding in the eye. One of the eye doctors places eye drops into your eyes to dilate the pupils. By doing this, they can get a better view of the inside.

Further diagnostic tests include:

  • Fluorescein angiography involves injecting dye into your arm’s vein. As the dye travels through the blood vessels, images are taken and sent to a computer screen/monitor.
  • Optical coherence tomography (OCT) provides cross-sectional images of the retina, indicating the thickness of the retina. An OCT determines the amount of liquid seeping into the retinal tissue.

How do you treat/manage diabetic retinopathy?

The severity of diabetic retinopathy determines the type and level of treatment you will receive. Typically, retinal disorders such as diabetic retinopathy and macular degeneration are treated with lasers.

Before applying a laser directly over a special lens above the ocular surface, the eyes are first numbed using anaesthetic drops. The procedure aims to target retinal blood vessels. Next, contact lenses are used to keep the eyelids open so that the laser can scan the surface area of the retina. This entire procedure is expected to take less than an hour. Alternatively, your eye doctor can use injections to treat advanced maculopathy affecting your eyesight. Surgery is often required when retinopathy becomes more severe, and blood and scar tissue develop in the eye. In this case, laser eye surgery is impossible because the condition has declined further.



Will diabetic retinopathy go away on its own?

Unfortunately, there is no way of curing diabetes and retinopathy. The best way to manage retinopathy is to attend regular eye screenings and keep active to prevent blood sugar from rising.

Can my eyesight be restored after finding out about my condition, diabetic retinopathy?

Early detection is the best way to prevent your vision from deteriorating further. However, there is still a possibility that the damage from retinopathy can be reversed.

What is considered the best treatment for diabetic retinopathy?

Laser eye surgery is considered the most effective procedure against proliferative diabetic retinopathy. In an advanced stage of retinopathy, new blood vessels form at the back of the eye. Laser surgery helps remove these weakened blood vessels that cause bleeding in the eyes.

Dr Philip and Dr Precious Phatudi
are skilled ophthalmologists based in Sandton