In people with diabetes, there is a risk that the tiny blood vessels in the retina at the back of the eye may become diseased and damaged due to the effects of diabetes. This is called diabetic retinopathy. The blood vessels can swell and leak blood or fluid, or may become blocked. If the blood vessels leak fluid into the retina, this can lead to retinal swelling (macular oedema) and subsequent reduction of vision. If blood vessels become blocked, this can lead to part of the retina to suffer from lack of blood supply (ischaemia). Eventually, this may lead to formation of weak abnormal new blood vessels (proliferative diabetic retinopathy), which may bleed inside the eye, causing sudden loss of vision and eventually scar formation. Damage usually occurs slowly over several months or years and as such, the longer you have diabetes the greater the risk of developing diabetic retinopathy.
If diabetic retinopathy is not treated there is a risk of serious eye damage that can eventually lead to blindness. Early diagnosis and treatment is the best way to prevent loss of vision. Diabetic retinopathy is not painful and there may be no noticeable change in vision until the disease has caused severe damage. As such, it is important for people with diabetes to have an eye examination every year. This way, any changes can be detected and treated early which will minimize any loss of vision.
A very important step in the treatment of diabetic eye disease is to maintain the diabetes under good control. It is strongly recommended that you keep the HbA1C below 7%. Also, if you have high blood pressure, or dyslipidaemia, it is important that they are treated as well.
Smoking and diabetes poses a significant increase to the risk of developing complications for diabetes to the eye, heart, brain and blood supply to the legs.
Swelling at the back of the eye from diabetes, (macular oedema) may benefit from injections or laser to reduce the swelling.
Proliferative diabetic retinopathy may need laser treatment to cause the new blood vessels to regress, eliminating he risks of bleeding inside the eye and subsequent scarring.