Eye Problems: Retinopathy and eye screening
What is retinopathy?
If you have diabetes you are at risk of developing eye problems. The most common of these is retinopathy, which is damage to the retina, the part of the back of the eye that converts light into electrical signals. Your brain interprets these signals to produce the images that you see. Blood vessels bring oxygen and nutrients to your retina. High blood glucose levels and high blood pressure can damage these blood vessels.
Risks for developing retinopathy
Everyone with diabetes, both type 1 and type 2, is at risk of developing retinopathy. This risk increases with
- the length of time you have had diabetes
- poor control of your blood glucose levels
- high blood pressure
- a high level of fat in the blood
- smoking
Reducing the risks
You can reduce the risk of developing retinopathy as follows:
- Keep your diabetes well controlled.
- Maintain healthy blood pressure and cholesterol levels.
- Make sure you have your eyes screened once a year.
- Do not smoke.
Diabetic eye screening
This is done at your local retinal screening unit, and should be carried out every year or every two years on anyone over the age of 12 who has diabetes. It reduces the risk of sight loss through the early detection, and treatment if required, of diabetic retinopathy.
Eye drops may be used to dilate your pupils to allow the back of your eye to be checked for changes caused by diabetes. The eye drops may affect your sight so you may need someone to take you home. You will not be able to drive until your sight returns to normal. You should take sunglasses with you as your eyes will be sensitive to light afterwards.
A photograph of the back of your eye will be taken and stored on computer, so next time the pictures can be compared.
Stages of retinopathy
There are various stages of retinopathy.
Background retinopathy
This is the earliest stage of changes to the retina. The small blood vessels have been affected and they may bulge slightly and leak blood or fluid.
Pre-proliferative retinopathy
This is the next stage, with more extensive changes to the retina. If you have pre-proliferative retinopathy you will need additional monitoring as there is an increased risk that you will lose your sight.
Proliferative retinopathy
This occurs when the retinopathy has progressed further and large areas of the retina no longer have sufficient blood supply. You may have a number of new blood vessels leaking blood or fluid. If this is diagnosed early you can receive treatment that will reduce the risk of you losing your sight.
Maculopathy
This occurs when diabetic retinopathy occurs near the macula. The macula is the small central part of the retina that you use to see things clearly. It is the most used area of the retina.
You will receive a letter after your eye screening test informing you that you have either
- no retinopathy
- background retinopathy
- degrees of referable retinopathy (pre-proliferative or proliferative retinopathy, or maculopathy) - "referable" means that you will be referred to an eye specialist
Treatment
If complications such as retinal bleeding or the growth of new blood vessels occur, you will be seen by a specialist eye doctor who may recommend laser treatment, injections or even surgery to treat the back of the eye.
Useful resources
Diabetic eye screening: easy read guide
Your guide to diabetic eye screening
Your guide to diabetic retinopathy
