Eye problems (retinopathy)

Eye problems

Type 1 diabetes can affect your eyes in many ways. Problems can be caused by a lack of blood supply to the eye or damage to the vessels.

The complications you may experience include:

• diabetic retinopathy, where blood vessels in the retina become damaged
• diabetic maculopathy, the central part of the retina develops leaky or blocked blood vessels

Untreated eye problems can cause sight loss. However, it usually takes several years for eye problems to reach this stage. Managing your diabetes and your overall health can help reduce your risk of eye problems.

What is diabetic retinopathy?

The retina at the back of the eye needs a constant supply of blood. Persistently high blood glucose levels can damage the blood vessels in your eyes. This is called diabetic retinopathy.

The NHS details three stages of diabetic retinopathy:

• background retinopathy – where tiny bulges in the blood vessels may bleed but this does not usually cause problems with your vision
• pre-proliferative retinopathy – changes happen to the blood vessels, causing substantial bleeding into the eye
• proliferative retinopathy – the retina develops scar tissue and new blood vessels, which bleed, and cause some loss of vision

Picking up any problems with your eyes early and taking steps to reduce your risk can all help.

What is diabetic maculopathy?

When the central part of the retina, called the macular, develops leaky or blocked blood vessels, this is called diabetic maculopathy or diabetic macular oedema. It’s a type of retinopathy.

It can happen at any age and if you do, you’ll experience poor vision in the centre of your eye. The vision at the side can remain normal. It can lead to permanent sight loss.

Spotting the signs of retinopathy or maculopathy

You’re unlikely to spot eye problems in the early stages yourself, so you’ll be invited to attend a diabetic eye screening appointment once a year.

“As diabetic eye screening only inspects the retina and surrounding area, you can also visit your local opticians to have a general eye check to pick up any other changes in your eye health.” ~ James Ridgeway, diabetes specialist nurse

It tends to take many years before vision loss happens, but it’s important to notice any changes to your sight including:

• blurred vision
• shapes floating in your vision (floaters)
• sensitivity to light
• gradual worsening vision
• sudden vision loss
• eye pain or redness
• difficulty seeing in the dark

If there are any changes to your sight, don’t wait for your next screening. Instead, speak to your GP who can help. If a problem with your eyes is picked up early, treatment can stop it getting worse.

Getting diagnosed with retinopathy or maculopathy

You may get diagnosed with an eye problem when attending your annual diabetic eye screening. The test involves having drops put in your eyes, examining the back of the eyes and having photographs taken.

If you have any signs of retinopathy or maculopathy, your specialist might discuss treatment options with you. You might need to attend more regular appointments.

If you experience any symptoms of eye problems, contact your GP or diabetes team straight away.

Reducing your risk of retinopathy or maculopathy

There are things you can do to reduce your risk of developing eye problems. This includes:

• keeping your blood sugar, blood pressure and cholesterol within your target levels as much as possible
• attending your screening appointments
• taking your medications
• getting medical advice from your Diabetes Healthcare Team quickly if you notice any changes to your sight
• having a healthy lifestyle including stopping smoking, maintaining a healthy weight and exercising

If you usually experience high glucose levels and bring them down over a short period of time, it can cause an advanced supply of blood to the vessels. If there is already damage, this can worsen symptoms and cause complications. It’s important to work with your healthcare team to drop your blood glucose levels safely.

Treatments for retinopathy or maculopathy

For more advanced stages of eye problems, the main treatments are eye injections, laser treatments and eye surgery. Your diabetes team will talk to you about the different options.

If your eye problems are in the early stages, you’ll get advice about controlling your diabetes to help prevent vision loss.

Where to go for more support

If you experience any symptoms of nerve damage, speak to your GP or Diabetes Healthcare Team. They can help you to reduce the risk of damage getting worse and give you treatments to reduce your symptoms.