With diabetes on the rise in Australia, plenty of attention is focused on the statistics. Over 100 000 people were diagnosed with diabetes in the past year and an estimated 1.7 million people are living with the disease.  With an increasing number of people being diagnosed with diabetes every year, it’s not surprising that Diabetes Australia refers to these statistics as an epidemic.

However, the eye diseases associated with diabetes receive far less attention. Diabetic eye disease is the leading cause of preventable blindness in Australia, with around 72 000 people living with diabetic retinopathy.  More than 15% of diabetics will develop diabetic retinopathy at some stage, with more than 1% of these people experiencing blindness as a result of the disease.

If you are living with diabetes, it’s important to get regular eye checks. Advanced diabetic eye disease can occur before you notice any symptoms, but early intervention can prevent damage to your eyes. Your GP at Bellbowrie Family Practice can perform regular eye checks or provide referrals to see an ophthalmologist.

We spoke to Ophthalmologist Dr Joseph Park, from Westside Eye Clinic to find out more about Diabetic Eye Disease and how it can be treated.

Diabetic eye disease occurs when high blood glucose levels cause damage to the small blood vessels in the retina at the back of the eye. This condition is called diabetic retinopathy and it is the most common form of eye disease caused by diabetes. In its early stage (known as the non-proliferative stage), the walls of the retina weaken, allowing blood and fluid leaks that cause blurred vision. Diabetic retinopathy usually affects both eyes.

This condition can move on to the proliferative stage where new blood vessels grow within the retina and can rupture and bleed. Bleeding can occur in the jelly of the eye leading to significant loss of vision. Scar tissue can also form and as a result can cause the retina to detach from the back of the eye. Although rare, Retinal detachment can result in significant vision loss and requires surgery to correct.

Diabetic retinopathy can also lead to another complication called diabetic macular oedema. Fluid leaks in the region of the macula lead to macular swelling, resulting in vision loss.

Other eye conditions associated with diabetes include glaucoma and cataracts. Diabetics are twice as likely to have glaucoma and up to five times more likely to suffer from cataracts. Both of these conditions can cause serious visual impairment and may require treatment.

The early stages of diabetic eye disease usually have few or no symptoms. However, as the disease progresses, the following symptoms may occur:

• Difficulties with sharp focus such as seeing people, reading or watching TV.
• Blurry or distorted vision that doesn’t improve with prescription glasses.
• Dark or empty patches in the vision.
• Difficulty seeing colour normally.
• Sensitivity to glare
• Problems with balance.
• Difficulties with night vision.
• Double vision (usually short-lived but may take a few months to resolve).
• Spots that appear to “float” in front of the vision.
• Vision loss.

Once you have a diagnosis of diabetic eye disease, your GP and ophthalmologist can develop a treatment plan to protect your eyes from further damage.

This may include:

• A comprehensive dilated eye exam at least once a year
• Treatment to control blood glucose levels
• Eye exams every 2-4 months if your condition is severe.
• Treatment to control cholesterol and high blood pressure.
• Intravitreal injections (eye medication injected directly into the eye)
• Laser surgery
• Vitrectomy surgery
• Taking specialised medication to control diabetes in the eye.

Studies have shown that controlling blood glucose levels is crucial when it comes to protecting your vision. Other studies have shown that controlling cholesterol and blood pressure also lessen the chance of damage to your eyes.

Lifestyle factors play a part in managing your diabetes and protecting your vision. Your GP at Bellbowrie Family Practice can advise you on lifestyle changes you can make, but here are some things you can incorporate into your daily life:

• Exercise
  Exercise can help to keep blood glucose levels stable by assisting your cells to use insulin better (5). Before you begin an exercise program, ask your GP about the best type of exercise for you.

• Healthy Eating
  The food you eat affects your blood glucose levels. Choosing healthy foods in moderate sized portions can help to keep your blood glucose levels stable.

• Avoid or Limit Alcohol Intake
  Alcohol can cause blood glucose levels to go too high or too low. Avoiding alcohol or limiting your intake can help you to control your levels and protect your eyesight.

• Reduce Stress
  Stress can cause your blood glucose levels to increase, putting your vision at risk of damage. Finding ways of managing your stress will help you to maintain healthy levels.

Getting regular check-ups is a must when you have diabetes. Ideally, you should see your GP every six months for a check-up. You should have an eye exam when you are diagnosed with diabetes and at least once a year (more often if eye disease has been detected) and annual checks for foot disease and nerve damage. Diabetes raises the risk of heart disease, so your GP will also check your cholesterol and blood pressure.

If you have diabetes and have not had an eye exam, it’s important to act early. Untreated diabetic eye disease can leave you with permanent damage to your vision.

If you live in the Bellbowrie area and would like to learn more about diabetic eye disease or you believe you are at risk, call our friendly team at Bellbowrie Family Practice on 07 3202 5360. You can also make an appointment using our online booking service.