Diabetic retinopathy | The Fred Hollows Foundation NZ

Diabetic retinopathy

Diabetes-related eye disease, also known as diabetic retinopathy, affects people with diabetes whose delicate retinal blood vessels are more likely to weaken and expand, leak, or bleed, resulting in scarring in and about the retina (the “seeing” layer of the eye), which results in blindness or severe vision loss.

Vision loss is caused by two processes:

  • Macular oedema: this is where fluid leaks into the macula, the part of the eye that is responsible for fine vision. The fluid causes swelling which blurs vision. Macular oedema can happen at any stage of the disease but is present in around half the cases of advanced diabetic retinopathy.
  • Proliferative retinopathy: in advanced cases, blocked blood vessels send messages to grow new blood vessels. This results in abnormal and fragile blood vessels growing on the surface on the retina and the vitreous gel that fills the inside of the eye. If these fragile vessels leak blood then vision loss or blindness can be immediate.

There are no symptoms in the early stages of diabetic retinopathy which makes diagnosis of diabetes and regular screening vital.

A person with diabetic retinopathy can experience blurred or distorted vision, increased sensitivity to glare and difficulty seeing at night.

Causes

Diabetic retinopathy is a complication of diabetes, which is becoming increasingly prevalent in developing countries as lifestyles become more westernised. Fluctuating blood sugar levels, or sustained high blood sugar levels increases the risk of developing diabetic retinopathy.

People affected

Diabetic retinopathy affects about 1 in 4 people who have diabetes. It particularly affects those who have had diabetes for more than 10 years.

Within 15 years of being diagnosed with diabetes, approximately 3 out of 4 people will experience some form of vision loss as a result of diabetic retinopathy.

Those with Type 2 diabetes are particularly at risk. Diabetic patients who have high blood sugar levels, high blood pressure, kidney disease or who smoke also have a greater chance of experiencing vision loss caused by diabetic retinopathy.

Stephanie Emma discusses the issue of diabetic retinopathy as part of The Foundation's FRED Talks series

Magnitude of the problem

There is enormous concern globally about the increasing level of diabetes in both developed and developing countries. Seven out of ten of the world’s worst incidence rates of diabetes are found in the Pacific. The rising incidence rates of diabetes are particularly notable in developing countries where communities are undergoing a transition from their traditional lifestyles to a western diet and lifestyle. Diabetic retinopathy accounts for 1% of global blindness but is also related to several other diseases such as glaucoma.

Prevention and treatment

Diabetic retinopathy can be prevented by prioritising community education in the signs of the disease, through early management of the disease and regular vision screening for diabetic patients.

Sight loss from diabetic retinopathy cannot be reversed, but regular eye examinations, timely laser treatment and closely managed blood sugar levels can prevent the situation worsening.

Early detection, treatment and intervention by specially-trained staff will allow thousands of patients to retain their vision.

Laser treatment, which is used to seal leaking blood vessels, is very successful in stopping any further damage to the retina. Sometimes surgery is necessary if more extensive retinal damage has occurred.

Although there are several other treatment options, laser is the mainstay. This is applied as an outpatient clinic procedure, with people able to return to daily activities immediately.

How The Foundation is tackling diabetic retinopathy

• Training specialist eye care staff from across the region to help people in their own communities – 25 diabetes eye care.
specialists have been trained to date.
• Screening and treating patients in the Diabetes Eye Clinic at our Pacific Eye Institute and in Lautoka, Fiji, at our clinic in Madang,
Papua New Guinea and in Nuku'alofa, Tonga.
• Screening patients in rural Fijian communities through our diabetes outreach program.
• Launching the Fijian Mobile Eye Clinic, in 2014.
• Launching the Regional Eye Health Centre in Honiara, Solomon Islands, in 2015.
• Providing portable lasers to treat patients in communities far from hospital services and developing plans to make them
available in isolated Pacific islands.
• Commissioning contextual research to better understand the challenge and inform efficient, cost-effective solutions.

Note: This information is general in nature and is not a substitute for specialist medical advice. Have your eyes checked regularly every two years, even if you have not noticed any symptoms or changes.

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