Diabetes and Your Eyes: A Complete Patient Guide

Overview

Diabetic retinopathy is the leading cause of preventable blindness in working-age adults. It progresses silently for years, and by the time vision is affected, significant retinal damage is already present.

Symptoms

• ◆Often none in early stages
• ◆Floating dark spots or cobwebs
• ◆Blurred or fluctuating central vision
• ◆Difficulty seeing at night
• ◆Sudden loss of vision (advanced)

Causes

• ◆Chronically elevated blood sugar
• ◆Long duration of diabetes (>10 years)
• ◆Uncontrolled blood pressure
• ◆Kidney disease

Risk factors

• ◆Poor glycaemic control (HbA1c > 7)
• ◆Hypertension
• ◆Pregnancy
• ◆Hyperlipidaemia

Diagnosis

Annual dilated fundus examination is the gold standard. OCT is added for macular evaluation and fundus fluorescein angiography (FFA) for treatment planning.

Treatment options

Ranges from lifestyle optimisation and observation to intravitreal anti-VEGF injections, pan-retinal photocoagulation laser and — in advanced cases — vitreoretinal surgery.

When to see a doctor

Every person with diabetes, starting from the day of diagnosis, should have a dilated retina check-up every year — even if vision seems normal.

Prevention

Tight glycaemic control (HbA1c < 7), blood pressure management, statin therapy where indicated, no smoking and annual eye check-ups.

Frequently Asked

References

• International Diabetes Federation – Eye Health Guide 2023