Diabetic Eye Disease
Annual screening detects diabetic changes long before your sight is affected.
Overview
Diabetes affects the smallest blood vessels first, and the retina is the only place in the body where those vessels can be examined directly. The early changes cause no symptoms: central vision often remains entirely normal while the circulation at the periphery deteriorates. This is why an annual dilated examination is advised however well controlled the diabetes is.
The aim of care is to act while treatment still preserves how you see — before fluid gathers at the centre of vision or fragile new vessels bleed. With modern scanning and prompt treatment, serious sight loss from diabetes is now largely preventable.
When to seek assessment
- Often nothing at all in the early, most treatable stages
- Blurred or fluctuating central vision
- Floaters, dark shapes, or a sudden shower of spots
- Difficulty reading or recognising faces
- A dark or empty patch in the middle of vision
- Sudden painless loss of vision — please seek care immediately
Diagnosis
How the assessment is made
Wide-field retinal photographs
A single capture that documents the whole retina, giving a record that can be compared precisely from one year to the next.
Macular scan
Detects and measures swelling at the centre of the retina — the change most directly responsible for reading vision in diabetes.
Circulation imaging
Maps the areas where blood flow has been lost and identifies fragile new vessels, which determines the timing of laser or injection treatment.
Treatment
Options and what each one is for
Injections into the eye
The first-line treatment for swelling at the macula, given in the clinic in a few seconds after thorough numbing, on a monitored schedule.
Slow-release implants
For swelling that has not settled with injections, or where a longer interval between treatments would suit you better.
Retinal laser
Treatment of the oxygen-starved outer retina to make fragile new vessels shrink back, protecting against bleeding and retinal detachment.
Working with your diabetes team
Findings are shared with your physician. Blood sugar, blood pressure and cholesterol influence the retina as much as any treatment given in the eye clinic.
Recovery
What to expect afterwards
After an injection
Mild grittiness and a small red patch on the white of the eye for a few days. Normal activity straight away; no swimming for forty-eight hours.
After laser
Blurring for several hours and some sensitivity to glare. Side and night vision may be permanently reduced a little — the trade made to protect central sight.
Ongoing
Review anywhere from four weeks to twelve months depending on the stage, with a scan at every visit where swelling is present.
Questions
Frequently asked
If your question is not answered here, it is welcome in consultation — or by message before you book.
Yes. Good control lowers the risk substantially but does not remove it, and early changes cause no symptoms whatsoever. Yearly examination is advised from the time type 2 diabetes is diagnosed.