An overview of diabetes
– what is diabetes?
– why is insulin so important?

How do I know I have diabetes?
– diabetes symptoms
– how is diabetes diagnosed?

What treatment will I need?

Prevention of diabetes

Managing diabetes
– Hypoglycemia and Hyperglycemia
– Diabetes and Heart Disease
– Diabetes and Oral Health
– Diabetes and Eye Checks
– Diabetes and Footcare
– Sleep Apnoea

Diabetes and Eye Screening

Diabetic eye screening is a key part of diabetes care. People with diabetes are at risk of damage from diabetic retinopathy, a condition that can lead to sight loss if it is not treated appropriately and in time.

Diabetic Retinopathy is one of the most common causes of sight loss among Diabetic. The diabetes affects the small blood vessels, damaging the part of the eye called the retina. When the blood vessels in the central area of the retina (the macula) are affected, it's known as diabetic maculopathy.

People with diabetes should also see their optician every two years for a regular eye check / test. Diabetic eye screening is specifically for diabetic retinopathy and can not be relied upon for other conditions.

What happens during Diabetic Eye Screening

1. The screening appointment should last about 30 minutes.
2. You'll be given eye drops to enlarge your pupils, which takes between 15 and 20 minutes, and photographs of your retina will be taken.
3. There will be a flash of light each time a photograph is taken, but the camera won't touch your eye. Although the light is bright, it shouldn't be uncomfortable.
4. The eye drops may cause your eyes to sting slightly, and after about 15 minutes your vision will be blurred. You may find it difficult to focus on objects that are close to you.
5. Depending on the type of eye drops used, the blurring can last between two and six hours. You won't be able to drive home from your appointment, so you may want to bring someone with you.
6. After the screening procedure, you may also find that everything looks very bright. You may want to take a pair of sunglasses to wear afterwards.

Side effects

In very rare cases, the eye drops can cause a sudden pressure increase within the eye. This requires prompt treatment at an eye unit.

The symptoms of a pressure increase are:

• pain or severe discomfort in your eye
• redness of the white of your eye
• constantly blurred vision, sometimes with rainbow halos around lights

If you experience any of these symptoms after screening, go back to the screening centre or your nearest accident and emergency (A&E) department. Your screening results

You won't get the results immediately as the photographs need to be studied by a number of different healthcare professionals, including someone who is trained in identifying and grading retinopathy.

The screening results may show either:

• no retinopathy
• background retinopathy – also called stage one retinopathy
• degrees of referable retinopathy – this means retinopathy that requires referral to an eye specialist for further assessment and treatment

You may need to have a further assessment if:

• the photographs aren't clear enough to give an accurate result
• you have retinopathy that could affect your sight and follow-up treatment is needed
• you have retinopathy that needs to be checked more than once a year
• other eye conditions are detected, such as glaucoma (a group of eye conditions that affect vision) or cataracts (cloudy patches in the lens of the eye)

If your results show no retinopathy or background retinopathy, you'll be invited back for another screening appointment a year later.

You can also reduce your risk of developing diabetic retinopathy in the future by controlling your blood sugar levels and blood pressure.

If screening detects signs that diabetic retinopathy or maculopathy is threatening your sight, you'll be given information about how far the condition has progressed. This will determine the type of treatment you receive.

Symptoms of Diabetic Retinopathy

Any diabetic patient complaining of any two or more of the following symptoms should be diagnosed for Diabetic Retinopathy especially after prolonged diagnosis of Diabetes.

• Blurred vision
• Spots or dark strings floating in your vision (floaters)
• Fluctuating vision
• Impaired color vision
• Dark or empty areas in your vision
• Vision loss

Causes of Diabetic Retinopathy

• High Blood sugar levels for extended periods of time
• Macular Edema (swelling) due to leaked blood, fluids and fats from the retina capillaries Closed off vessels thus causing Ischemia (Non Proliferative Diabetic Retinopathy (NPDR))
• Neglected diabetic eye problems that are left untreated lead to an advanced stage od Diabetic Retinopathy – Proliferative Diabetic Retinopathy (PDR)
• Retinal detachment/Wrinkling due to neovascularization (abnormal growth of new blood vessels as a cause of Ischemia)
• Glaucoma (as a result of neovascularization) damaging the optic nerve.

Treatment of Diabetic Retinopathy

Based on the patient’s diagnosis the following forms of treatment will be recommended:

• Laser
• Injections
• Surgery
• Counseling
• Medication and follow up

NOTE: Follow up (and frequency of visits post treatment) will be based on the Doctor’s recommendations and the extent to which the patient is diagnosed with Diabetic Retinopathy (or any other Diabetic Eye Disease)

Other Diabetic Eye Complications

These include:

• Vitreous Hemorrhage
• Retinal Detachment
• Blindness
• Diabetic Macular Edema (DME)
• Cataract
• Glaucoma