Diabetes and the Eye

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Diabetes and the Eye
July 2006
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Diabetes and the Eye

• Session outline
• The eye.
• Diabetes and the eye.
• Diabetic retinopathy.
• Risk factors.
• Other eye problems.
• Screening and prevention.

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Diabetes and the eye

• As blood glucose increases the glucose in the
  eyes fluid increases.
• Causes the lens to swell and distort which can
  affect vision.
• Common when newly diagnosed and will settle down
  once blood glucose levels are reduced.

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Diabetic retinopathy

• Occurs as a result of microvascular disease of
  the retina. It happens when elevated blood
  glucose levels damage the fine blood vessels of
  the retina.

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Classification of diabetic retinopathy

• Background retinopathy
• dot and blot haemorrhages
• macular oedema
• hard exudates (fatty deposits)
• Preproliferative retinopathy
• soft exudates (retinal infarcts)
• abnormal blood vessels
• Proliferative retinopathy
• formation of new vessels
• microaneurysms

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Vision threatening retinopathy

• New vessels on the optic disk or around it.
• Exudates or haemorrhage on or near the macula.
• Both can be prevented by early laser therapy.
• Damage affecting the macula is the most common
  cause of loss of sight.

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Risk factors

• Hypertension.
• Hyperlipidemia.
• Poor glycaemic control.
• Age and duration of diabetes.
• Family history.
• Smoking.

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Other eye problems

• Cataracts an opaque or cloudy lens can be made
  worse by high blood glucose.
• Glaucoma fluid in the eye builds up causing
  increased pressure and damage to the retina.
• Infections if glucose levels are high bacteria
  can grow.

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Screening prevention

• Keep blood glucose blood pressure under
  control.
• Assessment of risk factors and indicators will
  assist in prevention, early detection and
  management.
• Review should occur at the time of diagnosis in
  people with type 2 diabetes and within 5 years
  for people under 30 years who have type 1.
• Eye review at least every two years and more
  frequently if problems exist.