Diabetic patients should be examined by an eye professional at the time of diagnosis and then every 2 years.

Diabetes is increasingly prevalent, now affecting over 2 million people in Australia. This includes approximately 500,00o Australians with silent diabetes not yet diagnosed. An eye check is one of the essential steps in early diagnosis.

Diabetes affects many organ symptoms and is the leading cause of preventable blindness in Australia. The fine blood vessels at the back of the eye may be damaged due to diabetes, causing haemorrhage, swelling or compromised blood supply of the retina.

This is known as diabetic retinopathy. There are different forms of retinopathy in diabetes, including

• macular oedema
• background retinopathy
• proliferative retinopathy.

These may exist individually or in combination. An annual eye examination is vital to obtain an early diagnosis.

Improving diabetic control and attending to other risk factors can improve retinopathy and prevent visual loss. The important risk factors for diabetic retinopathy are:

• high blood sugar levels
• high blood pressure
• elevated cholesterol
• smoking
• lack of exercise

These factors are managed by your general practitioner, sometimes with the aid of a dietician and endocrinologist.

Diabetic eye disease treatment

Treatment is individualised for each patient. This may involve, sometimes in combination:

• periodic observation to detect progression (common in early stages of retinopathy)
• attending to risk factors
• drugs placed into the vitreous cavity near the retina (intravitreal injections)
• laser treatment
• uncommonly, diabetic eye surgery may be required (vireo-retinal surgery)

Cataracts do occur at an earlier age in diabetics than non-diabetic patients. This can be dealt with surgically with excellent results.

In general, with appropriate management, the majority of diabetic patients can have preservation of good long-term vision.