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Most
people with diabetes know that it can affect their eyes. One of
the eye problems caused by diabetes is diabetic retinopathy. It
is the commonest cause of blindness between the ages of 30-65 in
the United Kingdom. Each year 12% of people who are registered blind
and partially sighted have diabetic eye disease. When people first
develop diabetic retinopathy they have normal sight but must realise
that they are at risk of losing their sight. Diabetic retinopathy,
if diagnosed at this early stage, is a treatable condition. Over
the past 15 years laser treatment has been shown to be helpful in
either stopping the progress of the disease or in maintaining sight.
As
a diabetic it is important to know: 
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Diabetic retinopathy is the commonest cause of blindness.
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The only treatment for diabetic retinopathy is laser treatment.
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Sight tests for checking for diabetic retinopathy are FREE.
What
is Diabetic Retinopathy?
It
is a complication of diabetes that affects the retina. The retina
is the layer at the back of the eye which is sensitive to light.
For sight to take place, light must be able to pass to the retina.
It passes through the cornea, lens and vitreous (a jelly-like substance
in the eye). The focused light or images are then carried to the
brain by the optic nerve. The macula is the area of the retina concerned
with central detailed vision especially for reading. Diabetes causes
the capillaries (tiny blood vessels in the retina) to become blocked,
this may then lead to leakage in the central retina or result in
the growth of new vessels which may bleed and fill the eye with
blood (vitreous haemorrhage).
Retinopathy
Retinopathy
is usually classified according to the severity which may differ
in both eyes.
Background
retinopathy
Is the earliest stage in the development of retinopathy. It is rare
before 8-10 years of diabetes. At this stage vision is normal and
there is no threat to sight. The presence of diabetic changes of
haemorrhage, abnormal blood vessels (microaneurysms) and fatty deposits
(exudates) is a herald of more severe retinopathy, particularly
if the macula is affected (maculopathy). It alerts the doctor to
plan more frequent follow up.
Proliferative
retinopathy
The capillaries block and starve the retina of nutrients. In response
to this new vessels grow. They either grow in front of the retina
on to the back surface of the vitreous, or occasionally onto the
iris. The new vessels are fragile and may bleed into the vitreous.
This gives rise to floaters, either dots or lines, that if severe
cloud the vision or cause loss of vision. If vessels grow on the
iris they cause an increase in the pressure in the eye and cause
severe and painful glaucoma. The new vessels eventually produce
scar tissue which may result in a retinal detachment with severe
loss of sight.
Can
any diabetic develop retinopathy ?
Yes.
Diabetics of all types:
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the young and insulin dependent
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those on diet only
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'mild' diabetics on hypoglycaemic tablets
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the well controlled can develop it if they have had diabetes long
enough.
Is
there any way to prevent it ?
No.
But early diabetic control may slow down the rate of the progression
of complications.
You
should:
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Control your diet
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Always take your diabetic treatment. NOT taking treatment is harmful.
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Avoid becoming overweight
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Avoid smoking
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Avoid alcohol
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Have blood pressure checks
Improving
diabetic control rarely has an effect on diabetic retinopathy itself,
but should be undertaken to try to prevent any further deterioration.
Would
eye checks prevent it ?
No.
They would not have prevented disease but would enable early diagnosis
and early treatment and this would benefit your eyesight. Insulin
dependent diabetics need to have their eyes examined after they
have had diabetes for 8 years and then regularly. Other diabetics
(not on insulin) should have an eye examination every year by their
diabetic specialist, GP, ophthalmologist or optician. Sight tests
are FREE for diabetics.
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