LIVING WITH DIABETES: How you can control diabetes-related eye complications like retinopathy


You may have heard that diabetes, a common metabolic disorder affecting approximately 2% of the general population, causes eye problems and may eventually result in blindness.

“Both Type 1 (Juvenile Onset) and Type 2 (Adult Onset) diabetics are vulnerable to eye disease, which affects approximately 40% juvenile and 20% adult onset patients. Diabetes is the most prevalent cause of legal blindness between the ages of 20 and 65 years,” says Dr Michael Schultz, a resident Ophthalmologist at the Eye & Laser Institute, in Port Elizabeth.

“Diabetes affects the eyes through unstable/fluctuating refraction (spectacle prescription), accelerated cataract formation, ocular motor nerve palsies (resulting in double vision) and retinopathy (the malfunction of the nerve and sensory layer of the eye, the retina).”

Dr Schultz said retinopathy manifests in three basic forms: Early Background Retinopathy, which is relatively innocuous and seldom affects vision; Maculopathy, which affects vision and Proliferative Retinopathy, which may have dire visual consequences.

While most people who have diabetes have nothing more than minor eye disorders, regular check-ups can keep these problems minor.

“Comprehensive ophthalmic evaluation shortly after the initial diagnosis of diabetes is advised because Type 2 diabetes is often symptomless and up to 5% of newly-diagnosed Type 2 patients show signs of diabetic retinopathy.

“Depending on the findings at the initial assessment, regular follow-up visits will be scheduled to monitor the condition. All diabetics should have, at least, one annual ophthalmic evaluation. Since treatment may be required in the presence of absolutely normal vision, these follow-up examinations are most important,” says Dr Schultz.

Still, if you do develop a major problem, there are treatments that often work well if you begin them right away.

“Once vision threatening retinopathy is noted, different forms of laser treatment are employed to improve vision or prevent further complications. Some of these complications (e.g. vitreous haemorrhage, membrane formation or retinal detachment) may require surgical intervention. Maculopathy can be treated by intraocular injections of specialised drugs,” describes Dr Schultz.

He said the risk for diabetes-related eye complications depended on duration of the condition.

“The risk of juvenile diabetics’ eyes being affected after 10 years duration is approximately 50% - and at 30 years approximately 90%. Poor glycemic control, uncontrolled high blood pressure, smoking and pregnancy can also be contributory factors,” says Dr Schultz.

He advises that controlling these factors may delay, but not necessarily prevent, the onset of diabetic eye disease.

For more information visit, the Eye & Laser Institute along Cape Road in Mill Park, Port Elizabeth or call 041 373 0682.