Buchanan Optometrists

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Mrs Heather Cliffton

Diabetes

If you are diagnosed with diabetes (type 1 or 2), you may be aware that the condition can lead to changes in your eyes hence you are commonly asked at the minimum to have retinal photographs taken of your eyes once a year. This article explains the risk that diabetes poses to the eyes and how best to prevent problems using some of the most modern imaging techniques and 4D eye scanning.

How does looking inside the eye help see diabetic changes?

The retina inside the eye is the only part of your body where we can see your blood vessels without peeling back skin to have a look. By checking the health of these vessels, it gives us a good idea of the health of the vessels elsewhere in the body that we can’t see so easily. Diabetes can cause changes to the blood vessel walls which makes them weaker and more likely to leak. These changes are called diabetic retinopathy and are graded depending on the severity of the condition. 
Photography and scanning with the advanced Spectralis 4D OCT Eye Scanner that we have in practice allows us to zoom in on the blood vessels, seeing details as small as one micrometer.

What is the best way to detect diabetic changes early?

Standard diabetic photographs (carried out by the NHS) involve having drops put in your eyes to dilate the pupils before a digital image with a flash is taken. The Spectralis 4D Multicolour OCT scanner we use in practice negates the need for drops in most cases and also allows a better peripheral view of the retina. It also makes it possible to look underneath the retina which is not possible with standard photography.

Conventional digital cameras, used in many opticians and during your typical diabetic photographs (under the NHS), just look at the top surface of the retina, but a lot of problems in the eye start at a deeper level. The Spectralis 4D OCT Eye Scanner is equivalent to a CAT scan of your eye. Unlike retinal photographs, this new system not only allows us to take a very high-resolution detailed image of your retina but also helps us look below the surface at each layer of the retina to create a High-Definition map that provides us with information never before available. We can even see details in the walls of your blood vessels and tiny individual nerve fibres, helping us to find the smallest sign of diabetic eye disease particularly retinal oedema (swelling) far sooner than ever before.

What happens if I get diabetic retinopathy?

Detecting diabetic changes in your eyes early on means that any problems can be treated sooner. Improving diabetic control and blood pressure can often make a significant improvement to diabetic retinopathy. In some cases, you may require laser treatment to your retina to seal the leaking blood vessels and prevent further damage. Occasionally injections into the eye are needed to help stop leaking blood vessels. Without treatment diabetic retinopathy can lead to sight loss. Therefore, if you notice any changes in your vision, you must book an appointment immediately. Even if you are not due for a check up or have been seen recently, it doesn’t mean that problems can’t develop quickly so always book an examination if you are concerned.

How is diabetic retinopathy graded?

Diabetic retinopathy is classified depending on the severity of the condition. Following your annual diabetic photographs, you may receive a report which tells you the level of your diabetic change. Mild diabetic retinopathy is often monitored without treatment except for taking measures to improve diabetic control. More severe cases of retinopathy are often referred to as pre-proliferative or proliferative retinopathy or maculopathy. These cases often require treatment usually with a laser to prevent further damage to the eye.

How common is diabetic retinopathy?

Only between 5 and 10 percent of all people with diabetes develop proliferative retinopathy; much more develop earlier stages of retinopathy. It is more common in people with type 1 diabetes than type 2. Sixty Percent of type 1 diabetics show some signs of proliferative disease after having diabetes for 30 years.

How can I prevent diabetic retinopathy?

Direct links between diabetic control, smoking, blood pressure and diabetic retinopathy are well known. If you are diabetic you should:

Regular examinations including Spectralis 4D OCT Eye Scans can help detect any changes to your retina early, allowing earlier intervention and better treatment. For the best diabetic care, we recommend a Comprehensive Ophthalmic examination once a year.

What are the symptoms of diabetic retinopathy?

During the early stages, diabetic retinopathy does not cause any noticeable symptoms until the later stages, when your vision becomes affected.

In later-stage retinopathy you may notice:

If you notice any of these symptoms, you must see your optometrist or GP immediately.

Does diabetes put me at greater risk of other eye conditions?

Yes, being diabetic increases your risk of other conditions such as glaucoma, and cataracts. But don’t worry, the Spectralis 4D  OCT scanner can help us identify early signs of these conditions long before they may be visible on the retinal surface and can be seen by standard retinal photography or by looking into your eyes (ophthalmoscopy). The OCT 4D scan can help us diagnose and monitor all these conditions with the accuracy of one thousandth of a millimetre. Earlier detection leads to earlier treatment, a better prognosis and in some cases prevention of conditions developing at all.

Detailed examination of retinal blood vessels can often show up the signs of other systemic diseases.  High blood pressure can cause the blood vessels to become more tortuous over time – a little like a hose pipe that wiggles when you increase the pressure of the water. We can also identify hardening of the blood vessels by changes in their structure and colour. Sometimes we can also see blockages or thrombosis forming which can be an important sign of potential health problems such as stroke in the future. 

 

Remember, regular examinations including Spectralis 4D OCT Eye Scans and photography can help detect any changes to your retina early, allowing earlier intervention and better treatment. For the best diabetic care book a Comprehensive Ophthalmic examination now on 01634 240645.