The diabetic eye

About the guide

Content

  • Diabetic retinopathy
    • Why does it occur?
  • How to deal with diabetic retinopathy
    • Symptoms
    • Prevention
    • Recommended visits schedule
    • Comprehensive approach
    • Treatment

Cover of the guide The diabetic eye

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Diabetic retinopathy

Diabetes is a highly prevalent disease affecting 13% of the Spanish population that is increasing and hence becoming the most frequent metabolic disease. Bad monitoring of the pathology, which usually evolves slowly and silently, can result in complications seriously affecting the quality of life of these patients, whose risk of severe vision loss is 25 times higher than that of the remaining population.

One of the main complications of diabetes is diabetic retinopathy, a disease that has become the main cause of irreversible blindness at a working age in industrialised countries, although it is avoidable in 90% of cases, if treated early and appropriately. It is estimated that more than half of patients who have suffered from diabetes for 15 or more years have some degree of retinal vascular disorder and almost all with a history of more than 30 years show signs of diabetic retinopathy. To slow down its appearance or improve its prognosis, it is essential that patients get involved.

How to deal with diabetic retinopathy

diabetes-prevencionRegular examinations (at least annually) of the retina are essential, which, together with a strict metabolic control and the adoption of healthy habits, avoid important losses of vision due to diabetes. 

To slow down the appearance of diabetic retinopathy or improve its prognosis, it is essential that patients get involved. Specialists recommend: 

  • Carrying out a strict metabolic control of the risk factors: glycemia, blood pressure and plasma lipids
  • Adopting healthy life habits and avoiding obesity, a sedentary life style and tobacco consumption
  • Having the fundus tested once a year and intensifying eye examinations, if a problem is detected, as indicated by the specialist

Recommended visits schedule

Overall, this is the schedule of ophthalmological visits recommended for diabetic patients, depending on the type of diabetes, the lapse of evolution and the degree of diabetic retinopathy (with or without macular oedema):

No suspected diabetic retinopathy

recommended visits schedule for diabetes

With diabetic retinopathy

recommended visits schedule diabetic retinopathy

(*) If no treatment is required.

Comprehensive approach

In addition to patient involvement, cooperation between ophthalmologists, optometrists, endocrinologists and diabetes teachers is also key for a comprehensive management of the disease and its ocular complications, hence preventing them from reaching severe stages.

Treatment

Depending on the affected area and the degree of development of the disease, there are different treatment options:

  • Laser photocoagulation for the treatment of proliferative retinopathy and some macular oedemas.
  • Vitrectomy: surgery that removes the vitreous gel and is used in case of dense vitreous haemorrhage and/or traction on the retinal level.
  • Intravitreal injections: drugs are injected locally into the vitreous humour to reduce diabetic macular oedema. Currently, there are different types of drugs.

diabetes-prevencion-tratamiento

The progression of diabetic retinopathy is avoidable in 90% of cases, if treated early and appropriately.

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