Diabetic eye screening

Overview

Diabetic eye screening is a test to check for eye problems caused by diabetes. It helps find damage early so it can be treated before it affects your sight.

Diabetic eye disease is one of the most common complications of diabetes. Many people with diabetes will develop some degree of eye damage over time, but with regular screening and good diabetes management, serious vision loss can be prevented.

Anyone with type 1 or type 2 diabetes is at risk. The longer you have had diabetes, the higher the risk. People with poorly controlled blood sugar, high blood pressure, or high cholesterol are more likely to develop eye problems.

Symptoms

Common symptoms

• Early diabetic eye disease often has no symptoms.
• As it progresses, you may notice blurred vision, seeing floaters (small spots or strings), difficulty seeing at night, or colors appearing faded.

Symptoms in children

• Children with diabetes may not notice any symptoms. They might not tell you about vision changes.
• Regular screening is important because children can develop diabetic eye changes sooner than adults.

Symptoms in older adults

• Older adults may attribute vision changes to aging, but diabetic eye disease can worsen faster.
• They might notice difficulty reading, driving, or recognizing faces even with glasses.

Causes

Main causes

• High blood sugar levels over time can damage the tiny blood vessels in the retina (the light-sensitive tissue at the back of the eye). This can cause them to leak, swell, or close off, leading to diabetic retinopathy.

Risk factors

• Poor blood sugar control
• High blood pressure
• High cholesterol
• Long duration of diabetes
• Pregnancy
• Smoking
• Having kidney disease

When to see a doctor

See a doctor urgently if:

• If you have sudden vision loss, flashes of light, or a curtain-like shadow over your vision, seek emergency care immediately.

Book a routine appointment if:

• If you have diabetes and have not had an eye screening in the past 12 months, schedule one.
• If you notice gradual vision changes, such as blurriness or trouble reading, make an appointment with your healthcare team.

Diagnosis

Diagnosis is made through a diabetic eye screening test. This involves taking photographs of the back of your eye (retina) to look for signs of damage.

Tests that may be done

• Digital retinal photography (with or without eye drops to widen the pupil)
• Optical coherence tomography (OCT) if needed
• Sometimes a dilated eye exam by an optometrist

What to expect at your appointment

You will have drops put in your eyes to widen (dilate) your pupils. This may make your vision blurry and your eyes sensitive to light for a few hours. The screening is painless and takes about 20 minutes. You should not drive immediately after because of the drops.

Treatment

Treatment depends on the stage of diabetic eye disease. For early stages, good blood sugar, blood pressure, and cholesterol control are key. For more advanced stages, laser treatment, injections into the eye, or surgery may be needed.

Self-care at home

• Keep your blood sugar, blood pressure, and cholesterol under control.
• Attend all recommended screenings.
• Stop smoking.
• Wear sunglasses to protect your eyes from UV light.

Medical treatments

Laser treatment (photocoagulation) can seal leaking blood vessels. Injections of medicines into the eye can reduce swelling and abnormal blood vessel growth. These treatments do not cure the condition but can prevent further vision loss.

When is surgery considered?

Vitrectomy surgery may be needed if there is severe bleeding or scar tissue in the eye that does not improve with other treatments.

Living with this condition

Managing diabetes well is the best way to protect your eyes. Check your blood sugar regularly, take medications as prescribed, and attend all screenings. Notify your healthcare team if you notice any vision changes.

Lifestyle tips

• Eat a balanced diet rich in fruits, vegetables, whole grains, and lean protein.
• Exercise regularly (aim for 150 minutes per week of moderate activity).
• Maintain a healthy weight.
• Avoid smoking and limit alcohol.

Diet and exercise

A diet low in sugar and refined carbohydrates helps control blood sugar. Exercise helps lower blood sugar and blood pressure. Ask your doctor for advice specific to your health.

Mental health and emotional wellbeing

Worrying about vision loss can cause stress and anxiety. It is normal to feel this way. Talk to your healthcare team about your concerns. Connect with others who have diabetes.

Prevention

Diabetic eye disease cannot always be prevented, but you can greatly lower your risk by keeping your blood sugar, blood pressure, and cholesterol in a healthy range, and by attending regular screening.

Screening programmes

Regular diabetic eye screening is the most effective way to detect problems early and prevent vision loss. Screenings are typically offered every year or two.

Complications

If left untreated

• Without treatment, diabetic eye disease can lead to vision loss and blindness.
• It can also cause other eye problems like glaucoma (increased eye pressure) and cataracts (clouding of the lens).

Long-term outlook

With regular screening and proper management of diabetes, most people with diabetic eye disease can maintain good vision. Early treatment is very effective at preventing serious vision loss.

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