Protecting Your Vision: How Diabetes Can Also Cause Serious Eye Complications

10 October 2023

In conjunction with World Sight Day, devoted to raising awareness about eye health, we focus on a hidden threat to our vision — diabetic eye complications.

Diabetes, a condition that affects blood vessels throughout the body, can wreak havoc on our eyes, potentially causing irreversible vision loss. One in five Malaysians was found to have diabetes in 2019, the highest in Asia with a 68.3 per cent increase.

Dr Tara Mary George, consultant ophthalmologist and medical retina specialist at Sunway Medical Centre, shares the intricacies of diabetic eye issues, their associated risks, prevention strategies, and available treatments.

Understanding Diabetic Eye Complications

Many diabetes patients do not realise the gravity of diabetic eye complications. According to a recent study, only 58.6 per cent of the patients knew that they could have eye problems at diagnosis.

Still, only 43.0 per cent of the patients knew that eyes must be checked at the time of diabetes diagnosis. Dr George shares how diabetes can impair the blood vessels in the retina, a critical focal point of the eye, leading to damage and irreversible vision loss.

Diabetes can also influence other aspects of ocular health, causing cataracts or dry eyes — conditions that can be managed without causing permanent vision impairment.

The prevalence of diabetic retinopathy in Malaysia has progressively risen from 44.1 per cent in 1981 to 51.6 per cent in a 2005 study and more in recent years. The number is also much higher than in other countries such as the United Kingdom (22.7 per cent) or Japan (39.6 per cent).

“The most concerning manifestation is diabetic retinopathy, where diabetes affects the retina. It poses a dual threat to vision — bleeding within the retina or the swelling of this delicate tissue, referred to as vitreous haemorrhage and macular edema,” said Dr George.

Macular edema, characterised by the swelling of the central part of the retina, and vitreous haemorrhage, which involves bleeding within the eye’s gel-like substance, are two critical complications of diabetic retinopathy that can threaten vision.

Early Warning Signs And The Significance Of Routine Eye Examinations

Diabetic retinopathy can stealthily creep up without warning signs. In a recent study, 29.2 per cent of type 2 diabetic patients in Malaysia were found to have retinopathy in their first eye test.

Dr George emphasises the importance of not waiting for symptoms to surface before seeking the counsel of an eye specialist.

“The recommendation is not to defer until a problem manifests itself before seeking medical attention. Instead, individuals diagnosed with diabetes should embrace the practice of regular eye check-ups.”

This includes a comprehensive retina evaluation, which can be conducted through pupil dilation or advanced retinal cameras that eliminate the need for dilation. These devices are widely available, making screening swift and accessible.

Preventing Vision Deterioration In Diabetes: Expert Recommendations

Dr George imparts a comprehensive strategy for forestalling vision loss in diabetes:

• Early Diagnosis: Regular medical check-ups are paramount for early diabetes detection, especially for those with a family history.
• Routine Eye Screening: Once a patient is diagnosed with diabetes, it is imperative to undergo annual eye screenings, even without apparent issues.
• Effective Diabetes Management: Well-controlled diabetes is instrumental in significantly diminishing the risk of diabetic retinopathy. Monitoring HbA1C levels is crucial, with a recommended target below 7.5.

In recent years, there has been an increase in the availability of screening and testing services.

“Many private hospitals and government health centres have adopted these technologies, rendering screening expedient and hassle-free. If they undergo appropriate training, optometrists and paramedical staff can administer screenings and refer individuals to ophthalmologists when necessary,” said Dr George.

Pre-Diabetes And Its Implications

Regarding concerns about eye complications for individuals in the pre-diabetes phase, Dr George clarifies that eye complications do not typically arise for them.

Nevertheless, this stage provides an opportunity to stave off full-fledged diabetes by adopting preemptive measures and maintaining blood sugar levels.

Treatment Options That Make A Vast Difference In Patients’ Quality Of Life

Dr George explains various treatment options for diabetic eye complications:

• Systemic treatment includes diabetes control, blood pressure and cholesterol management.
• Intra-vitreal injections, including anti-VEGF agents, effectively tackle retinal swelling and bleeding, particularly in diabetic macular edema.
• Laser treatment is used in severe cases of vitreous haemorrhage or proliferative retinopathy to arrest or mitigate eye bleeding.

Dr George also shares that those advancements in treatment, notably the adoption of anti-VEGF injections, have yielded remarkable improvements.

“The root of our success lies in patient empowerment, emphasising understanding and compliance in diabetes management and regular eye screenings. Treatment choice hinges on individual circumstances and severity, with physicians opting for combinations of injections and laser therapy as deemed appropriate.”

“Do go for regular eye screenings. Diabetic eye screenings are swift, uncomplicated procedures that can safeguard your vision. Prevention remains the linchpin in averting the complications of diabetic retinopathy.

“Remember, age is not the deciding factor; the key determinants are diabetes control and the duration of living with the condition,” added Dr George.

As we commemorate World Sight Day, let’s prioritise our eye health. Regular eye screenings have the potential to make a world of difference in preserving our invaluable eyesight.

Source: Code Blue

   后退