Eye conditions related to diabetes

Quick links
– How can diabetes affect my vision?
– What are the types of diabetic retinopathy?
– How can I reduce the risks?
– Diabetes in different communities
– What can be done about diabetic retinopathy?
– Staying independent with sight loss caused by diabetes
– Coping

How can diabetes affect my vision?

• The changes in blood sugar levels caused by diabetes can affect the lens inside your eye, especially when your diabetes isn’t controlled. These changes can result in your vision blurring, which can change throughout the day and from day to day, depending on your blood sugar levels.
   
• Diabetes can cause the lens in your eye to become cloudy. This condition is known as a cataract. If you have diabetes, you’re more likely to develop a cataract, and diabetes can cause cataracts to develop at an earlier age.
   
• Some people with diabetes may develop glaucoma, an eye condition that can cause damage to the optic nerve, often due to raised pressure inside the eye.
   
• Over time, diabetes can affect the network of blood vessels supplying the retina at the back of the eye, affecting how the retina works. This is known as diabetic retinopathy. There are different types of diabetic retinopathy and how it can affect vision will depend on the severity of the changes to the blood vessels.
   
• Diabetes can also be associated with or increase the risk of other eye conditions including retinal vessel occlusion, corneal eye conditions or eye muscle problems.

Not everyone who has diabetes develops an eye condition.

What are the types of diabetic retinopathy?

Diabetes can cause blood vessels in the retina to become blocked, to leak or to grow incorrectly. The type of diabetic retinopathy you have depends on how badly your blood vessels are affected by diabetes. There are different types of retinopathy:

• Background diabetic retinopathy: Background retinopathy does not usually affect your sight, but your eyes will need to be monitored carefully to make sure your retinopathy doesn’t become worse.
   
• Proliferative diabetic retinopathy: If background retinopathy gets worse, many of the retinal blood vessels become damaged or blocked. When these changes affect a large area of your retina, blood supply to the retina is reduced. The body tries to fix this by growing new blood vessels on the retinal surface or into the vitreous gel. Unfortunately, these new vessels are weak, and they bleed very easily, which may affect your vision.
   
• Diabetic maculopathy and diabetic macular oedema: Diabetic maculopathy is when your macula is affected by retinopathy. If the blood vessels near the macula are leaky, fluid can build up at the macula and cause macular swelling. This is called diabetic macular oedema (DMO) and it can cause vision to be blurred and distorted, as well as making colours appear washed out.

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How can I reduce the risks?

If your diabetes is well controlled, you’re less likely to have problems, or they may be less serious. However, some people with diabetes do have serious sight loss because of their retinopathy. You can reduce your risk of developing retinopathy, or help to stop it from getting worse, by:

• Keeping your blood glucose or blood sugar level within normal levels.
• Tightly controlling your blood pressure.
• Controlling your cholesterol levels.
• Keeping fit and maintaining a healthy weight.
• Giving up smoking. Nerve damage, kidney and cardiovascular disease are more likely in smokers with diabetes. Smoking increases your blood pressure and raises your blood sugar level, which makes it harder to control your diabetes.
• Having regular retinal screening. The most effective thing you can do to prevent sight loss due to diabetic retinopathy is to go to your retinal screening appointments. Early detection and treatment can stop you from losing sight.

• Download the full transcription of Linda's diabetic eye screening
• Watch the video on YouTube with subtitles

Diabetes in different communities

If you or your family are from a South Asian or African-Caribbean background, you’re two to four times more likely to get type 2 diabetes. The factors behind this aren’t fully understood but are thought to involve insulin problems, genes, diet and lifestyle.

Find out more about diabetes in different communities and how to reduce your risk.

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What can be done about diabetic retinopathy?

Diabetic retinopathy can be treated with laser treatment to prevent sight threatening complications. Laser can be used in two ways:

• Localised laser treatment may be used when only a small part of your retina is affected by retinopathy. The laser seals your blood vessels, to stop them from bleeding and help to reduce swelling. The treatment normally only takes a few minutes. You don’t usually notice a worsening of your vision after this procedure because only a small patch of your retina is treated with the laser.
   
• Pan-retinal laser treatment. When new blood vessels begin to grow (a process known as neo-vascularisation), a larger area of your retina may need to be treated by laser. Treating more of your retina stops it from producing the growth factors that make new blood vessels develop. When the treatment is successful, the new blood vessels get smaller and disappear over a few months.

Diabetic macular oedema (DMO) can be treated with anti-VEGF treatment. This is usually given when your macula has swollen to a certain size. Anti-VEGF treatment can help to improve your vision by reducing your macular oedema and helping the fluid to be reabsorbed.

Staying independent with sight loss caused by diabetes

If you have sight loss, you may find that this makes managing and monitoring your diabetes at home more difficult. In our video, Carol talks about how she uses lighting, magnifiers and tactile aids to help her monitor her diabetes. 

• Download the full transcription of Carol's video
• Watch the video on YouTube with subtitles

More helpful information on staying independent with sight loss can be found in our Making the Most of Your Sight guide.

• Download Making the Most of Your Sight (PDF)
• Download Making the Most of Your Sight (Word)

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Coping

It’s completely natural to be concerned when you’ve been diagnosed with an eye condition related to diabetes. We’re here to support you every step of the way, and to answer any questions you may have – just get in touch with our Sight Loss Advice Service. 

Useful contacts

• Diabetes UK is the leading charity who supports and connects those affected by diabetes.
• Read information and advice on diabetes from NHS Choices.
• Moorfields Eye Hospital has information on diabetic retinopathy.

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