Eye health and diabetes

Looking after your eyes is important when you have diabetes.

People with diabetes have an increased risk of developing eye problems. If left untreated, this can lead to poor vision and blindness.

There will be often be no signs or symptoms of problems. In fact, changes in vision may be so gradual that a person may not notice it for some time.

The good news is that most vision loss from diabetes can be prevented with regular eye checks and early treatment. The earlier the treatment, the better the result.

Unfortunately, many Australians miss out on important diabetes eye checks. They might not be aware of how important they are, or they simply struggle to fit them in to their busy lives.

Why is it important to have eye checks?

Diabetes can cause a range of eye problems. The most common of which is Diabetic Retinopathy (DR), in which the tiny blood vessels in the back of the eye are damaged. As DR can cause vision loss, it’s important that it is identified and treated early.

DR has no symptoms during the early stages, so people usually will not know they have it. In the later stages, people may notice blurred, hazy or double vision or they may have sudden loss of vision. The only way to know if you have DR is to have a diabetes eye health check.

But remember all vision loss from diabetes is preventable with early detection and treatment.

What does a diabetes eye check involve?

A diabetes eye health check focuses on looking for early signs of diabetes-related changes in your eyes, such as changes to the blood vessels at the back of your eyes.

Getting a diabetes eye check is easy. You don’t need a referral from your GP. You can book an appointment directly with an optometrist. When you do, be sure to tell them you have diabetes and that you would like your eye check recorded with the KeepSight program.

The check is usually done by an optometrist, or sometimes a GP, who will take a photo of the back of your eye. Your optometrist will examine your eyes and look at the photo to check the blood vessels at the back of your eyes for any damage caused by diabetes or any other cause.

The check only takes about 30 minutes and usually can be bulk-billed.

Your optometrist may give you eye drops to help them to see the back of your eye. If you do have eye drops, they may be a little uncomfortable. The drops can also leave you sensitive to light, so bring your sunglasses and be prepared to wait a while for your vision to return to normal or ask someone else to join you if you have to drive.

If the optometrist sees any signs of damage to the back of your eye, your optometrist will either monitor it or arrange treatment with an ophthalmologist.

What happens if eye disease is detected and you need treatment?

Your eye health professional will advise you of your treatment options. In the early stages, treatment may not be needed to monitor any signs of progress, but you may be asked to have eye health checks more frequently to monitor DR.

You can slow progression of diabetic eye disease by keeping your blood glucose, blood pressure and cholesterol as close to target as possible.

If your condition progresses, you may need to see an ophthalmologist for specialist treatment.

If I register with KeepSight, who will see my information?

Your personal patient information will be used by KeepSight and Diabetes Australia to remind you when eye examinations are due in the future. Your information is not available to any others. If you consent, your de-personalised information can be used by researchers interested in improving care for people with diabetes.

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Looking after your eyes FAQs

How does the eye work?

The eye works a bit like a camera. Light enters through the cornea and the pupil before passing through the lens, which focuses the light onto the retina. Special cells in the retina detect the light, forming the focused image like the film in the camera. The image is sent along the optic nerve to the brain. At the centre of the retina is the macula which is responsible for the seeing part of our central vision while the retina is responsible for seeing from the edges of our vision.

How does diabetes affect eyes?

High blood glucose levels can cause changes in the shape of the lens, which can temporarily cause blurring of your vision. This commonly occurs before being diagnosed with diabetes or when diabetes isn’t well managed. The blurriness usually disappears when blood glucose levels are reduced through appropriate treatment. Therefore getting new glasses should be delayed until blood glucose levels are back within the recommended range. High blood glucose levels for long periods of time can increase the risk of more serious eye problems in people with diabetes, including:

  • Retinopathy
  • Cataracts
  • Macular Oedema
  • Glaucoma

As many people with diabetes do not notice changes in their vision until the condition is very serious, it is essential to have regular eye checks so that problems can be detected early and treated promptly.

What are the symptoms of eye disease?

Often diabetes-related eye complications have no signs or symptoms and there may be no obvious deterioration in vision until the condition is quite advanced. Changes in vision may also be so gradual that you do not notice it for some time. Where signs and symptoms are present, they can include:

  • Floaters and flashes
  • Blurry, blocked or dim vision
  • Poor night vision
  • Halos around lights or sparkles
  • Sensitivity to light and glare
  • Need for brighter light for reading and other activities
  • Distortion or holes in vision
  • Frequent changes in eyeglass prescriptions

Any change in your vision should be checked by your optometrist, ophthalmologist or doctor.

How to care for your eyes?

  • Have an eye examination by an eye care professional when you are first diagnosed with diabetes and then at least every 2 years (or more often as indicated by your doctor or eye care professional). The frequency of examination may vary with different people, for example, people with type 1 diabetes, children, women during pregnancy and people who already have eye complications.
  • Examination of your eyes involves viewing the back of your eyes. This will involve adding eye drops to dilate the pupils or taking a photograph of the back of your eyes.
  • If retinopathy is detected, you will need to have your eyes examined more often and you may be referred to a medical eye specialist (ophthalmologist).
  • Notify your eye care professional immediately if you notice any changes in your vision.
  • Keep your blood glucose levels, HbA1c, blood pressure and cholesterol within the recommended ranges. High blood glucose, cholesterol and blood pressure increase the risk of developing eye complications as well as increasing the severity of eye complications.
  • Have regular health checks including blood pressure readings, cholesterol measurements and kidney function tests as recommended by your diabetes care team. It is important that you discuss the results with your doctor and seek further advice for any results that are not in the recommended range.
  • If you smoke, stop.
  • Maintain a lifestyle that includes regular physical activity and healthy eating to better manage your blood glucose levels.
  • Always take your medications as instructed by your doctor.

Most eye complications can be treated successfully if detected early. Early detection and treatment can also prevent eye complications from getting worse. However, treatment generally cannot restore vision once it has been lost. Regular eye examinations and early treatment are therefore important to prevent vision loss.

Can eye disease be treated?

Common treatments for eye complications

  • Laser
    This involves the use of a special form of light of a specific wavelength that is able to heat retinal tissue and blood vessels. This can minimise leakage from blood vessels and cause regression of any new and fragile vessels.

  • Surgery
    A surgical procedure called a vitrectomy is used in cases of advanced retinopathy. It involves the use of fine instruments inside the eye with the aim of repairing the most severe damage caused by diabetic retinopathy.

  • New treatments
    If your condition is not responding to other treatments, your eye care professional can give you more details of new treatments that are constantly being developed.

Who can help you to look after your eyes?

Your eye health care team consists of your general practitioner (GP), optometrist and ophthalmologist.

  • General practitioner
    Your GP will support you in your day-to-day diabetes management and will be the contact point for referral to other specialist health care team members as required.

  • Optometrist
    An optometrist may be involved in the ongoing management of your eye health. An optometrist will diagnose and manage diabetes-related eye complications. If changes are detected by your optometrist, this will be reported to your GP and if necessary you will be referred to an ophthalmologist. To find your nearest optometrist visit Optometry Australia.

  • Ophthalmologist
    An ophthalmologist (medical eye specialist) may also be involved in the ongoing management of your condition. An ophthalmologist will be involved if specialised medical care or treatment is required, such as laser surgery or other specialist procedures to improve vision or to prevent loss of vision. For more information about ophthalmologists visit The Royal Australian and New Zealand College of Ophthalmologists (RANZCO).

Source: Healthy WA