Diabetes is the leading cause of blindness in working age worldwide. A recent study shows that over time, over 97% of type 1 diabetics will develop damage in their eyes.
Diabetic retinopathy is damage to the back part of the eye from leaking blood vessels near the back of their eyes due to damage caused by abnormally high blood sugar levels.
These leaks can cause the retina to swell and form deposits which often lead to blindness or vision loss especially if it affects macula called DME (diabetic macular oedema) in patients who have diabetes for more than 10 years. While diabetic retinopathy is a serious condition, it can be treated effectively if diagnosed in early stages. People with retinopathy have no symptoms but with early detection, vision can be saved in many cases. We recommend a dilated eye exam every year.
DR and vision loss may be reversible with early detection and treatment. It is critically important to see these patients regularly.
In the past, DR was almost always a prognosis of eventual blindness. Now we are able, in many cases, to prevent progression of the disease.
DME occurs in both eyes in > 50% of people with the condition although vision may not always be affected in both. If you already have DME in one eye, talk to your eye doctor about how you can reduce the risk of DME occurring in your other eye.
There are a number of factors both within and outside of your control that can put you at increased risk of developing DME, or making it worse if you already have it. All patients with type 1 or type 2 diabetes are at risk of developing DME. Risk factors for developing or worsening type 2 diabetes include:
The following are additional risk factors associated with DME:
All people with – both type 1 and type 2 are risk of developing DME; your level of risk is related to how long you have had diabetes and how well your blood sugar is controlled
What can I do?
Your vision is precious, so do whatever is within your control to help you hold on to it. There are specific things you can do that may help to prevent or delay vision loss. Vision loss is not evitable.
PROACTIVELY MONITOR YOUR VISION
Visit your eye doctor regularly – do not miss any scheduled appointments
If you notice a change in your vision, contact your eye doctor immediately.
Be proactive about vision rehabilitation and the use of visual aids e.g. using a magnifying glass
BE AWARE OF THE SIGNS
You will probably be the first person to detect changes in your vision, such as:
TAKE CONTROL OF YOUR DIABETES
You have an important role to play in controlling your diabetes, ensuring that vision loss is caught early, and getting treated as soon as possible. Making certain changes to your lifestyle can reduce your risk
ASSESSMENT OF CENTRAL VISION AT HOME:
This is done with Amsler Grid. Ask your eye doctor about how to use it
TREATMENT FOR DME
DME is a chronic condition, and monitoring your vision and diabetes is essential. It’s important for you to get regular checkups done on your eyes, to keep your blood sugar under control, and to make lifestyle changes that can reduce the risks of vision loss.
It is important to follow up on your DME diagnosis with treatment as soon as possible, as the speed at which DME progresses is dependent on a variety of factors which can be hard to control.
Remember, if one of your eyes is affected, the risk of developing DME in your other eye goes up significantly. It is important to check your sight in both eyes regularly with tests like the Amsler grid.
Today, there are several treatment options open to patients with DME. Treatment of DME is a process involving you and your eye doctor working together. Current treatment strategies
Although DME is a chronic disease, current therapy options such as anti-VEGF therapy, now make it possible to delay, stop or reverse your vision losses and preserve your sight for longer, helping you to continue the activities you enjoy.
HOW ANTI-VEGF THERAPY CONTROL DAMAGING EFFECTS OF DME
The latest treatment for your condition is called anti-VEGF therapy. Anti-VEGF stands for anti-vascular endothelial growth factor. “Anti” means against and “vascular” refers to blood vessels. Anti-VEGF treatment works by stopping the action of extra VEGF present in your eye because of your condition.
DME + ANTI-VEGF THERAPY
Anti-VEGF therapy has been designed to reduce the damaging changes in blood vessels in the macula of your eye that occur in DME. By reducing these leaky blood vessels in your eye, anti-VEGF therapy can help to reduce your vision loss and can even restore your sight if administered early.
ANTI-VEGF THERAPY – WHAT TO EXPECT DURING YOUR TREATMENT
If you are prescribed an anti-VEGF treatment, anti-VEGF drug will be injected directly into your eye, for maximal effect.
The injection needs to be given in a sterile way and you may have the treatment in an operating theatre, though more commonly it may be given in a room which has been designed for this type of treatment sometimes called a clean treatment room
The needle used for the injection is small and short and the injection itself only takes a few seconds. As you will have had an anesthetic drop in your eye the injection feels like a small point of pressure on your eye rather than a scratch. Your eye should feel comfortable by the next day.
Talk to your eye doctor more about this treatment and if it is right for you.
LIVING WITH VISION LOSS DUE TO DME
Vision loss due to DME does not necessarily mean that you will become blind; however, the disease can have a profound effect on your quality of life. A significant loss of central vision can severely impact your ability to function as before, making some things that you’ve always taken for granted, extremely difficult. However, the vast majority of patients retain their independence.
VISUAL AIDS AND REHABILITATION CAN HELP YOU TO RETAIN YOUR INDEPENDENCE
One of the most difficult things to overcome, however, is the emotional toll that severe vision loss takes. On first diagnosis, people can experience a range of emotions including: anger, denial, disbelief, loss, rage, resentment, sadness, and shock. If you feel depressed, it is important to address these feelings
ASK FOR HELP IF YOU NEED IT. YOUR LOVED ONES, FAMILY, FRIENDS, AND EVEN OTHERS WITH DME ARE THERE TO HELP YOU
Learning to carry on in new ways is the key. People who learn to adapt to altered vision can continue to do the things they love, independently and with confidence. For example, if you enjoy reading, you could try using a magnifier or listening to audio books.