Diabetic Retinopathy: The role of screening
Diabetes can affect the small blood vessels at the back of the eye (the retina), leading to a condition called diabetic retinopathy. The macula is the small central part of the retina that allows you to see fine detail. When this is affected, you can develop diabetic maculopathy.
The incidence of diabetes mellitus is increasing globally with the majority of patients having Type II diabetes, a preventable chronic disease. Both the duration of diabetes and blood sugar control are independent risk factors for severity and progression of diabetic retinopathy. Diabetic retinopathy is more prevalent in older age groups with long-standing disease. This also applies to diabetic maculopathy.
Many studies exist on diabetic eye disease in different parts of the world, all of which provide a picture of increasing concern with respect to the increasing prevalence of this disorder. Patients with uncontrolled blood pressure are also at increased risk of worsening diabetic eye disease.
Diabetic eye screening is important as it helps to prevent sight loss. Screening can detect the condition early before you notice any changes to your vision. Eye screening should be a key part of your diabetes care. Untreated diabetic retinopathy is one of the most common cause of sight loss in people of working age. When the condition is caught early, treatment is effective at reducing or preventing damage to your sight.
Background retinopathy is seen as tiny red dots due to changes in blood vessels (microaneurysms) and blot haemorrhages (similar to bruises on the skin). This is detectable on screening but does not need to be referred for further treatment.
Leaking blood vessels around the macula lead to protein and fats being deposited in the retina (above) as exudates. The central area can also become waterlogged or have a reduced blood supply. These are conditions that require referral.
Abnormal blood vessels can grow at the back of the eye (above). This condition requires an urgent referral for laser treatment.
Screening involves taking photographs of the back of the eyes with photographs that are sent electronically to an expert to review. The appointment usually lasts approximately 30 minutes and should be available to all diabetics over the age of 12 years.
Screening can detect:
- Early signs of retinopathy
- If you need a follow up appointment to see whether you need treatment
- If you need to have more frequent checks.
Article written by Tracey Bushell of the Barbados Diabetes Foundation