Diabetic Retinopathy and How to Prevent It
I am incredibly squeamish when it comes to anything to do with eyes. I am pathetic even administering eye drops and cannot imagine ever being able to wear contact lenses.
However, upon being diagnosed with type 2 diabetes I quickly realized that I would have to get over this phobia to protect my eyes and more specifically, my vision.
People with both type 1 and type 2 diabetes are at risk of developing diabetic retinopathy – a common complication of diabetes where high blood sugar levels damage the cells at the back of the eye (the retina).
The retina is the light-sensitive layer of cells at the back of the eye which converts light into electrical signals. The signals are sent to the brain (through the optic nerve) and the brain interprets them to produce the images that you see. Very clever!
The retina needs a constant supply of blood through tiny blood vessels to allow it to work effectively, and over time, a continuously high blood sugar level can cause the blood vessels to narrow, bleed or leak, damaging the retina. Worst case scenario, the retina stops working and causes blindness, sometimes very suddenly.
In fact, during the initial stages of the condition there are very few symptoms and you might not realize you have developed retinopathy until your vision is affected – probably permanently – which is why it's so important to get your eyes checked at least once a year, by an optician and by a specialist looking specifically for diabetic retinopathy.
Keeping an Eye on Your Vision
We are lucky that in this modern age there is the equipment and medical know-how to spot and stop the condition before this happens as long as diabetic patients attend retinopathy appointments.
My late grandmother was not so lucky, and was forced to swap from helping out as a volunteer at the local centre for the blind to being one of the blind people being helped. I think seeing her struggle with even simple tasks, and having to give up her books – her greatest pleasure – made me determined that this was not going to happen to me.
So what can you expect at your retinopathy appointment? Well, the process varies slightly depending where you are in the world, but basically you will take a simple eye test, with your glasses on if you normally wear them.
Then you will have your pupils dilated with eye drops and then a special camera will take pictures of the back of your eye. At no point does anything other than the drops touch your eye.
My local hospital used to give anaesthetic eye drops before the dilating drops but (probably in a cost-cutting exercise) they don't bother now. However, even without the anaesthetic the drops only cause a slight stinging sensation, which soon passes.
At Your Appointment
After a few minutes you might notice your vision is slightly blurry, and if you try and read text, on paper or on your phone you will find it almost impossible to make out the words.
Take some time to relax and escape from the demands of your smartphone for a while before you are called in for the photography section of the procedure.
In my hospital I am taken into a small room, asked to sit, and put my chin on apparatus very similar to that found in a good optician's office for checking for glaucoma. The operator asks me to look for the floating dot, first on one side, then the other, then there's a bright flash of light as she takes each picture. Job done.
If you're lucky you might spot the picture of your eyeball on the computer screen, but don't try to interpret it – someone will let you know if any further measures need to be taken.
On a good day I can be in and out within half an hour. Of course I can't hop into the car and drive home as my vision remains blurry for anything from two to six hours after the procedure.
Apart from being dangerous, I discovered driving after retinopathy screening generally invalidates your vehicle insurance! So remember to book a taxi or ask a friend to accompany you and take you home.
You will probably be advised to bring sunglasses to wear after the retinopathy test too, especially if it's a sunny or snowy day as your pupils are dilated everything might seem almost painfully bright. Some people say the procedure gives them a headache - the first time you go it might be wise to plan a few quiet hours afterwards until you know how you react.
What If I'm Diagnosed?
And what if the doctor diagnoses diabetic retinopathy? Caught in the early stages, a real commitment to improving blood sugar control can prevent it from getting worse. More advanced retinopathy might require laser surgery or injection therapy to prevent the damage worsening.
Once again, the key to maintaining good health and vision is to maintain good control of your condition. Ensure you take any medication prescribed, eat a healthy balanced diet and inform your healthcare provider immediately if you notice any changes to your vision. And always attend any screening appointments.
An afternoon of blurry eyes is preferable to a lifetime of blindness.