By Elle Carson, Specsavers Optometrist 

Diabetic retinopathy and diabetic macular oedema are both common eye complications linked to diabetes. While they are different vision conditions, unfortunately, both can lead to vision loss. 

People with all types of diabetes are at risk of developing one of these, and it’s possible to have both at the same time. If your blood glucose levels are higher than your target range for a long period of time, it can cause problems in the layer at the back of your eye called the retina. The retina plays a crucial role in how you see and, if left untreated, these issues can lead to serious vision problems. 

Unfortunately, these changes often go unnoticed until they reach a more advanced stage. However, the good news is that if you keep up with regular eye health checks, any changes in your eyes can be detected early, monitored, and treated, which can save your sight. 

What is diabetic retinopathy? 

Diabetic retinopathy occurs when high blood glucose levels damage the tiny blood vessels that supply nutrients to the retina. These damaged vessels start to leak blood, creating tiny dot-like spots that are visible during an eye exam, referred to as dot and blot haemorrhages. 

If blood glucose levels remain high, the damage worsens, leading to more frequent and larger bleeds. Over time, the blood vessels may also become blocked, cutting off the oxygen supply to the retina. When this happens, retinal cells begin to die off, which shows up as yellow spots known as cotton wool spots. 

If the blockages become more severe, the eyes try to compensate by growing new blood vessels. Unfortunately, these new vessels are weak and abnormal, causing even more bleeding and leakage into the retina. This stage of the disease is known as proliferative diabetic retinopathy. These fragile blood vessels may form around the optic nerve – the part of the eye that sends visual information to the brain. If this area is affected, it can lead to permanent vision loss. 

What is diabetic macular oedema? 

In addition to bleeding, damaged blood vessels may start leaking fluid into the retina at a region called the macula. This is known as diabetic macular oedema (DMO). The macular area is the central part of the retina and is responsible for sharp, detailed vision. When DMO occurs, the fluid build-up can cause a significant shift in vision and ultimately lead to serious vision impairment, making it harder to read, drive, or recognise faces. DMO can occur at any stage of diabetic retinopathy but is more common in the advanced stages, when blood vessels are severely damaged. 

Managing diabetes-related eye problems 

To preserve your vision, it’s essential to manage your diabetes well. This starts with keeping your blood glucose levels in your target range and having regular eye check-ups with your optometrist. Any sudden changes in vision should be checked by an eye care specialist immediately. 

When was the last time you had a diabetes eye check? 

Regular eye checks are the best way to prevent diabetes-related vision loss. Simply book an appointment directly with your local optometrist. Diabetes Australia runs a free diabetes eye check reminder program called KeepSight, which sends reminders when you’re due for an eye check appointment. You can find out more at keepsight.org.au.