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DIABETIC RETINOPATHY
Dr William Taylor - Eye Specialist, Auckland Eye
What is it?
Diabetic retinopathy is an abnormality of blood vessels
which supply the retina, the layer lining the inside of
the eye which acts like a film in a camera.
These blood vessels leak fluid which causes a loss of
reading vision, or abnormal blood vessels develop which
can haemorrhage and lead to a more severe loss of vision.
Who gets it?
All diabetics are at risk of the condition which is largely
related to the duration of the diabetes. In younger insulin
dependent diabetics the onset of the condition is rapid
whereas in older diabetics it comes on more slowly and the
exact onset is therefore more difficult to pinpoint. After
10 years of the disease all diabetics will have some degree
of retinopathy and about 40-50 percent will develop complications
which can cause an effect on vision.
Can it be prevented?
Good control of the blood sugars will reduce the incidence
of retinopathy and control of hypertension is also important.
Smoking is associated with greater risk of the condition.
The most important preventative measure with regard to
visual loss from diabetes is regular examinations by an
eye specialist to detect the early changes of retinopathy.
Special care needs to be taken in pregnant diabetic patients.
Can it be treated?
Laser treatment before symptoms is very effective in preventing
loss of vision and is imperative, although may be less effective
once symptoms have developed. Therefore, regular checks
by an eye specialist to detect the changes before symptoms
is absolutely mandatory and particularly so after 10 years
of diabetes.
The laser treatment may need to be quite extensive and
consists of multiple small burns on the surface of the retina.
This is performed as an out patient sitting in front of
a laser machine.
Following the laser treatment the vision is quite blurred
for about a week and after that vision largely recovers
but the eye remains less able to adapt to changes of light,
particularly when going from light to dark conditions.
If the retinopathy progresses to haemorrhages and more
damage to the retina, vitreoretinal surgery may be required.
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