Diabetic retinopathy – how eye disease can result from diabetes

Posted: 17/11/2022

Monday 14 November 2022 was World Diabetes Day. Diabetes can have various health consequences, one of which is known as diabetic retinopathy.

Diabetic retinopathy

Diabetic retinopathy can impair a person’s sight, lead to glaucoma, or even total blindness, and is one of the most common causes of blindness in people of a working age. It occurs when a person has high blood sugar levels caused by diabetes. Over time, having too much sugar in your blood can cause damage to the retina – the part of the eye that detects light and sends signals to the brain, creating the images we can see. When the retina is damaged, the eye will not function properly, resulting in impaired sight, or even blindness. 

In order to function properly, the retina requires a good blood supply. In healthy individuals this is not a problem as a network of tiny blood vessels maintains the blood supply to the retina. But if a person has too much sugar in their blood because of diabetes, it will cause bulges in the blood vessel walls. These can leak blood and fluid into the eye, and they may also become blocked. Over time, this will reduce the blood supply to the retina and impair its function, resulting in sight loss.

Why does diabetes cause retinopathy?

Retinopathy is a problem associated with diabetes patients because diabetes is a condition in which the body cannot break down glucose (sugar) properly. The glucose ends up in the bloodstream, meaning the patient has high blood sugar levels. If a diabetic’s blood sugar levels are not well controlled, and are persistently high, they will be at an increased risk of suffering injury to their sight, caused by diabetic retinopathy.

Diabetic retinopathy may not have any symptoms in the early stages. However, once the condition has advanced, a person with the condition may notice:

• blurred vision;
• floaters in their vision; and
• loss of vision.

Screening, detection and treatment

Anyone with diabetes and visual symptoms should seek help from their doctor immediately. If they have, or are at risk of diabetes, then they should be referred urgently for assessment and possible management if retinopathy is found to be present. Even if there are no symptoms present, all diabetes patients over the age of 12 should be offered a diabetic eye screening test once every year.

It is important that patients attend these appointments because the condition may not cause any symptoms in the early stages, and the best outcomes from diabetic retinopathy are associated with early detection. However, once the retina becomes seriously damaged, it cannot be repaired. Any sight that has been lost at the point of detection is very likely to be permanent and it will only be the remaining sight that can be preserved with treatment.

Treatment will depend on the stage of retinopathy present at diagnosis. Early-stage retinopathy can be controlled with better diabetes management to reduce blood glucose levels and prevent further damage to the retina. More advanced retinopathy (known as ‘proliferate’ or ‘advanced diabetic retinopathy’) should be treated with laser therapy, to remove scar tissue around the retina, and, in more serious cases, intra-vitreal injections.

Complications

If diabetic retinopathy is not treated, the condition will almost certainly get worse; damage to the retina will become increasingly severe and sight will continue to deteriorate. Diabetic retinopathy can also cause serious complications including glaucoma, diabetic maculopathy, and retinal detachment.

Arran Macleod, a senior associate in Penningtons Manches Cooper’s clinical negligence team says: “It is important that patients with, or at risk of, diabetes know what diabetic retinopathy is, and are aware of the serious and life-changing consequences it can have if not detected and managed early.

“Sadly, in our work, we come across diabetes patients who have sought advice about their visual symptoms from their doctors at an early stage, but who were not managed appropriately. This has led to those people going on to develop advanced diabetic retinopathy, and developing far worse sight loss than would have occurred had they been managed by their doctors differently.

“We have seen, in the work we do, how traumatic sight loss can be and the life altering consequences it can have. A person may no longer be able to work, live in their home, or live an independent life. We have experience in identifying the impact that sight loss can have on a person, and help our clients obtain compensation to mitigate the effects of their loss of sight.”

If you have any concerns about the management of your diabetes and visual symptoms, then please do not hesitate to get in touch with our specialist ophthalmology claims team.

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