Diabetes induces changes in blood vessels. In the eye these leak fluid or blood, or new blood vessels may form in response to inadequate oxygen. Vision is at risk from changes in the macula (diabetic maculopathy) usually as a result of fluid build-up; and from bleeding from fragile new blood vessels (proliferative retinopathy). Risk factors for the development of retinal complications from diabetes include:
Duration of diabetes
Adequacy of control of diabetes
Smoking
High blood pressure
Pregnancy
Clinical Features
Often none in early stages
Reduction or distortion of central vision in diabetic maculopathy
Sudden onset floaters with reduction of vision indicates vitreous haemorrhage from abnormal new blood vessels in proliferative retinopathy. If untreated further loss of vision may occur from scarring causing a retinal detachment
Management
All patients with diabetes need regular eye screening, usually arranged via the GP
Any significant retinal changes require referral to an ophthalmologist
