Eye health is important for everyone. But for people with diabetes, the risk of eye disease and vision loss is much higher, making regular eye checks an essential part of your care plan.

Around one in three people with diabetes will develop some form of diabetic eye disease, most commonly diabetic retinopathy. The good news is that most diabetes-related vision loss can be prevented – as long as it’s detected and treated early.

“Unfortunately it is not uncommon for people to wait for their vision to be reduced before they present for a diabetes eye check,” says Associate Professor Peter van Wijngaarden, a Principal Investigator and Deputy Director at CERA.

“By that time the eye disease is often advanced and more difficult to manage. Early detection is the key to best outcomes.

“Too many Australians are experiencing diabetes-related vision loss, because approximately half of those with diagnosed diabetes are not receiving eye examinations within the recommended timeframes.”

How can diabetes affect your eyes?

In the short term, high blood glucose levels can cause blurred vision. This is due to temporary changes to the shape of the lens in your eye. When your blood glucose levels are stable again, your vision should return to normal.

Over a longer period of time, diabetes increases your risk of more serious eye problems. This includes:

• Diabetic retinopathy (DR). The most common form of diabetic eye disease, DR is characterised by progressive damage to the tiny blood vessels in the retina at the back of the eye. The best way to reduce your risk of DR is to achieve good long-term control of your blood sugar, blood pressure and cholesterol, and to have regular eye checks to pick up the early signs. If left untreated, it can lead to blindness.
• Diabetic macular edema (DME). This is a complication of DR that occurs when the blood vessels in the macula (the central area of the retina that is responsible for detailed vision) leak fluid, causing swelling. It can result in blurred central vision, interfering with tasks such as reading, driving and recognising faces.
• Cataracts. A cataract is a clouding of the lens of the eye. Most people will develop cataracts as they age, but diabetes can lead to earlier onset and more rapid progression. Cataracts can be effectively treated with surgery. However, vision improvement after surgery may be delayed or reduced in some people with diabetic retinopathy and diabetic macular oedema.

Managing your eye health

There are things you can do to make a big difference to your risk of experiencing vision loss from diabetes. Here’s how to give yourself the best chance of protecting your sight.

Get regular eye checks – at least every two years

One of the most important things you can do for your eye health is to have regular checks with an optometrist or ophthalmologist. If you sign up at keepsight.org.au, you will receive free reminders by SMS, email or post when you’re due for your next eye check. It’s a convenient way to ensure your regular diabetes eye checks don’t slip your mind.

As a general guide, you should have your eyes checked when you are first diagnosed with diabetes, and then at least every two years. Some people may need to have checks more often – for example, if you have existing diabetic retinopathy or other complications of diabetes, like foot ulcers or reduced kidney function.

More regular checks are also recommended for Indigenous Australians, people who have had diabetes for many years and women who are pregnant or planning a pregnancy. Your eye doctor will recommend a check-up schedule that’s best for you.

An eye check only takes about 30 minutes. Your eye health professional will take a photo of the back of your eye to check the blood vessels and may give you eye drops to dilate your pupils.

Manage your blood glucose levels

High blood glucose levels over the long term increase your risk of developing diabetic eye disease and can make existing diabetic eye disease worse. The better you can manage your diabetes, the better for your eyes. Keep up your regular health checks and follow your doctor’s recommendations to keep your blood glucose in the target range.

Control your blood pressure and cholesterol

Along with blood glucose, it’s important to keep your blood pressure and cholesterol levels in check. Get tested regularly as recommended by your doctor.

Eat a healthy diet

Following a healthy diet will help you manage your diabetes. Think fresh, whole foods – colourful fruits and vegetables, leafy greens, wholegrains, lean protein and healthy fats. Your GP, a nutritionist or a dietitian can help you develop a healthy eating plan if you need more guidance.

Get moving

Getting regular exercise can also help you control your blood glucose, increase your body’s sensitivity to insulin, lower blood pressure, reduce harmful cholesterol and manage your weight.

Quit smoking

Smoking increases your risk of eye disease and can make managing your diabetes more difficult. Quitting is one of the best things you can do for your overall health. It isn’t easy, but there is a lot of support available to help you. Talk to your doctor, call Quitline on 137 848 or visit quit.org.au

Keep an eye out for any vision changes

If you notice any changes to your vision, don’t wait for your routine eye check. Symptoms like blurry or dim vision (that isn’t improved by prescription glasses), floating spots or flashes, or sensitivity to light and glare should be checked by your eye health professional promptly.

Remember that eye disease from diabetes can have few symptoms until it is at an advanced stage, so it’s important to get checked even if your vision seems normal. Ophthalmologists have a range of highly effective treatments for diabetic eye disease, but outcomes are best when these treatments are given before the most advanced stages of the disease.

Sign up for KeepSight to get free reminders when you’re due for your next eye check.