People living with diabetes are at risk of developing eye conditions that can lead to vision loss, such as diabetic retinopathy and diabetic macular oedema. While the thought of losing you sight is scary, the good news is it can often be prevented if changes are detected early by your optometrist and a course of treatment is started. Fortunately, there are some preventative measures and treatment options available that can help you care for your eyes and preserve your vision.[i]

1. Lifestyle changes to protect your eyes

In many ways, managing your lifestyle and diabetes is like giving your eyes a daily dose of preventive medicine. While other treatments address symptoms, lifestyle choices can directly impact the progression of diabetes-related eye disease and the severity of symptoms.

Lifestyle modifications such as maintaining healthy blood glucose levels, eating a balanced diet, exercising, and managing blood pressure and cholesterol can make a significant difference and help prevent or slow the progression of eye disease.[ii]

• Blood glucose management: Consistently out of target blood glucose levels can weaken blood vessels and cause them to leak into the retina, resulting in blurry vision and even severe vision loss. Keeping blood glucose within a target range reduces the risk of blood vessel damage and reduces the need for more intensive treatments down the line.
  
• Healthy diet and regular exercise: Eating a diet rich in vegetables, whole grains, lean proteins, and healthy fats can help stabilise blood glucose and reduce inflammation, which benefits not only your eyes but your overall health. Regular exercise, even just 30 minutes a day, can improve insulin sensitivity, helping to keep blood glucose in check.[iii]
  
• Blood pressure and cholesterol management: High blood pressure and cholesterol levels can worsen diabetes-related eye disease.[iv] Proper management through lifestyle changes and medication, when needed, reduces the strain on eye health.

2. Eye injections to minimise inflammation and control swelling

Intravitreal injections (into the eye) have been shown to significantly improve vision for people with diabetic macular oedema and reduce the progression of diabetic retinopathy. Injections can deliver corticosteroid medications directly into the eye, relieving swelling in the macula, and block the growth of abnormal blood vessels. They are especially effective at preserving central vision, which is vital for activities like reading and driving.

Depending on the severity of the condition and how a person responds to the medication, injections may be required every 4–12 weeks.[v] Adherence to regular injections is essential, as missing a scheduled injection can allow fluid to accumulate in the retina again, causing further vision loss. With consistent eye injection treatment, many people experience stability or improvement in their vision.

3. Laser therapy to reduce risk of severe vision loss

Laser treatment is typically a quick procedure performed by an ophthalmologist and can significantly reduce the risk of severe vision loss, especially in advanced stages of diabetic retinopathy. It works by applying focused laser light to abnormal blood vessels in the retina, reducing their growth and stopping them from leaking and causing vision loss. While it doesn’t cure the disease, laser treatment can stabilise vision and prevent further deterioration. Importantly, it reduces the risk of retinal detachment and helps preserve central vision, which is essential for everyday tasks.[vi]

Continuing with treatment is important, as delaying or skipping could result in further damage to the retina. Your health professional will guide you on how many treatments are necessary based on your specific condition.

4. Attending regular diabetes eye checks

Of course, one of the simplest ways to look after your eyes is to attend your scheduled eye appointments with your local optometrist. With regular eye tests, your optometrist can check and monitor your vision and detect tiny changes before you notice any issues.

If you need help remembering when your next eye check is due, it’s worthwhile signing up to KeepSight, Australia’s Diabetes Eye Check Reminder Program, to receive free reminders when it’s time for your next appointment. Register at keepsight.org.au.

Adherence and consistency are key

Sticking to your eye health treatment plan, whether it’s lifestyle changes, laser therapy, or injections, is vital for protecting your eyes from diabetes-related vision loss. Proactive measures and management options are most effective when applied consistently and sustained over time, helping you safeguard your vision and continue enjoying a high quality of life for years to come.

By Shinae Warren, Specsavers Optometrist

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[i] Sayin, N., Kara, N., & Pekel, G. (2015). Ocular complications of diabetes mellitus. World journal of diabetes, 6(1), 92–108. https://doi.org/10.4239/wjd.v6.i1.92

[ii] Bryl, A., Mrugacz, M., Falkowski, M., & Zorena, K. (2022). The Effect of Diet and Lifestyle on the Course of Diabetic Retinopathy-A Review of the Literature. Nutrients, 14(6), 1252. https://doi.org/10.3390/nu14061252

[iii] Bird, S., Hawley, J. (2017). Update on the effects of physical activity on insulin sensitivity in humans. BMJ Open Sport & Exercise Medicine.

[iv] Tomić, M., Vrabec, R., Raštegorac, P. et al. (2021). Hypertension and Hypercholesterolemia are Associated with Cataract Development in Patients with Type 2 Diabetes. High Blood Press Cardiovasc Prev 28, 475–481. https://doi.org/10.1007/s40292-021-00472-8

[v] Wong, T. Y., Sun, J., Kawasaki, R., Ruamviboonsuk, P., Gupta, N., Lansingh, V. C., … & Taylor, H. (2018). Guidelines on diabetic eye care. Ophthalmology, 125(10), 1608–1622.https://doi.org/10.1016/j.ophtha.2018.04.007

[vi] Pande, G. S., & Tidake, P. (2022). Laser Treatment Modalities for Diabetic Retinopathy. Cureus, 14(10), e30024. https://doi.org/10.7759/cureus.30024