Diabetes Awareness Month

November is Diabetes Awareness Month


If you, or someone close to you has diabetes, you will know that it is one of the biggest causes of vision loss. We answer some of your questions:
How does diabetes affect my eyes?
Diabetes causes problems with blood flow and blood vessels inside the eye. The blood vessels can weaken, leak or bleed, affecting the retina at the back of the eye. Damage to the retina is called retinopathy.
Does it happen to everyone with diabetes? 
Leaking can happen even if your diabetes is well controlled, and whether you are Type 1 or Type 2. But, when the diabetes is not well controlled, you’re more likely to have leaks and bleeding. New blood vessels start to grow, trying to compensate for oxygen shortages caused by damage in the original blood vessels. New blood vessels are called neovascularisation. These break and bleed even more easily so seeing them is a bad sign.
How can you see diabetic retinopathy? 
We routinely examine the retina of every patient, but if we know that you are diabetic, we will focus on specific areas which are more at risk. Fluid leaking into the macula can dramatically affect vision because the macula is our area of clearest, central vision. We may photograph or scan your retina so we can keep accurate records and compare tiny leaks over a few weeks or months. Improving diabetes control – reducing your blood sugar – can improve the retinopathy. We will show you your photographs and scans and explain what we’re seeing. The same type of leaking that results in retinopathy can happen in your kidneys as well, so it’s helpful if you allow us to share your results with your medical doctor.
How will diabetes change my vision? 
Diabetes can cause changes in vision from damage to the blood vessels, or changes to the lens of the eye. As the lens swells and shrinks back, your glasses prescription can change with it. If your diabetes is newly diagnosed, or if your medication has changed, your vision and your prescription is likely to fluctuate. We may delay making your final glasses until we can confirm that your levels have stabilised.
What else should I be aware of? 
The lens in the eye, which eventually changes to become a cataract, may do so more quickly in diabetes. We’ll check this progress at each visit and let you know when it’s time to refer you to the surgeon to discuss cataract surgery.


We will also discuss the frequency of your follow-up visits, depending on our findings during the examination. Patients with well-controlled diabetes should have a routine examination every year. If we want to follow your progress more closely, we may ask you to come in sooner. Leaking at the macula can happen at any stage of diabetes, in Type 1 and Type 2, so patients should come in between scheduled visits if they feel that their vision may be changing.


Wednesday 14 November is World Diabetes Day. If you, or someone close to you is diabetic, please ask them to have a diabetic eye examination. We are here to answer your questions on diabetes and how it affects your eyes.
Davida van der Merwe

Did you know?

  • Quite often, we are able to diagnose diabetes in patients who didn’t know that they had it, because of the changes in their eyes.
  • Patients with diabetes have other risks. They get infections more easily, and don’t heal very well, so we are particularly careful with our contact lens patients who are diabetic.
  • The only treatment for Type 1 diabetes is insulin injections. Type 2 diabetes, which usually starts in adulthood, may be treated with diet changes, tablets and insulin.
  • If you have hypertension (high blood pressure) and high cholesterol, your risk of diabetes-related damage is higher. If you have those 3 together, please be sure to keep your regular, annual eye health examinations.

What is well-controlled diabetes?

Very good question! Just taking your medication doesn’t mean that your diabetes is properly controlled. If you check your sugar at home, and you find that it stays within the specific range you’ve discussed with your doctor, that’s a good sign. Check your blood sugar first thing in the morning, before you eat anything. In well-controlled diabetes it should be between 4 and 6 mmol/l.

If you have been to your doctor and had a blood test called a HbA1c, please bring those results with you. The HbA1c should be under 7{da9b8e2febe438ab8d65e5bfed4ed55b3a6f38bd2d2281fa9c1405a8cec522db}. The higher your A1c is, the greater your risk of leaking and bleeding in the retina.

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