Diabetic retinopathy is a leading cause of preventable sight loss in Scotland. According to recent figures, 15 per cent of people who are eligible for diabetic retinopathy screening across Scotland have not attended in the previous 15 months. We want to ensure that people understand that sight loss is a potential complication of diabetes. Also, that regular screening can pick up the early warning signs so that people can get the treatment they need to help prevent permanent damage. PLEASE attend when invited for your retinal screening.
Watch this 90-second film narrated by actor Brian Cox CBE.
https://www.diabetes.org.uk/in_your_area/scotland/campaigning_media/how-do-you-see-Scotland
Don’t turn a blind eye to retinal screening
By Lizzi Rogers, Retinal Screener, Southampton Diabetic Eye Screening Programme at University Hospital Southampton on why looking after your vision and having your eyes checked is a vital part of diabetes management.
Focus on Diabetes
The point of retinal screening is always to identify and reduce the impact of potentially sight-threatening retinopathy – a complication of diabetes, which occurs when high glucose levels cause damage to blood vessels in the retina.
Unchecked, the damage can adversely and permanently affect vision. Screening appointments can greatly increase the chance of retinopathy being caught at an early stage, providing the opportunity for patients to improve their blood sugar control and other risk factors, slowing down the progression of a detrimental effect on their sight.
Why do people miss their retinal screening appointments?
Perhaps there is still too little education available about diabetes and its impact.
Perhaps it is the attitude that diabetes will inevitably have an impact, so why bother?
Perhaps it is the fact that good vision is not an indication of severity of retinopathy and sometimes the vision can be good until late on and then suddenly the patient has a bleed in the eye and the vision is lost?
Perhaps it is fear of finding something, and what that might mean?
Perhaps it is the other things in life take priority?
I would suggest it is a combination of these and more factors, all of which contribute to the staggering impact on the NHS budget, and to the statistic that retinopathy remains the second most common cause of blindness amongst working age adults in the UK.
The NHS Diabetic Eye Screening Programme has found that early identification and treatment of diabetic eye disease could reduce sight loss.
History of success
Retinal screening has a history of success; proven by the fact that diabetic retinopathy is no longer the primary cause of blindness amongst working-age adults in the UK.
There are no two ways to look at it – screening saves sight – national screening services have a track record of effectively safeguarding against preventable vision loss from diabetic retinopathy.
The programme nature of the condition, coupled with the fact that sight may not recover, even with treatment, once it deteriorates, might be expected to be motivation enough to attend the appointments which could preserve vision.
Key to prevention
The key to prevention understands – without that foundation, no amount of screening programmes will be able to safeguard the sight of people with diabetes. Responsibility needs to be taken at individual, corporate, and government level in order to boost engagement with the services on offer.
It is at this stage that I realise you, as a reader, are one of these already interested in diabetes wellness, by the very virtue of having read this article….and here is where my cynicism kicks in:
The people we need to reach are those who probably would never have chosen to read it!
There is a need for fundamental change to the attitudes towards diabetes in the UK, and the manner in which patients are engaged – that mush is absolutely clear.
The ‘how’ is a matter on which we, ironically, need a cleaner vision.
More information
The DRWF leaflet how can diabetes affect my eyes? Can be downloaded at https://www.drwf.org.uk/
Diabetes-leaflets or ordered by emailing [email protected] or by calling: 023 9263 6136.
Why the NHS needs better-behaved patient’s articles on the BBC website: hhtp://www.bbc.co.uk/news/health-35168721
NHS diabetic eye screening (DES) programmed website
hhtps://www.gov.uk/topic/population-screening-programmes/diabetic-eye
Royal National Institute of Blind People (RNIB) website:
hhtp://www.mib.org.uk/
RNIB article on Understanding eye conditions related to diabetes can be read at: bit.ly/Xvi6H4
Visually impaired
If you are visually impaired we can supply a copy of the Diabetes Wellness News in alternative formats, including larger print and audio
Please call 023 9263 6132 to discuss your requirements, or email [email protected]
What is diabetic retinopathy?
Diabetic retinopathy is a sight-threatening long term complication of diabetes. The retina lines the inside of the eye and acts rather like the film in a camera. The macula is the small central part of the retina you use to see things clearly and is the part you are using now to read this leaflet. The rest of your retina is used to view the world around you and to see in the dark.
Specific changes in the eye develop as a direct effect of raised glucose levels on the small blood vessels in the part of your eye called the retina and are known collectively as ‘diabetic retinopathy’. Changes to these retinal blood vessels can damage your sight.
Let’s look at how these changes might affect your vision in more detail.
Background retinopathy
These are earliest changes. Small swellings develop on the blood vessels and appear as tiny red dots. These are called microaneurysms. Larger red dots are called retinal haemorrhages. They lie within the retina and are rather like a bruise on your skin. Background retinopathy will not affect your vision and does not need treatment.
Proliferative diabetic retinopathy
With time, the blood vessels may become constricted, starving the retina of oxygen and nutrition. Different signs can be seen in the retina during this progression. These changes are called ‘pre-proliferative retinopathy’.
Eventually new blood vessels may develop on the surface of the retina. This is called ‘proliferative diabetic retinopathy’. If this happens your sight will be at risk as these new blood vessels may bleed or may develop into scar tissue.
Diabetic maculopathy
A more frequent effect of diabetes on your vision is if damage occurs to the blood vessels in the macular region of the retina. This is called ‘diabetic maculopathy’.
The commonest change is that the blood vessels become leaky. Fats and fluid that are normally carried along in the bloodstream leak into the macular region. Fluid leakage causes water-logging in the retina and is called ‘oedema’. Because the macula is used for detailed vision, if you develop maculopathy you may notice progressive blurring of your vision, particularly when reading.
Background retinopathy causes microaneurysms and haemorrhages
Proliferative diabetic retinopathy – new vessels develop on the retina and start to bleed.
