Diabetes

Early diabetic retinal changes often go unnoticed. Fluid accumulation in the retina (macular edema) leads to distorted vision, and straight lines may appear wavy. If bleeding occurs into the vitreous body, vision suddenly deteriorates and everything appears darker. In the event of retinal detachment, a visual field defect occurs that increases in size and ultimately leads to blindness.

Early stages are often asymptomatic. Warning signs for advanced stages include:

• Blurred vision or fluctuating visual acuity (often dependent on blood sugar levels).
• Distorted, wavy vision due to fluid accumulation in the macula.
• “Floaters” or dark spots (in cases of bleeding into the vitreous body).
• Distorted vision (straight lines appear wavy).
• Shadows in the visual field (in cases of impending retinal detachment).

• Vision test and eye pressure measurement.
• Retinal examination with dilated pupils: This allows for a precise assessment of the vessels into the periphery.
• Optical Coherence Tomography (OCT): This painless cross-sectional imaging of the retina detects swellings (edema) at a stage when they are not yet visible during a normal examination.
• In cases of advanced changes or bleeding, an ultrasound examination of the eye is sometimes necessary.

As a rule, an annual check-up is recommended for diabetics. Depending on the duration of the diabetes, the management of long-term blood sugar (HbA1c value), and the severity of retinal changes, more frequent check-ups (every 3 to 6 months) may be necessary.

• IVOMs (intravitreal injections): Medications administered directly into the eye to reduce swelling and stop the growth of abnormal blood vessels.
• Laser therapy: Used to seal leakages or to cauterize retinal areas suffering from oxygen deficiency.
• Vitrectomy: A surgical procedure to remove blood from the vitreous cavity or to repair the retina.
• Cataract surgery: Since diabetics tend to develop cataracts earlier, surgery can often significantly improve vision once the retina has stabilized.