Diabetes is linked, both directly and indirectly, to a number of eye diseases. For this reason, it is important for people living with diabetes (PwD) to have access to regular eye screenings in order to protect their eye health. Diabetic retinopathy (proliferative & non-proliferative) and diabetic macular edema are examples of eye conditions that are directly caused by diabetes. Diplopia, cataracts and glaucoma are eye conditions that can be exacerbated by diabetes.
Diabetic retinopathy & Diabetic macular edema
Diabetic retinopathy is a diabetes-related complication that causes visual impairment. It is one of the leading causes of preventable blindness in the world. In Europe, it is estimated that between 20% and 35% of people with diabetes will develop diabetic retinopathy.
Diabetic retinopathy is caused by prolonged high blood glucose levels. Over time, high sugar glucose levels can weaken and damage the small blood vessels within the retina. If left untreated, this can develop into Diabetic Macular Edema (DME) leading to vision impairment and blindness. The prevalence of DME among people living with Type 1 diabetes in Europe is around 8.8%.
As diabetic retinopathy typically presents no symptoms during the early stages, regular screening is needed to reduce the risk of vision impairment or vision loss. It is essential for PwD to receive uninterrupted access to affordable screening, treatment and care throughout their life. We must work together to create health-enabling environments and patient-centred healthcare systems that guarantee equal access to medicines, technologies, and care.
Diplopia, cataracts & glaucoma
Diplopia is also known as double vision and is caused by damage to the nerves that control eye movement coordination. This nerve damage can be caused by diabetes.
Cataracts can occur in one or both eyes and cause clouded, blurry vision. Some of the leading causes of cataracts include diabetes, ageing and smoking. According to Diabetes.co.uk PwD are at a 60% greater risk of developing cataracts than people without diabetes. Age-related cataracts also tend to appear earlier in PwD.
Glaucoma is a set of conditions caused by the build-up of fluid in the eye. When this fluid builds up it can block the eye’s ‘drainage system’, effectively trapping the fluid and causing it to exert pressure on the optic nerve. This can lead to permanent vision loss or visual impairment. Neovascular glaucoma develops as an advanced form of diabetes retinopathy.
Many cases of eye disease in PwD, both directly and indirectly linked to the condition, could be avoided with regular screening. For example, systematic screening has been in place in the UK for many years, which has greatly improved the health outcomes of PwD. We must work together to ensure diabetes retinopathy screening programmes are set up in all European countries and that inequalities in access to eye care are eradicated to reduce the risk of preventable blindness.
Resources on diabetes and eye disease
- IDF Policy Brief – Diabetic Retinopathy: A Call for Global Action
- Integrated care for diabetes and eye health: A global compendium of good practice
- IDF – Clinical Practice Recommendations for Managing Diabetic Macular Edema
- IDF Factsheet on Diabetic Macular Edema
- WHO – Diabetic retinopathy screening: a short guide
- Free course on Diabetic Retinopathy
- Free course on the Management of Diabetic Macular Edema