EyeWise Vision Clinic

Diabetic Eye Screening

Diabetes is a common disease that may result in complications in the eyes. The changes occur mainly in the retina, the light-sensitive layer at the back of the eye responsible for vision.

As a result of prolonged elevated sugar levels in the blood, the delicate blood vessels in the retina become fragile and start to leak fluid and proteins into the retinal tissue. This causes swelling of the retina (see Fig 1) especially in the centre area (macula) where vision is most detailed, resulting in blurred vision. Other changes in the retinal blood vessels lead to narrowing and closure of some of the smaller blood vessels, causing insufficient blood supply, resulting in parts of the retina being starved of oxygen and nutrition. These areas of the retina, when they are starved of oxygen can be detected by the eye surgeon during routine eye examinations (see Fig 2), but will not be noticed by the patient until it is too late.

The late changes that occur, which will be noticed by the patient only when vision is markedly reduced, include bleeding into the eye from abnormal new blood vessel formation and swelling of the macula (macular oedema). This is why it is ESSENTIAL when you have diabetes to go for regular eye examinations (Regular Diabetic Screening) to detect the earlier diabetic changes, when there are no changes in vision yet. These can then be treated at an earlier stage with a much better visual outcome.

Not all changes in the retina resulting from diabetes need to be treated. If they are very early, improvements in diabetic sugar control over the long term can cause those eye changes to reverse.

If your diabetic eye disease has progressed to a later stage, then treatment may be indicated, and Dr Khng will inform you. Treatment usually involves the laser and are mainly of 2 types: Central (macular) laser, and Peripheral laser (what surgeons call PRP, or pan-retinal photocoagulation).

 Central laser is for vessel leakage around the area of detailed vision (macula), and is designed to reduce the amount of fluid leakage, thus leading to improvement in the retinal swelling. Peripheral laser is designed to reduce the amount of retinal tissue that is not receiving adequate oxygen. It does this by reducing the oxygen usage of parts of the peripheral retina less important for vision. Both macular laser and PRP laser will require a few sessions on separate appointments to complete. Dr Khng has access to and uses pattern scanning laser from OptiMedica, which completes the treatment in much less time and with NO PAIN, compared to conventional Argon or standard treatment lasers. If you have been treated with a conventional laser for diabetic eye disease before, this is completely a different experience. A consult will determine your suitability for these treatments.

Please contact EyeWise Vision Clinic to arrange for an appointment. The earlier the treatment the better.