Eye damage (diabetic retinopathy)

Diagnosing Diabetic Retinopathy at London Diabetes Centre

Over time, diabetes can damage the eyes and put your vision at risk. Regular eye screening is an essential part of good diabetes care. The London Diabetes Centre offers a cutting-edge eye-screening service, led by world-leading ophthalmologists and diabetologists.

Effective eye screening can help identify eye disease early, so that treatment can be initiated and disease progression can be prevented. The London Diabetes Centre provides a comprehensive package of care that extends far beyond the standard NHS service, to help diagnose diabetic eye-disease at an early stage and protect your eyesight.

What is retinopathy?

Retinopathy is an eye disease that can develop in diabetes, particularly when the condition is poorly controlled. The tiny blood vessels supplying the back of the eye become progressively damaged and can bleed. Without prompt and effective treatment, retinopathy can cause visual disturbance, blurring and blindness.

In the early stages, retinopathy doesn’t affect vision or show any symptoms. The London Diabetes Centre offers regular eye screening by leading experts, so that diabetic eye disease can be picked up before it progresses. Eye screening is important for people with type 1 and type 2 diabetes because identifying and treating retinopathy at this early stage can prevent damage and protect your vision.

Retinopathy screening at the London Diabetes Centre

Eye screening can identify serious eye problems before they impair your vision. All people with diabetes should have screening annually, however, if you have developed retinopathy or other long-term complications of diabetes, your consultant may recommend more frequent check-ups.

The London Diabetes Centre is equipped with the very latest technology for accurately diagnosing eye disease. The clinic offers a comprehensive eye screening package to identify retinopathy, maculopathy and other eye pathology.

At your appointment, your specialist will examine the back of the eye using an ophthalmoscope. Drops are applied to open up the pupils and make it easier to inspect the retina. These can affect your vision for up to six hours, so it’s important to bring sunglasses to protect your eyes and come with a friend or family member, who can escort you home.

A member of the diabetes team will photograph the back of the retina. You will notice flashes of light during the procedure, but the camera does not touch your eye. The screening process is quick, simple and pain free.

Tests include:

Visual Acuity

A visual acuity test is an eye examination that checks how well you see the details of a letter or symbol from a specific distance.

Intraocular pressure (IOP)

People with diabetes are at increased risk of glaucoma. The specialist team at the London Diabetes Centre use Tonometry to measure the fluid pressure inside the eye and screen for glaucoma.

Fundus Photography

Photography of the back of the eye can identify retinopathy and monitor the progression of the disease.

Expert analysis and treatment planning

At the London Diabetes Centre, the screening results and fundus photographs are reviewed by an experienced consultant ophthalmologist for reporting. Patients can be alerted immediately if there is an abnormality and immediate arrangements made for specialist review and treatment with a consultant on the same day. An appointment will be made to take you through the results. Your consultant will take time to discuss the screening findings and develop a bespoke treatment plan to treat any retinopathy.

Retinopathy prevention with the London Diabetes Centre

The best way to prevent retinopathy and other long-term complications of diabetes is to carefully control blood glucose and blood pressure levels. Eating a healthy diet, living an active life, monitoring blood sugar levels and taking the right treatment can help reduce the risk of damage to the small blood vessels at the back of the eye.

The multidisciplinary diabetes team at the London Diabetes Centre are leaders in modern diabetes care. They will work with you to improve your diabetes control and prevent retinopathy. This can include:

Keeping your blood sugar levels within your target range. Regular diabetes checks will help you stay on track and ensure problems are picked up at an early stage.

Regular eye checks and education about eyesight awareness: If you notice floaters, dim vision or problems seeing in the dark make an early appointment for an eye check with the specialists at the London Diabetes Centre.

Blood pressure control: The London Diabetes Centre diabetes team will monitor your blood pressure and treat any hypertension; you should commit to taking any medication regularly and reliably.

Management of cholesterol and lipid levels: The London Diabetes Centre will regularly check your advanced lipid profile and provide any treatment you need. All patients with diabetes are recommended to be on a statin, however the London Diabetes Centre also offers ground-breaking new PCSK9 inhibitor drugs to control lipid levels.

Stopping smoking.

Exercise: Physical exercise can lower blood pressure, help weight loss and improve diabetes control.

Eating a healthy balanced diet can protect your cardiovascular system and prevent diabetes complications. The London Diabetes Centre’s specialist dieticians can provide advice and support.

Maintaining a healthy BMI: If you’re overweight, getting to a healthy BMI can put type 2 diabetes into remission and reduce the risk of diabetes complications. The London Diabetes Centre can provide a personalised weight management programme to help you lose weight and keep it off.

What does proliferative retinopathy mean?

Proliferative retinopathy is an advanced stage of diabetic eye disease. At this stage, there is evidence of scarring and new blood vessel formation on your retina. These vessels can bleed and cause the retina to detach from the back of the eye. When you have proliferative retinopathy, there is a high risk of losing your vision, so rapid treatment is important to stabilise your vision and prevent any further deterioration.

Can retinopathy be treated?

When diabetic retinopathy is advanced and is threatening your vision, the expert ophthalmologists at the London Diabetes Centre offer a range of treatments to prevent further damage. These include:

Laser therapy: The latest laser devices can be used to treat the new blood vessels in the retina and may be able to stabilise macular disease.
Eye injections: Precise injection of medications can treat severe maculopathy that could put vision at risk.
Eye surgery: The specialist ophthalmologists can operate to remove areas of scar tissue or blood in people with advanced retinopathy.

I’ve had results from NHS screening. What do they mean?

NHS screening results usually provide a series of letters and numbers which indicate the presence and severity of any diabetic eye disease. It can seem confusing but here’s a key to what stands for what, and what the NHS management is at each stage:

R0: There is no evidence of retinopathy, ongoing annual eye screening is recommended.

R1: Background changes of retinopathy are visible; an earlier screening appointment may be given.

R2: There is evidence of non-proliferative retinopathy, more regular eye screenings are recommended.

R3: Proliferative retinopathy is present; you should be seen quickly by an ophthalmologist for treatment.

M0: Mild swelling in the macula at the back of the eye is visible.

M1: Treatment for maculopathy is recommended.

If you have diabetes and are worried about your results, or concerned about the health of your eyes, make an appointment with your doctor or arrange a check-up with the specialist diabetologists and ophthalmologists at the London Diabetes Centre.

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