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Diabetes and the eye 

Diabetes and the eye
Chapter:
Diabetes and the eye
DOI:
10.1093/med/9780199544967.003.0004
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date: 21 September 2019

Diabetes mellitus is still one of the commonest causes of blindness worldwide.

The ophthalmic complications of diabetes include diabetic retinopathy, cataracts, primary open angle and neovascular glaucoma, and cranial nerve palsies.

Retinovascular disease including retinal vein and artery occlusion and non-arteritic ischaemic optic neuropathy are more common in diabetic subjects.

Diabetic retinopathy occurs in approximately 40% of diabetic subjects, with ethnic differences.

The primary abnormalities of diabetic retinopathy are capillary basement membrane thickening, such that it becomes porous, and capillary occlusion with resultant retinal ischaemia.

In type 1 diabetes diabetic retinopathy is almost invariable after 15 years of disease duration. In type 2 diabetes 20% have retinal signs at diagnosis of diabetes, rising to a prevalence of 60% after 15 years of known disease duration.

Major modifiable risk factors for diabetic retinopathy include poor glucose and blood pressure control and increasing lipid levels.

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