Summary Diabetic eye disease notes

Diabetic eye disease

pancreas (responsible for insulin production)
food is digested and enters blood stream; insulin removes the glucose and is used for energy
in diabetes- body is unable to break glucose into energy- either not enough insulin
production or cells don’t react to the insulin.
1. Type 1 (insulin dependent) ~ 10%
2. Type 2 (non- insulin dependent)
3. Pre-diabetes
4. Gestational
Anterior segment:
 Dry eye
 Diabetic keratopathy
 Uveitis
 Cataract
Posterior segment:
 Vitreous haemorrhage
 Diabetic retinopathy

In diabetic patients the cornea doesn’t have a normal healing system which can lead to
recurrent corneal epithelial defects and reduced sensitivity to treatments.
Reduced corneal nerve density=reduced corneal sensitivity
Epithelial defects wont be felt on the eye and they may be there for a long time.
There is also microvascular damage to the lacrimal gland= reduced aqueous production=
aqueous deficient dry eye
Diabetic patients have reduced corneal sensitivity- important in CL wear

Anterior uveitis
Common presenting feature of undiagnosed diabetes.
Diabetics have disruption to the blood retinal barrier= increased amount of inflammation.
Same presentation as any other and managed the same but if recurrent may consider
speaking to GP for diabetes tests.

Cataract
Tend to be cortical and nuclear
More prone to developing younger
Snowflake cataract- juvenile onset DM which is poorly controlled

Diabetic retinopathy
 Microaneourisms
 Haemorrhages- flame, dot, blot
 Hard exudates
 Cotton wool spots- area of the retina has become ischaemic (not enough blood
reaching that part of the retina- indication of underlying nerve fibre layer damage)
 Venous beading- (calibre of vessel constricts and bulges)
 Neovascularisation- can be in retina or vitreous
 Tractional retinal detachment