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Diabetic Retinopathy

Diabetic Eye Service | Dr Eric Falletisch

T: 021 824 1206 | E-mail: admin@falletisch.co.za

Cure Day Hospitals Somerset West

Paardevlei Specialist Medical Centre, 18 Gardner Williams Avenue

Paardevlei, Somerset West

T: 021 824 1240 | E: somersetwest@cure.co.za

INFORMATION SHEET FOR PATIENTS AND PRIMARY CARE GIVERS:

By 2030, diabetes is predicted to afflict 1 in 10 South Africans

Diabetes affects small to mid-sized blood vessels and frequently presents with strokes, heart attacks, kidney problems, poor circulation to the feet, abnormal sensation to the feet, lower leg amputation and blindness.

The ONLY place in the body where these small to mid-sized blood vessels can be directly visualised is in the back (retina) of the eye.

What can be seen in the eye is indicative of what is happening to these blood vessels in other organs of the body.

The changes visible in the eye are called Diabetic Retinopathy.

The presence of diabetic retinopathy is related to the duration of diabetes:
  • After 10 years of diabetes, there is a 50% chance of retinopathy
  • After 20 years of diabetes, there is a 90% chance of retinopathy

Good control of sugar levels does not prevent the occurrence of retinopathy.

Good control does however mean less severe retinopathy, possibly even to the level where treatment is not required.

The severity of diabetic retinopathy is related to the level of blood sugar (blood glucose) control. There is greater risk with persistent high blood sugar, high cholesterol and high blood pressure.

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Screening:

Diabetes retinopathy screening can assist to reduce further complications by early detection. This enables recommendations for changes in medication, lifestyle and self-management and can prevent any problems from getting worse.

Fortunately screening for diabetic retinopathy has become easier for patients, thanks in large part to advances in camera technology.

Screening photographs of the retina can now be done through an un-dilated pupil. This means patients can continue with their normal activities immediately after the screening; and can drive themselves.The latest advances in technology allow for grading of photographs using Artificial Intelligence (AI).

This provides an almost immediate response as to the presence or absence of retinopathy. AI allows for screening without having to see a Specialist Ophthalmologist, which should make screening more accessible – your optometrist may be able to assist you with AI screening.

Medical schemes are also recognising the advantages of screening and are beginning to provide benefits for diabetic retinopathy screening (Discovery are leading the field in this regard)

The presence of any retinopathy on AI screening will prompt referral for further evaluation by an appropriately qualified medical doctor.

This may include an evaluation of risk factors, further investigation in the form of specialised retinal scans eg (OCT +/- OCT angiography), patient education and recommendations on treatment, if indicated.

The Diabetic Eye Service, based at the Somerset Eye, Cure Day Hospitals, Somerset West is uniquely positioned to evaluate the diabetic eye.

The Service has state-of-the-art Zeiss cameras which allow for un-dilated wide-field visualisation of the retina.

Zeiss OCT, OCT-angiography and fluorescein angiography are available on site when indicated.

The evaluation is performed by a medical doctor with many years of ophthalmic experience and is backed up by five ophthalmologists, should a Specialist Ophthalmic opinion be needed.

The Somerset Eye together with Cure Day Somerset West Hospital is able to offer comprehensive medical and surgical treatment of the eye complications of diabetes, where necessary.

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