Types of diabetic eye disease

Diabetic retinopathy is the most common form of eye problem affecting people with diabetes. Additional diabetes-related eye problems are also seen in these patients (1).

The ocular complication of diabetes may be specific to progression of the ocular disease or, more commonly, may be non-specific recognised associations of diabetes in the eye.

• Specific:
  • retinal detachment cataract
    • caused by the accumulation of fluid between the neural retina and the retinal pigment epithelium and in non-diabetic patients most commonly results from a tear in the retina (rhegmatogenous retinal detachment)
  • rubeosis iridis
    • growth of new vessels on the iris in eyes with advanced retinal ischaemia
  • cataract
    • a specific form of “snow-flake” cataract is recognised in younger patients with diabetes
  • optic neuropathy
    • presents as swelling of the optic discs associated with gradual reduction in visual acuity
  • ocular muscle palsies
    • particularly with type 2 diabetes
• Non-specific:
  • cataract
    • age-related cataract occurs earlier in patients with diabetes.
  • glaucoma
    • glaucoma is found more readily diabetics
  • retinal vein occlusion/optic disc swelling
    • people with diabetes are at higher risk of developing optic nerve disease due to vascular occlusion, which is distinct from diabetes-specific optic neuropathy
    • usually occurs in older patients with Type 2 diabetes and hypertension (2).

Reference:

1. American Academy of Ophthalmology (AAO) 2019. Preferred Practice Pattern guidelines. Diabetic retinopathy.
2. Ghanchi F; Diabetic Retinopathy Guidelines Working Group. The Royal College of Ophthalmologists' clinical guidelines for diabetic retinopathy: a summary. Eye (Lond). 2013 Feb;27(2):285-7. doi: 10.1038/eye.2012.287.