One-third of diabetes patients at risk of vision loss: World Retina Day–24 September

In South Africa, nearly one in nine adults are affected by diabetes impacting around 4.4 million people between the ages of 20 and 79. Globally diabetes is the fourth leading cause of blindness and the most common cause of vision loss among working-age South Africans.

According to the Ophthalmological Society of South Africa (OSSA) approximately one-third of diabetic individuals will develop diabetic retinopathy – a condition where abnormal blood vessels grow in the retina. Yet, less than 20% of diabetic patients undergo yearly screening that could prevent vision loss.

Prof Linda Visser, board member of OSSA and head of the Ophthalmology department at Tygerberg Academic Hospital, stresses that diabetic retinopathy is a serious yet preventable consequence of diabetes.

“Diabetes, a chronic metabolic disorder characterised by elevated blood sugar levels, can lead to diabetic retinopathy, a progressive eye disease that damages the blood vessels in the retina – the light-sensitive layer of tissue in the back of your eye that detects light and sends signals to your brain through the optic nerve in the back of your eye. This damage can lead to vision impairment or blindness if not detected and treated early,” says Prof Visser.

Preventing diabetes and ensuring access to regular screening is crucial to reducing the risk of blindness in diabetic patients. Prof Visser advocates for routine screenings and early diagnosis to combat the long-term impact of diabetic retinopathy.

“Diabetes is one of the world’s costliest health challenges and places a significant socio-economic burden on South Africa. The costs associated with this disease are not only direct medical expenses but also indirect costs related to inability to work, sickness, vision loss, disability, pre-mature retirement and premature death, as well as intangible costs such as the physical and psychological pain or suffering.”

Prof Visser calls for a coordinated effort from government and healthcare providers to increase public awareness about diabetes and promote healthier lifestyles. “It’s vital to educate communities—especially children and young adults—about the importance of regular screenings and lifestyle changes such as healthy eating and physical activity.”

Diabetic retinopathy often shows no symptoms in its early stages. By the time vision changes become noticeable, the disease may have progressed to an advanced stage, potentially resulting in irreversible vision loss.

“Research shows that blindness due to diabetes is preventable with early diagnosis, effective management of risk factors and timely treatment. Early detection is both cost-effective and crucial to avoid the high costs of advanced treatment and the burden of disability,” says Prof Visser.

Modern camera imaging capabilities have improved along with the artificial intelligence (AI) revolution. Systems are now being developed to allow low-cost camera images taken of the back of the eye in diabetic patients and interpreted via AI software to guide caregivers regarding which patients should be referred to eye specialists for treatment.

In advanced stages of diabetic retinopathy, the blood vessels in the retina may begin to bleed into the vitreous—the gel-like fluid that fills the eye. This causes dark, floating spots or cobweb-like shapes to appear in one’s vision. Left untreated, scarring may develop further increasing the risk of significant vision loss.

Treatment options include, depending on the advanced stage of vision loss, laser therapy, intravitreal injections and surgery.

Preventing diabetes is key to reducing the risk of diabetic retinopathy. Prof Visser recommends the following preventive measures:

•  Yearly examination to screen for diabetes
• Maintain a healthy weight
• Regular exercise of at least 30 minutes a day
• Limit alcohol consumption
• Quit smoking
• Balanced diet of fruit, vegetables and whole grains
• Avoid sugary beverages and processed foods

For those already diagnosed with diabetes, Prof Visser stresses the importance of annual retinal imaging screenings, which not only detect retinopathy but may also predict the risk of other serious complications such as stroke, heart attack, and kidney disease.

“Early intervention is the best way to prevent irreversible damage. Diabetic patients should be screened for retinopathy annually, and these screenings are readily available at various eye care centers across South Africa.”

To screen for diabetes, visit your local clinic or GP and if you have been diagnosed with Type 1 or Type 2 diabetes, screen your eyes yearly at one of the many eye care centres around South Africa.

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Author: Linda Christensen from Jigsaw PR on behalf of OSSA.

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