Sight Loss and other conditions
Sight loss can sometimes be part of a larger set of medical conditions. It may go unnoticed because the other condition takes precedent or it may be caused by another condition. First, here is a brief look at some of those relationships.
Stroke
Ana Palazon, Director of the Stroke Association Cymru, said: “Up to two thirds of people experience some changes to their vision after stroke. Having trouble with your vision can be distressing and it can affect the rest of your recovery ... Problems with vision can sometimes be missed, so if you think you or someone you know has visual problems after a stroke, talk to your doctor.” (Stroke Association website, 2015).
A mini-stroke (transient ischaemic attack or TIA) can cause symptoms such visual disturbance, although these symptoms usually disappear quickly. A TIA is a warning that you are at risk of a full stroke. Read ‘Steve’s Story’ below.
Multiple Sclerosis
‘Many people with MS have a problem with their vision at one time or another. It’s often an early symptom, although problems can occur at any time.’
https://www.mssociety.org.uk/about-ms/signs-and-symptoms/eyes- and-sight
The two most common eye movement problems in MS are double vision (diplopia) and involuntary eye movements (nystagmus). John Sanders’ article below gives more on this.
Sepsis
Some sepsis survivors experience a variety of physical, psychological and emotional problems while recovering, including changes in vision. This is known as Post Sepsis Syndrome (PSS) and usually lasts between 6 and 18 months, sometimes longer. (UK Sepsis Trust website)
Dementia
http://www.visionuk.org.uk https://www.alzheimers.org.uk/about-dementia/symptoms-and- diagnosis/sight-hearing-loss
The Alzheimer’s Society has a factsheet on ‘Sight, perception and hallucinations in dementia’.
Vision 2020 has a factsheet on dementia and low vision and another that gives advice on cataract operations for people with dementia.
Cancer
‘Some cancer drugs can affect your eyes and your eyesight. Changes can include cataracts, eye infections and eyesight changes.’ (Cancer Research UK website). Various types of cancer, including brain tumours, nasal, nasopharyngeal and sinus cancer can cause sight problems.
Diabetes
Info from Diabetes UK and Wales Diabetic Retinopathy Screening Service.
Learning Disabilities
People with learning disabilities are at increased risk of sight problems. Seeability has info and factsheets. More below.
Down’s Syndrome
Read Maggie Woodhouse’s article below for a detailed overview.
Multiple Sclerosis (MS) and topsy-turvy vision impairment
Most of us have heard of Multiple Sclerosis (MS). However, unless we have personal experience of this condition, we tend to think of it as mainly affecting the muscles, control of our limbs and mobility. What is less well known is that MS often affects vision too.
The National Multiple Sclerosis Society estimates that at least half of those with the condition experience disruption to their vision at some stage. The MS Society adds that vision disturbances can occur at any time and are sometimes an early sign that a person has MS before other symptoms become apparent.
The three common vision conditions linked to MS are optic neuritis, diplopia and acquired nystagmus. Optic neuritis is a temporary loss or disturbance of vision and can be painful. Diplopia means double vision where you see two of the same object or person, usually side by side or one above the other. If you have acquired nystagmus and MS your eyes move involuntarily and so does the world around you.
Serious impact
How vision is impacted varies widely. Some with MS have no problems with their vision at all or are only slightly or occasionally affected. However, for others having optic neuritis, diplopia or acquired nystagmus seriously reduce their quality of life and mental wellbeing, even to the extent of making people feel suicidal.
These three conditions can limit your ability to do everyday things like work, drive, walk, read or even watch television. Their impact is, however, sometimes under-estimated. The author has heard from people with MS who have been told by professionals that they will “simply have to learn to live with nystagmus.”
Why vision impairment associated with MS is sometimes sidelined is hard to say. It may be because the vision aspects of MS are less obvious than some of the other symptoms. Or it may be because people with optic neuritis, diplopia and acquired nystagmus can still see and, to put it bluntly, probably don’t fit the stereotype of being blind or vision impaired.
Nonetheless, all three conditions add to the strain and tiredness experienced by people with MS. Having a vision problem on top of other MS symptoms undoubtedly eats away at your already limited reserves of energy, stamina and confidence.
Few easy answers
Optic neuritis is possibly the most common eye condition associated with MS and often responds well to treatment with steroids. However, there are no easy fixes to diplopia and acquired nystagmus. Glasses and contact lenses probably won’t help because the damage is behind, not in, the eyes. Drugs such as baclofen and gabapentin also help some people with acquired nystagmus, but not everyone. And the side effects of these drugs are often not worth any small gains.
What people actually find helps them most is having a good understanding of the effects of diplopia and acquired nystagmus in particular. Part of that comes from talking to others with these conditions so that they feel less isolated and can share experience and advice.
Making changes
Simple strategies make an important difference. Knowing for example that your vision may be more disrupted at certain times of day or when you’re tired is both reassuring and means you can plan activities with a greater chance of success. Similarly, it helps to know if looking in certain directions aggravates your diplopia or acquired nystagmus.
Making changes at home helps too. Installing grab rails, reducing trip hazards, improving lighting and contrast are simple but effective modifications. Low Vision Aids (LVAs) make some tasks easier and are available free in Wales. Local charities specialising in vision impairment and high street optometrists can advise on adaptations and equipment.
People in Wales can also tap into extra support at the moment thanks to an MS Society project called “My MS, My Rights, My Choices”. The project offers befriending and emotional support, courses on symptom management and mindfulness among other topics, as well as individual advice and advocacy on employment, benefits, housing and social care.
Finally, one of the biggest frustrations for people with MS is that family and friends don’t always realise how difficult and draining it is to live in a topsy-turvy world. Thankfully, technology in the shape of Simulation Specs and virtual reality goggles now allows anyone to briefly get some idea of these conditions. A few minutes of having your world turned upside down soon helps you understand how distressing it is for those who face such confusion on a daily basis.
- John Sanders February, 2019
Steve's story.
Rehabilitation Officer, Ian Moran, tells us about his work with Steve, whose vision was badly affected by stroke.
I worked with Steve for just under 6 months and got to know him really well over that period. I would like to thank him for letting me share his story so openly. It explains some of the difficulties he has experienced over the past 6 years. Steve's story highlights how working in partnership can get the best outcomes for people. Each person we work with has their own individual needs and concerns. This is Steve's story.
Background
Steve is an aquatic caretaker and fish keeper. He did it as a job and as a hobby for many years, even travelling to South America to rescue fish. He said that his wife used to go crazy at him because he had turned the living room, garage and spare room into an aquarium. His passion was the source of most arguments
6 years ago Steve had a TIA (small bleed on his brain) and lost all useful vision in his right eye. At the time he was working and was the main carer for his wife who was very ill from cancer.
Steve told me that it was a difficult time for him but said that he was able to manage with the loss of this vision. He said that his main priority was to stay strong for his family. He hid his health and vision problems from them to avoid them any further worry.
Steve said that shortly after his TIA his wife passed away. He had support from his family and from a McMillan family support worker. He said that he couldn't have got through this without them. He eventually told them about his health and what he had been hiding from them. He did have good vision in his left eye and said he could manage to continue to do everyday tasks.
Steve's son moved away and his daughter had finished her first year nursing in Newport. Steve said that this was a difficult time because he was not used to living alone. He said that he now started to spend more time meeting friends to play skittles.
2 years ago Steve had another TIA and lost a substantial amount of vision on the left hand side of his good eye.
The impact
This had a massive impact on Steve's life.
Steve had to give up his job because it was felt that it would be too unsafe for him to continue to work.
He was scared to go out. He explained that because he was now living alone he had to go out shopping and attend hospital/GP appointments by himself. He said that this caused him a great deal of anxiety and he was at a very low point in his life. He had several falls and knocks when he did attempt to go out. He was bumping into people and becoming disorientated. He was spending all his savings on taxis and was starting to struggle financially.
The drop in vision meant that he could no longer read his bills and was struggling with all near tasks. He told me that he was struggling to look after himself but more importantly to him he was finding that he could not look after his fish.
He told me that he was burning himself and cooking was extremely difficult. He had become very isolated. He was unable to use his phone to contact his friends and family and had to rely on them calling him.
Steve slipped through the net
Steve didn't really understand what had happened with his vision. He was being passed from hospital to hospital and from Ophthalmology to Neurology and was confused about what he was being told and about what had happened.
By chance he was out in Cardiff with his daughter after going to the Heath Hospital for an appointment. They walked past RNIB/CIB offices and saw somebody with a cane going in. His daughter persuaded Steve to go in and ask for help and where he could get a cane.
Cardiff Institute for the Blind contacted our first response team and referred him for a specialist assessment from a Rehabilitation Officer.
Steve was a high priority because he lived alone, was experiencing falls and burns and had become isolated.
He was allocated to me and I first visited early last summer. When I asked Steve what his main goals were, he said "he needed to get out and take back control of his life."
What we did
We referred him to his high street optometrist to check eye health, assess functional vision and access the Low Vision Service.
Steve was issued with a hand magnifier, UV shields and monocular. The optometrist identified the extent of his visual field loss and shared his low vision record card with me.
We carried out low vision training using his magnifiers and explored different strategies to avoid his field neglect on the left hand side. We also looked at tracking and tracing exercises using his monocular. His UV shields made a huge difference and reduced the glare he was getting. They also helped with transitioning from light to dark areas.
This was an early success for Steve and he was now able to access text and could read his correspondence, cooking instructions on packages and organise his own medication.
We then started to look at more practical solutions for him in the kitchen. Steve had already been cooking but had burnt his arms on his oven. We looked at how to reduce these risks and I encouraged Steve to repeatedly practice while the oven was switched off. This eventually became muscle memory.
Steve has qualifications in computer science and had been an iPhone user for several years. We looked at changing the accessibility settings on his phone and how to switch ‘voice over’ on and off. Steve picked this up extremely quickly. He was now able to make calls, send and receive emails, text messages and access his social media. Steve downloaded traveline Cymru app and was again able to plan routes and track his bus. Later on in the intervention Steve would use the GPS to assist with orientation.
We started a mobility program. Steve was very nervous when going out and it was essential that he use a long cane to increase safety. The main issue he had was he felt that he needed to look down at the floor to see what was coming up. This had a negative impact on his posture and was the main reason for the falls and the knocks he was having.
We started off learning techniques that he would need to identify what was happening with the ground and practiced straight line travel. Encouragement was needed to keep his head up to make best use out of residual vision and improve his posture. Steve picked this up extremely quickly. The program progressed to controlled and uncontrolled road crossings.
Steve knows his local area very well so not too much work was needed in orientation. We started to look at the different routes Steve needed and built these into our sessions. Steve confidence started to increase and I started to pull back as he no longer needed instruction.
The routes started to become more complex and we looked at bus and rail travel. I again started to pull back and would meet Steve at the end of his journeys.
Steve was now able to travel independently using public transport to pick up his live bait for his fish. This saved him over £35 in a taxi fare.
After several months and numerous sessions Steve had met all the outcomes identified in his assessment. He told me he looked forward to our weekly sessions and didn't even mind the rain.
Before I ended my involvement, I referred Steve back to Cardiff Institute for the Blind. They had recently employed a community development officer. Steve said he wanted to start swimming again. Carys and Kristian from CIB undertook awareness training with the staff and she accompanied Steve to his first few sessions. She also encouraged Steve to attend some of their groups.
I visited CIB offices about 3 months after ending my involvement with Steve. They showed me some of the pictures they had taken over the past few months. It was with delight that I seen Steve playing walking football in one, riding a bike in another and a group picture in the pub with Steve in centre sharing a laugh with other members.
As a rehabilitation officer, we visit people with varying degrees of vision impairments, The emotional impact that a loss of vision can have must not be underestimated and a certain level of resilience and acceptance is needed by people for positive outcomes to be achieved, We are invited into people's homes to address problems that are of a personal nature and in some cases this can be distressing for people to face. It is important that we recognise, not only what vision has been lost, but also recognise what impact this has had on a person's identify.
Steve's story so far...
Steve is now meeting up with his friends again to play skittles. He uses his monocular and tells me his game hasn't dropped.
He is accessing the local leisure centre to go the gym and go swimming.
He attends an under 50's group in Pontypridd. (Steve is an honorary member because he is a bit older).
He's enjoying cycling.
He volunteers and fundraises for McMillan and completed the Llantrisant walk independently to raise money for them.
He goes to Newport on the train to visit his daughter and travels all over the Rhondda to meet friends.
He is now a proud grandfather and ...
He's continuing to look after his fish - he now has another hospital tank in his living room!!!
The rehabilitation process did not fix Steve. He still has the same challenges everyday that he did before I met him. He still gets anxious about going out at times and things do knock his confidence back. What work we did together was to give Steve the tools to take these challenges head on.
On behalf of Steve and myself we would like to thank Cardiff Institute for the Blind for referring into our service and supporting him to get back into the community, Davies and Jones opticians in Talbot Green for assessing Steve and providing us with the clinical and functional information we needed, and McMillan for helping Steve get through the loss of his wife.
Finally, I want to thank Steve for letting me share his story.
- Ian Moran, Rehabilitation Officer
Down’s syndrome and sight loss
People with Down’s syndrome are described as ‘visual learners’; that is, they are more reliant on their vision to understand the world around them, than are typical people; and that is saying something when you consider that vision is supposed to contribute to 80% of ordinary people’s learning. Children with Down’s syndrome, once considered to be ‘uneducable’, are now achieving more and more, because teachers are aware that they learn in a different way to typical children; they need to be shown rather than told. What this means, of course, is that a visual impairment will have a greater negative impact on someone with Down’s syndrome than on a typical person. However, it has long been recognised that people with learning disabilities, including Down’s syndrome, are much more likely than the general population to have eye and sight problems.
Long and short-sight and astigmatism
In developing countries, the most common cause of visual impairment is uncorrected refractive errors (that is, long, short-sight or astigmatism). It many come as a shock to readers (and it should, because it’s scandalous) that for people with a learning disability in the developed world, the major cause of poor sight is the same, that is, needing spectacles and not having them. The UK and Down’s syndrome are no exceptions. Recent studies in special schools throughout the UK have shown that about 50% of pupils need spectacles and only a quarter to a third of those that need them, have them.
The situation is improving. Most areas now have healthcare pathways so that all young children with Down’s syndrome are referred to their local hospital for eyecare and are prescribed spectacles if needed. The problem comes later, when the children are older and are discharged from the hospital. Many parents are unable to find suitable eye care in the high street, or they take their child for an eye test once and the experience is so negative (some parents describe it as ‘horrific’) they are too embarrassed or distressed to try again. Their children then go without spectacles.
Help is at hand. More optometrists are developing the skills required to see children with special needs, as our professional associations are prioritising training in this area. Very recently, a Facebook Group called ‘Optometrists working with people with Down’s syndrome’ has formed, so that we can connect and exchange ideas. As I write this, there are 138 members (not all are optometrists or opticians; we have some orthoptists, teachers and others on board). Very soon we will 7have a database of eye care professionals with expertise in Down’s syndrome, available to parents, so watch this space!
Near focusing
Those of us who are over 40 will know that we lose the ability to focus on near tasks as we age – we find ourselves holding the newspaper further and further away. This is a natural ageing process caused by the lens in our eye getting stiffer and unable to change focus. And, of course, this will happen to anyone with a learning disability as well. In the general population we come to rely on ‘reading specs’. But we use near spectacles (or bifocals/varifocals) for lots of other things as well – sewing, drawing, looking at photos, using our phones; the list is endless. Almost all people with Down’s syndrome will be doing many near tasks in middle age and will benefit from suitable spectacles.
Recent research has demonstrated that the problem of poor near focusing can happen even in children with Down’s syndrome. In fact, it may be that as many as three quarters of children are unable to focus properly on near tasks, including their school work. In these children, the cause is not a stiffening lens; in fact we don’t know what the underlying mechanism is. However, it’s quite clear from a number of international publications, that if children with Down’s syndrome wear spectacles for long or short sight only, most will remain visually
impaired for near tasks. Bifocals are the solution, and most children wear them perfectly happily and enjoy clear near as well as distance vision. Many hospital clinics now measure near focusing and prescribe bifocals, but by no means all. Some hospital clinics stick to their old ways and don’t consider the children’s needs at near, where, of course, they do all of their learning. It is vital that parents insist on the children’s near focusing being measured and insist on bifocals if there is a problem, or demand referral to a clinic that does offer care for near vision.
Nystagmus
Nystagmus is a continual ‘wobble’ of the eyes that is associated with visual impairment. It occurs along with most eye conditions that are present at or soon after birth, and it can also exist without an underlying condition – this latter form is called ‘idiopathic’, meaning no known cause. Nystagmus appears in about 15% of children with Down’s syndrome; sometimes it spontaneously resolves in infancy. If it remains, it is, of course, associated with poor vision just as it is in typical children. However, in some cases (all too many, in my experience) parents are not given any information about nystagmus at their hospital visits, or even told that it affects the way their children see. In fact, some parents are told that wobbly eyes ‘are nothing to worry about’ in a child with Down’s syndrome, and then, tragically, no compensation is made at school for poor sight. It is, therefore, essential that children with Down’s syndrome and nystagmus are managed in exactly the same way as typical children with the condition; investigation for any underlying cause and referral to the educational support services.
Keratoconus
This is a condition of teenage years and early adulthood, in which the cornea thins and grows abnormally into a conical shape causing distortions that cannot be corrected with spectacles. If it progresses, sight can be threatened by scarring of the fragile cornea. Keratoconus is common in Down’s syndrome (1 in 10 as opposed to 1 in 1,000 in the general population) and used to inevitably lead to visual impairment. However, there is now a treatment, called collagen cross linkage, which comprises a one-off instillation of drops, followed by bathing the eye in UV light, which ‘sets’ the cornea and prevents further growth. Some people with Down’s syndrome can have the therapy under local anaesthetic; others who are unable to keep still enough during the procedure, will have a general anaesthetic.
The challenge in cross-linkage therapy is that it is only feasible in the early stages of keratoconus, while the cornea is still reasonably thick. The normal cornea in people with Down’s syndrome is considerably thinner than in typical people, so identifying keratoconus early is much more urgent than in the general population. Because people with Down’s syndrome are less likely to complain that their vision has worsened and thereby trigger an eye examination, it is imperative that families and carers arrange regular (at least annual) eye checks for teenagers and young adults with Down’s syndrome, and that the optometrist is aware of the risk of keratoconus.
Cross-linkage therapy halts progression of keratoconus; it does not restore the cornea to a ‘normal’ shape. So following therapy, or in non- progressive cases, or cases in which therapy is not feasible, vision will be poor. In the general population, keratoconus is managed very well with contact lenses, and there are many examples of young people with Down’s syndrome wearing lenses very successfully. Contact lens wear may require close supervision, but a young person should never be denied a trial of contact lenses on the grounds that they have Down’s syndrome.
Cataracts
Congenital cataracts are rare but are slightly more common in children with Down’s syndrome than typical children. The treatment and prognosis, however, are exactly the same; removal of the cataracts if they are sight-threatening, at as early an age as possible.
Age-related cataracts are common in the general population and almost all readers will have an elderly relative or neighbour who has undergone cataract surgery. Research suggests that cataracts are just as common in people with Down’s syndrome, but that they can occur at a much younger age. Regular eye examinations are therefore important throughout life. Cataract surgery may be a little more challenging for a person with Down’s syndrome in that many will require a general anaesthetic and overnight hospital stay, plus close supervision in the recovery period. Down’s syndrome should never be a contra-indication for surgery.
Diabetic retinopathy
Diabetes (both types 1 and 2) is more common in people with Down’s syndrome than in the general population. Yet research suggests that diabetic retinopathy is less likely. Isn’t it nice to report good news?
‘Normal’ vision
Children with Down’s syndrome who are fortunate enough to escape any of the conditions described above, or who are wearing the correct spectacles, still have vision that is poorer (both in detail and in contrast) than typical children. ‘Normal’ vision in Down’s syndrome is not poor enough for the children to qualify as ‘sight-impaired’, but nevertheless, it is significantly reduced. This means that accessing the same materials in school or the workplace as typical people is a real challenge for people with Down’s syndrome. Larger, bolder print and clear pictures are needed and it is essential that teachers and trainers are aware of the visual limitations. The Down’s Syndrome Association includes advice on vision in Down’s syndrome in all of its guidelines for parents and teachers.
Summary
Although there are no eye conditions exclusive to people with Down’s syndrome, children and adults with the syndrome are more likely to have eye problems than are members of the general population. No one is too disabled to have an eye examination, and there are many optometrists who have a real interest in helping people with special needs. Families and carers should ensure that people with Down’s syndrome have an eye examination at least every year, so that they can have the best eyesight they can, and they can have early treatment, if they are unlucky enough to develop a sight-threatening condition.
- J Margaret Woodhouse, Senior Lecturer and Optometrist, School of Optometry and Vision Sciences, Cardiff University
Sight loss and learning disabilities
We are very grateful to SeeAbility for allowing us to use the following information which has been taken from their website, https://www.seeability.org. SeeAbility is a charity that provides specialist support, accommodation and eye care help for people with learning disabilities, autism and sight loss.
Eye care is extremely important for people with learning disabilities. Good eyesight enables us to learn, communicate and feel more confident, but the reality is that adults with learning disabilities are 10 times more likely to have serious sight problems. Children with learning disabilities are 28 times more likely so it’s important for eye care to start at a young age.
A sight test is the only way of keeping track of eye health and vision. Due to the increased likelihood of eye problems everyone with a learning disability should have an eye test every two years, particularly as there may be no obvious signs of poor eye health. Some people may need one more often. What makes matters worse is that many people with learning disabilities are not getting the eye care they need. SeeAbility’s research suggests that a shocking 50% of people with learning disabilities have not had a sight test in the last 2 years. The charity has put forward the following suggestions to overcome the barriers that these people face:
- Prioritise having an eye test
- Plan for a successful eye test, for example by visiting theopticians in advance, and explaining what is involved.
- Ask for extra support at the opticians, who should make reasonable adjustments for people with disabilities.
- Support the individual to wear glasses – they may need time to get used to them.
- Make sure that you ask your optician whether you are eligible for free eye tests or basic glasses.
For more details information, read SeeAbility’s guide, ‘How to be eye care aware’, which is available by searching at www.seeability.org
The following resources from SeeAbility are also relevant:
The ‘Eye Care’ section on the SeeAbility website: https://www.seeability.org/looking-after-your-eyes
‘People with learning disabilities and eye care’ leaflet: https://www.seeability.org/Handlers/Download.ashx?IDMF=ec927c b9-7ea3-4cbd-8d33-626c695afc2e
Dementia and sight loss
Both sight loss and dementia are more common as people get older, and a recent study suggested that nearly one-third of people with dementia also had significant sight loss. This sight loss may be caused by an eye condition, such as cataracts, another health condition, such as stroke, normal ageing of the eye or the dementia itself. People with dementia may have visual difficulties (specifically problems with perception) but still have healthy eyes. These problems are caused by the effect of dementia on the brain. Dementia conditions which may have an impact on vision are: Lewy body dementia, posterior cortical atrophy, Alzheimer’s disease and vascular dementia.
Because of the difficulty in differentiating between problems caused by sight loss and dementia, the Vision UK Dementia and Sight Loss Committee recommend that patients diagnosed with dementia should have an eye examination with a registered optometrist on diagnosis and should then have their eyes examined at yearly intervals.
It is possible to have an eye examination if you have dementia. Your optometrist (optician) should be able to adjust the eye examination to meet your needs, accurately measure your vision and prescribe and update any specs you may need. RNIB’s factsheet ‘Dementia and Sight Loss’ has a useful checklist to help identify whether a person with dementia has a sight problem, and also some handy tips for visiting the optometrist. You can find out more and read the factsheet on RNIB’s website: https://www.rnib.org.uk/professionals-social-care- professionals-complex-needs-social-care/dementia-and-sight-loss.
The Alzheimer’s Society website also has some useful information:
https://www.alzheimers.org.uk/about-dementia/symptoms-and- diagnosis/sight-hearing-loss.
Diabetes and eye problems
Diabetes is the leading cause of preventable sight loss in the UK. Some people with the condition develop a serious problem with their eyes, diabetic retinopathy, which can lead to sight loss. However, if detected early enough, eye problems can usually be treated to avoid long-term problems.
If blood sugar levels and blood pressure are consistently high, you can seriously damage your blood vessels, which can affect theretina. However, there are lots of things you can do to keep your blood sugars and blood pressure in your target range, which will reduce your risk of developing serious problems with your eyes. The Diabetes UK website has more information on how to do this.
Diabetic Eye Screening Wales (DESW) is a free service established for all eligible people registered with diabetes in Wales to reduce the risk of vision loss due to diabetic retinopathy. If you are diagnosed with diabetes, you will be referred by your GP and should receive an invitation to attend screening within 3 months of being placed on the DESW register.
Retinal screening is a straightforward procedure that should take approximately 40 minutes. Photographs of the retina are taken using a specialist camera and then forwarded to a team of retinal graders who look for signs of diabetic retinopathy. On completion, results are then sent to the patient and GP. It is important to note that this screening process is not a replacement for regular sight tests that you should continue to attend.
In addition to the risk of diabetic retinopathy, diabetes makes you one and a half times more likely to get glaucoma and three times more likely to get cataracts. Both can lead to blindness, but can be detected during your regular eye test, which should be free if you have been diagnosed with diabetes. DESW screening should pick up any signs of a cataract developing, but not glaucoma.
The Diabetes UK website has more information about sight problems as a complication of diabetes: https://www.diabetes.org.uk/guide-to-diabetes/complications/retinopathy
For more about Diabetic Eye Screening Wales, visit the Eye Care Wales website: http://www.eyecare.wales.nhs.uk/diabetic-retinopathy-screening- service-w
These articles originally appeared in Roundup 33.