Common questions

Please find below answers to some commonly asked questions about  about diabetic retinopathy.

Can I continue to drive?

The law requires you to inform the Driver and Vehicle Licensing Agency (DVLA), and your insurance company, of any change in health or sight likely to affect the safety of your driving. You must be able to read a number plate at 20.5 metres (25 yards) in good daylight and with spectacles if worn. You must also have an adequate field of vision. The DVLA may request that you go to an optometrist registered with them for the appropriate field test. Standards are more stringent for vocational drivers. To drive when you are unable to meet the standard is an offence and may invalidate your insurance. Inability to meet these standards requires you to notify the DVLA. You should not drive until you have had confirmation that your vision meets the standards. For more detailed information, please contact the DVLA.

What other help is available?

Low vision aids (usually magnifying devices) can enable most patients to continue to perform everyday tasks such as reading newsprint, price tickets or road signs. They may be very simple hand held magnifiers or more complex electronic devices.

My child is diabetic, is he/she likely to develop retinopathy?

Children do not typically develop sight-threatening retinopathy until puberty or older, although it is very important that they do continue with the management of their diabetes as well as possible. Poor management of the condition can be a factor in the development of diabetes in later life. Children with diabetes should start having regular eye tests from the age of 12.

Can any person with diabetes develop retinopathy?

Essentially yes. Some people with diabetes seem constitutionally resistant to developing retinopathy, though diabetes of all types predisposes to retinopathy. Patients whose diabetes is controlled by diet, tablets or insulin can develop complications of diabetes. Even young patients, or those with well-controlled diabetes, can develop retinopathy if they have had diabetes for long enough. Retinopathy can be worsened by coexisting conditions of hypertension or high cholesterol, and puberty or pregnancy can sometimes exacerbate retinopathy.

Is there any way to prevent diabetic retinopathy?

Good diabetic control

Good diabetic control, especially if instituted early in the course of disease, slows down the rate of the progression of complications, though is unlikely to reverse existing retinopathy.

• Take control of your diabetes: monitor your own blood sugars and find out from your GP what your three-month control is like (HBA1c). Aim to reduce your HBA1c level as much as possible without running into the risk of hypoglycaemic attacks
• Control your diet.
• Always take your diabetic treatment. Not taking treatment is harmful.

Control of hypertension

Studies have shown that hypertension seriously increases the risk of progression to sight-threatening retinopathy, particularly in type II diabetes. Hypertension also increases the risk of nephropathy (kidney disease), and cardiovascular complications of diabetes such as heart attacks or strokes. If raised, your blood pressure requires treatment at lower levels than if you were not diabetic. Indeed, some specialists use blood pressure medication, even where blood pressure is normal, to help prevent complications of diabetes.

Maintain a healthy lifestyle

• Avoid becoming overweight (which is likely to increase your resistance to the effect of the body's own, or injected insulin, and worsen your diabetic control).
• Take regular exercise (you should discuss this with your physician if you have a pre-existing heart condition).
• Avoid smoking (smoking increases the risk of cardiovascular complications such as heart attack, stroke, and loss of limb through ischaemia even more than in people without diabetes).
• Avoid alcohol (which upsets your body's metabolism).

Liaise with your diabetic nurse, GP and diabetic physician

• Have cholesterol checks (high levels of fat in the blood such as cholesterol and lipids will worsen diabetic maculopathy).
• Have blood pressure checks.
• Have tests of your kidney function.
• Find out about your disease.