Diabetic Eye Disease and Retinopathy Care in Saskatoon

What is diabetic retinopathy?

The retina is the light-sensitive layer at the back of the eye. Over time, high blood sugar can damage the tiny blood vessels that feed it. This is called diabetic retinopathy.

• Non-proliferative (early) retinopathy: small vessels weaken, bulge or leak small amounts of blood and fluid.
• Proliferative (advanced) retinopathy: the retina grows new, fragile blood vessels. These can bleed into the eye or cause scar tissue that pulls on the retina, which can lead to retinal detachment.
• Diabetic macular edema (DME): fluid leaks into the macula, the centre of the retina used for reading and seeing detail. DME is a common cause of vision loss in people with diabetes and can happen at any stage.

Diabetes also raises the risk of cataracts and glaucoma, so a full eye exam looks for these too.

Who is at risk?

Anyone with type 1 or type 2 diabetes can develop diabetic retinopathy. Your risk is higher if you:

• Have had diabetes for many years
• Have blood sugar that is often high (a high A1C)
• Have high blood pressure or high cholesterol
• Have kidney disease
• Smoke
• Are pregnant (retinopathy can worsen during pregnancy)

Diabetes is common in Saskatchewan, and some communities are affected more than others. Regular eye checks are one of the most important things you can do to protect your sight.

Diabetic eye exams in Saskatchewan

If you have type 1 or type 2 diabetes, see an eye care professional at least once a year, or as often as advised. In Saskatchewan, people with a valid Saskatchewan Health Card and a confirmed diagnosis of type 1 or type 2 diabetes are covered for one annual eye exam with an optometrist every 12 months. A doctor’s referral is not needed for this exam. Routine follow-up exams are not covered, and pre-diabetes is not eligible. (Sources: Government of Saskatchewan; Saskatchewan Association of Optometrists.)

If your optometrist or family doctor finds signs of retinopathy that need treatment, they can refer you to an ophthalmologist at Conlon Eye Institute.

How it's diagnosed

• Dilated eye exam – drops widen the pupil so the doctor can see the whole retina. Plan for blurry, light-sensitive vision for a few hours, and consider having someone drive you.
• Retinal photographs – record the retina and help track changes over time.
• OCT scan – a quick, non-contact scan that shows swelling in the macula.
• Fluorescein angiography – in some cases, a dye is injected in the arm to show leaking or blocked vessels.

Treatment options

Managing your diabetes is the foundation of treatment. Keeping blood sugar, blood pressure and cholesterol in your target ranges lowers the risk of retinopathy starting or getting worse. Work with your family doctor or diabetes team on this.

When retinopathy or macular edema needs treatment, options include:

• Eye injections – offered at CEI. Medicine injected into the eye can reduce swelling in the macula and slow the growth of abnormal vessels. Treatment usually starts with a series of injections, with the spacing adjusted over time. The eye is numbed first.
• Laser treatment – offered at CEI. Laser can help seal leaking vessels or shrink abnormal new vessels (panretinal photocoagulation) in proliferative retinopathy.
• Surgery (vitrectomy) – may be needed for bleeding that does not clear or for scar tissue pulling on the retina. If you need it, we can help coordinate a referral to a retina specialist.

Treatment aims to slow or stabilize the disease and protect the vision you have. It does not cure diabetic retinopathy. Some people see improvement, especially with macular edema, but not everyone does.

Living with diabetes and follow-up

• Keep your annual diabetic eye exam, even if you see well.
• If you have retinopathy, follow-up may be every few months, depending on severity.
• Keep working on blood sugar, blood pressure and cholesterol targets, and don’t smoke.
• Tell your eye doctor if you are pregnant or planning pregnancy.
• Report any new vision changes promptly; don’t wait for your next visit.