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Through a mother's eyes - Sarah Mawer, Melbourne

Diabetic retinopathy

For Sarah Mawer, the joy and anticipation of being pregnant for the first time was short-lived.

By the end of her first trimester, 28-year-old Sarah was living with the real fear that she might never see her unborn child. Sarah, an insulin dependant diabetic, had suddenly started going blind.

Sarah’s eyes had succumbed to complications associated with her diabetes. Overnight her eyesight deteriorated rapidly. She woke with blurry vision, unable to read or drive.

Sarah was diagnosed with diabetic retinopathy, a condition where blood vessels at the back of the eyes start to swell and eventually leak fluid. The disease was slowly eroding her sight. And unfortunately for Sarah, by the time the symptoms of vision loss were obvious, the disease was well advanced.

“My greatest fear was not being able to see Arnya when she was born. It was really scary for me to think I was going to have this beautiful little baby and not be able to see her or watch her grow up. It was a cause of anxiety. I was a mess, an absolute mess,” Sarah said.

“I remember my mum saying at around 20 weeks into the pregnancy that I should be glowing but I just couldn’t. I was too worried – too scared.”

In week 12 of her pregnancy, Sarah started weekly laser treatments at Melbourne’s Royal Victorian Eye and Ear Hospital – hundreds of individual bursts of laser beam targeting damaged blood vessels to stop the leakage. Sarah’s eyesight was already permanently damaged. Her fight now centred on preventing further loss.

By week 28, Sarah’s eyes were getting worse. Her ophthalmologist suggested a more aggressive treatment – steroid injections directly into the back of her eyes to reduce the swelling.

Between the steroid injections and the weekly laser treatments that continued throughout her pregnancy, Sarah was able to save almost all of her vision. And at 33 weeks Sarah laid eyes on baby Arnya.

“She was so little. They wrapped her up and brought her to me. I felt like all my vision problems went away – I could see her nose, her hair – it was a huge burden lifted – I was over the moon,” Sarah said.

Diabetic retinopathy is one of the leading causes of blindness in adults aged 20-60 years in Australia, and is a real risk for anyone with diabetes, including gestational diabetes during pregnancy.

But according to Dr Alex Harper, Ophthalmologist at Melbourne’s Royal Victorian Eye and Ear Hospital, significant blindness is preventable if people manage their glycaemia, blood pressure and cholesterol levels and get their eyes checked regularly for signs of retinopathy.

“If you’ve got diabetes you need to make regular eye checks a part of your diabetes management plan. If we can pick up signs early we can act to minimise or stop sight loss,” Dr Harper said. “We cannot bring back sight that is lost, so the earlier we can detect and treat the condition the more sight we can save.

“Diabetes cannot be left unchecked or unmanaged. It is a condition that requires people to take control of what they eat and their physical wellbeing.”

Sarah says her case highlights the need for people to take control of their diabetes and to get regular eye checks to pick up signs of retinopathy early.

Although she started strictly managing blood levels and diet when she discovered she was pregnant (at around six weeks), she says that she had not been vigilant in the past.

“I stopped properly managing my diabetes when I was a teenager. I suppose it was that young adult mentality where I had other things to do. I was young and thought I was invincible. I thought I could go out every week and party like everybody else.

“This whole experience with my eyes on top of the pregnancy just made life horrible. It was truly horrible. What was worse is that I know that if I had looked after myself maybe it wouldn’t have happened.”

Sarah said the experience refocused her resolve to stay on top of her diabetes. By the time she fell pregnant with her second child, now-six-month-old Lila, Sarah had her diabetes well under control.

“I did my HbA1C – this is a test that measures the amount of glycosylated hemoglobin in your blood. It helps you look at how well your diabetes is being managed over time. I am eating better, exercising more and generally taking better care of myself. I had my diabetes under control when I had Lila.”

Sarah says she will be forever grateful to the people at the Eye and Ear Hospital for saving her sight and allowing her to watch her children grow up.

For more information about what you can do to protect your vision or the vision of the people you care about, visit www.health.gov.au/eyehealth

Page currency, Latest update: 14 October, 2010

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