Diabetes Impacts Eyes

A normal eye-before Diabetes Impacts Eyes

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Diabetes impacts eyes because diabetics have an increased risk of developing eye complications which, if left untreated, can lead to poor vision and blindness. However, 98% of serious vision loss from diabetes can be prevented with regular eye examinations and early treatment. Glucose crystals  as a resultant of too high sugar readings are damaging your organs. However, this can be avoided with regular eye examinations.

How does the eye work?

The eye works a bit like a camera. Light enters through the cornea and the pupil before passing through the lens which focuses the light onto the retina. Special cells in the retina detect the light, forming the focused image like film in an old fashioned camera. The image is sent along the optic nerve to the brain. At the centre of the retina is the macula which is responsible for the ‘seeing’ straight ahead part of our  vision while the retina is responsible for ‘seeing’ from the edges of our vision.
A normal eye

Diabetes Impacts Eyes How

High blood glucose levels can cause changes in the shape of the lens which can temporarily cause blurring of your vision. This commonly occurs before being diagnosed with diabetes or when diabetes isn’t well managed. The blurriness usually disappears when blood glucose levels are reduced through appropriate treatment. Therefore getting new glasses should be delayed until blood glucose levels are back within the recommended range.
High blood glucose levels for long periods of time can increase the risk of more serious eye problems in people with diabetes, including:

Most diabetics underestimate the fact that diabetes impacts eyes and sight,  partly because  they do not notice changes in their vision until the condition is very serious, it is essential to have regular eye examinations so that problems can be detected early and treated promptly. Few diabetics get the luxury of early warning signs, often the damage is done before you even begin to get any symptoms.

Diabetic Retinopathy

  • Non -proliferative


The longer you have diabetes, the greater the risk of small blood vessels at the back of the eye being damaged by high blood glucose and high blood pressure. This can result in leakage and often progresses to blockage of the vessels that supply the retina with nutrients. This stage is called non -proliferative or background retinopathy and there may be no noticeable change in your vision.

    •   Proliferative

Without early detection and treatment, non-proliferative diabetic retinopathy can progress and the retina may grow new blood vessels. This advanced stage is called proliferative retinopathy. The new blood vessels are weaker and can bleed onto the retina or the vitreous, the jelly-like centre inside your eye. Vision can be affected, sometimes seriously and suddenly.

The growth of new vessels may also lead to developing scar tissue which can cause further problems such as a retinal detachment. Once these changes occur it is hard to
restore any lost vision and the resulting damage can lead to blindness. Sometimes new vessels may grow on the iris and this can lead to neovascular glaucoma (see below).

Macular oedema

Blood vessels in the macula, the central area of the retina, can leak fluid causing swelling and can result in central vision loss.

Changes or problems in the lens can result in clouding and decreased vision known as cataracts. Although ageing is the main risk factor, people with diabetes tend to develop cataracts more rapidly and at a younger age.
Glaucoma is an eye disease in which the optic nerve is damaged. The progression of glaucoma is usually slow. Glaucoma can affect anyone but it appears to be more common in people who have diabetes. People with diabetes may also have a less common form of glaucoma which develops as a complication of severe diabetic retinopathy or neovascular glaucoma.
What are the symptoms of diabetes related eye complications?
Often diabetes-related eye complications have no signs or symptoms and there may be no obvious deterioration in vision until the condition is quite advanced. Changes in vision may also be so gradual that you do not notice it for some time.
Where signs and symptoms are present, they can include:

  • Floaters and flashes
  • Blurry, blocked or dim vision
  • Poor night vision
  • Halos around lights or sparkles
  • Sensitivity to light and glare
  • Need for brighter light for reading and other activities
  • Distortion or ‘holes’ in vision
  • Frequent changes in eyeglass prescriptions

If you are a diabetic any change in your vision should be checked by your optometrist, ophthalmologist  or doctor.

Caring for your eyes

  • You should be told as soon as your diabetes is diagnosed that diabetes impacts eyes, Be aware of your personal risk
  • Have an eye examination by an eye care professional when you are first diagnosed with diabetes and then at least every two years (or more often as indicated by your doctor or eye care professional).
  • Examination of your eyes involves viewing the back of your eyes. This will involve adding eye drops to dilate the pupils or taking a photograph of the back of your eyes.
  • If retinopathy is detected, you will need to have your eyes examined more often and you may be referred to a medical eye specialist (ophthalmologist).
  • Notify your eye care professional immediately if you notice any changes in your vision.
  • Keep your blood glucose levels, HbA1c, blood pressure and cholesterol within the recommended ranges. High blood glucose, cholesterol and blood pressure increase the risk of developing eye complications as well as increasing the severity of eye complications.
  • Have regular health checks including blood pressure readings, cholesterol measurements and kidney function tests as recommended by your diabetes care team. Diabetes impacts eyes and other organs.It is important that you discuss the results with your doctor and seek further advice for any results that are not in the recommended range.
  • If you smoke, stop!
  • Maintain a lifestyle that includes regular physical activity and healthy eating to better manage your blood glucose levels.
  • Always take your medications as instructed by your doctor.

Can diabetes-related eye complications be treated?
Most eye complications can be treated successfully if detected early. Early detection and treatment can also prevent eye complications from getting worse. However, treatment generally cannot restore vision once it has been lost. Regular eye examinations and early treatment are therefore important to prevent vision loss.Diabetes impacts eyes in all cases and this is not something you can ignore.

The most common treatments for eye complications are:

Laser This involves the use of a special form of light of a specific wavelength that is able to heat retinal tissue and blood vessels. This can minimise leakage from blood vessels and cause regression of any new and fragile vessels.

A surgical procedure called a vitrectomy is used in cases of advanced retinopathy. It involves the use of fine instruments inside the eye with the aim of repairing the most severe damage caused by diabetic retinopathy.


Diabetic retinopathy- Causes and Prevention

diabetic retinopathy

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Diabetic retinopathy is one of the most common complications of diabetes type 1 and diabetes type 2, recent studies by the American diabetic association have found that fifty percent of people with raised sugar levels in the pre-diabetes stage are at risk .

What is diabetic retinopathy?

Diabetic retinopathy occurs when elevated sugar levels damages the tiny blood vessels inside the retina. The retina is the light sensitive part of the eye and it is imperative for healthy vision, which is why blindness occurs when the retina is damaged. Sadly there is very little warning or symptoms before the onset of diabetic retinopathy. Which is why all

diabetic retinopathy
Cross Section of the eye.

diabetics should have dilated eye exam at least once a year. As diabetic retinopathy has four stages, if it is detected early enough there are treatments to halt the progression of the disease so that it does not lead to blindness. If you should see spots of blood or spots floating in your vision, even if it only happens once go and have an eye test, don’t wait for further damage to occur. Sometimes these spots will clear without any treatment, but hemorrhaging can occur in the night and blurred vision is the likely result.

Diabetic retinopathy has four stages:
1. Mild Nonproliferative Retinopathy.

The retina has many small blood vessels and small microaneurysms or swellings occur.

2. Moderate Nonproliferative Retinopathy.

These swellings get worse until they block blood vessels to the retina.
3. Severe Nonproliferative Retinopathy.

The blocked vessels become more swollen which deprives several area of the retina of their vital blood supply, to compensate the retina asks the brain to grow more blood vessels
4. Proliferative Retinopathy.

In the fourth and final stage of diabetic retinopathy new blood vessels develop, but they are fragile, too frail to cope with blood flow and once these blood vessels leak the end prognosis is loss of vision, or blindness.

Another complication is macular edema, the macular is the centre of the retina and it controls straight ahead and sharp vision. Statistically fifty percent of people with proliferative retinopathy also have macular edema.

Even at this stage of blurred vision treatment is possible. The most usual treatment is by laser,the resulting tiny burns seal the blood vessels and prevent further leakage. Sometimes more than one session is needed but most treatments are completed in one session, although practitioners usually leave a gap of several months if both eyes need treatment.
How are macular edema and diabetic retinopathy detected?

The test is normally in two part a test to see how sharp your vision is over distance and a dilated eye examination. Drops are placed in the eye to widen the pupil and then the surface of the retina and optic nerve is examined. The test is not painful but the after affects of blurred vision can linger for a few hours.

What is a vitrectomy?
If you have a lot of blood in the center of the eye in the vitreous gel you may need a vitrectomy to restore your sight. During a local or general anaesthetic
A vitrectomy is performed under either local or general anesthesia.  The vitreous gel is removed because it is clogged with blood, and it is replaced with a saline solution which has a a similar composition to the vitreous gel. Because an incision is made in the eye you may need to wear an eye patch for a time to stop any infections in the eye.

Although both the treatments have a similar success rate, they do not actually cure the condition. The condition will not be cured whilst your glucose levels are elevated. Modern research is looking at ways to inhibit the signals that ask for new blood vessels to be made.
A better prevention is to reduce your blood sugar levels. This will not only prevent diabetic complications in other organs such as the kidney , and prevent nerve damage.

Don’t forget there are rarely any warning sign and if left untreated diabetic retinopathy causes blindness. A simple painless eye once a year can prevent all these complications, if you listen to the video, you will hear that most sufferers’ of diabetic retinopathy will agree that they could have avoided diabetic retinopathy with regular eye checks.