Effect of Diabetes to the Eyes

Nrs Oke Ololade

Diabetes is a very serious disease in which the glucose (sugar) levels in the blood are high. It can cause problems such as blindness, heart disease, kidney failure, and amputations. In this edition, my friend Baale Babatunde, a student Optometrist will be sharing with us the effects of diabetes to the eyes. Excerpts:

What are the types of diabetes?

There are three different types of diabetes.

Type 1 diabetes: It is also called juvenile diabetes because it usually occurs at an early age. Since type 1 diabetes starts in childhood, complications occur at an earlier age.  The pancreas does not produce insulin and, if it does, it does so in low quantities.

Insulin is a hormone that works like a key opening a door so glucose can enter the cells. Without this key, the doors will not open and the glucose cannot enter the cells, resulting in too much glucose remaining in the blood.

Type 2 diabetes: It occurs when either the body does not produce enough insulin or the cells ignore the insulin produced by the body.

Gestational diabetes: It develops during pregnancy.  The glucose levels return to normal after the baby is born. It is important to know if a woman had gestational diabetes because her risk is higher for developing type 2 diabetes in the future.

What are the risk factors for developing diabetes?

There are several major risk factors for developing diabetes. These risk factors include;

• Family history: A person is at a greater risk for developing diabetes if any member of the immediate family has diabetes. This includes the father, mother, grandparents, brothers, sisters, and first cousins.

• High blood pressure: Blood pressure higher than 140/90 mm/Hg is a risk factor for diabetes. For people with diabetes, blood pressure should be lower than 130/80 mm/Hg.

• Obesity: Obesity is a strong risk factor for diabetes. Most often, obesity is due to overeating and lack of exercise. Regular exercise, such as walking at least 30 minutes five times per week, is strongly recommended. Following a healthy diet is also important for avoiding obesity.

• Gestational diabetes: If a woman develops gestational diabetes during pregnancy, she is at a higher risk for developing type 2 diabetes later in life.

• High cholesterol and high triglycerides

What is diabetic eye disease?

Diabetic eye disease refers to a group of eye problems that people with diabetes may face as a complication of this disease. Diabetic eye disease can cause permanent vision loss or low vision. Low vision means that even with regular glasses, contact lenses, medicine, or surgery, people find everyday tasks difficult to do. Reading the newspapers, watching TV, and writing can all seem difficult.

Diabetic eye disease includes:

•  Diabetic retinopathy: Is a damage to the blood vessels in the retina. The longer someone has diabetes, the more likely he or she will get diabetic retinopathy. There are often no symptoms in the early stages of diabetic retinopathy. There is no pain, and vision may not change until the disease becomes severe.

The eyesight of a person with diabetic retinopathy can be damaged due to various causes:

– Bleeding

– Detachment of the retina

– Presence of abnormal blood vessels in the retina (proliferative retinopathy)

Vision loss may be prevented by finding and treating the disease in its early stages. Early detection, timely treatment, and appropriate follow-up care can reduce the risk of blindness by 95%.

•  Cataract: Is a clouding of the lens in the eye that affects vision. Diabetes increases the risk of cataract.  Cataract can occur in one or both eyes. It cannot spread from one eye to the other.

Symptoms that can appear to indicate cataract include the following:

– Cloudy and blurry vision

– Faded colors

– Poor night vision

– Double vision

– Problems with bright lights, especially at night

In earlier stages, the cataract is not yet visible; an eye exam is necessary for detection. Symptoms of early cataract may be improved with new eyeglasses, brighter lighting, anti-glare sunglasses, or magnifying lenses. If these measures do not help, surgery is the only effective treatment. Cataract surgery is usually safe and successful; the cloudy lens is replaced with a plastic lens.

•  Glaucoma: Is a group of diseases that can damage the optic nerve and result in vision loss and blindness. Glaucoma may be caused by an increase in eye pressure. However, in some forms of glaucoma, eye pressure is normal. People with diabetes are at an increased risk for an aggressive type of glaucoma called neovascular glaucoma. In this form, abnormal blood vessels grow in the front part of the eye.

A form of the disease called open-angle glaucoma is diagnosed most often in the  following groups of people:

– African Americans aged 40 and older

– Everyone over age 60, especially Hispanics/Latinos

– People with a family history of glaucoma

People may not realize they have glaucoma until the disease is advanced. In the early stages, it often has no symptoms because one eye compensates for the other. Vision lost to glaucoma cannot be restored. However, with early detection and treatment, vision loss may be prevented or slowed down.

What can people with diabetes do to protect their vision?

Finding and treating the disease early, before it causes vision loss or blindness, is the best way to control diabetic eye disease.  All people with diabetes should make sure to get a dilated eye examination at least once a year.

A comprehensive eye exam measures vision, checks for refractive errors (such as nearsightedness, farsightedness, or astigmatism), and includes dilating the pupils to detect eye disease.

A dilated eye exam allows an eye care professional (ophthalmologist or optometrist) to see more of the inside of your eyes to check for signs of disease.

A person with diabetes should remember the following:

• Early detection and timely treatment can help reduce the risk of blindness.

•  Some eye diseases do not have symptoms. Do not wait to visit an eye care professional.

• A person with diabetes should have a dilated eye exam at least once a year.

•  The dilated eye exam is short, simple, and painless.

•  Only an eye care professional can tell what is happening inside the eye.