Diabetes, a metabolic disease that affects the body’s ability to metabolize blood sugar, is a chronic condition with wide-ranging health implications. The pancreas produces insulin, which carries sugar molecules to cells for energy production. However, in certain circumstances, the body may not produce enough insulin or the cells may become resistant to its effects, leading to high glucose levels in the blood, known as hyperglycaemia.
The body experiences a variety of negative impacts from hyperglycaemia, especially on the kidneys, the heart, and the eyes. In fact, diabetes is the leading cause of blindness in individuals between the ages of 20 to 74. Diabetes can cause vision loss if it affects the eyes, which are particularly sensitive.
This comprehensive guide aims to provide all the necessary information about diabetic eye problems. It will cover three major eye problems associated with diabetes: diabetic retinopathy, diabetic macular edema (DME), cataracts, and glaucoma.
Diabetic retinopathy is a prime cause of irreversible blindness. The risk of developing retinopathy increases with the duration of diabetes. Unfortunately, individuals with diabetes often remain unaware of any eye damage until it is too late and vision loss occurs.
The retina, the light-sensitive tissue at the back of the eye, is crucial for vision. High blood sugar levels cause damage to the blood vessels and nerves around the retina, leading to blockages and reduced blood supply. Initially, there are no noticeable symptoms of this damage. However, as the damage progresses, symptoms such as:
- Blurry vision
- Color defects in vision
- Dark spots in vision
- Complete vision loss
- Dark strings floating in the vision
There are two types of diabetic retinopathy:
Early Diabetic Retinopathy (Non-Proliferative Diabetic Retinopathy – NPDR): This is the more common form, where the eyes attempt to compensate for the damage by creating new blood vessels. However, these new vessels may not develop properly, leading to NPDR.
Advanced Diabetic Retinopathy: This stage occurs when the damaged blood vessels seal off, causing the growth of new but abnormal blood vessels. When these vessels leak into the fluid inside the eye (vitreous hu-mor), the pressure inside the eye increases, which can eventually lead to glaucoma. Other complications associated with advanced diabetic retinopathy include vitreous haemorrhage, retinal detachment, and permanent blindness.
Diabetic Macular Edema (DME):
DME occurs when fluid accumulates in the macula, the central part of the retina responsible for clear and sharp vision. It is a leading cause of vision loss in individuals with diabetic retinopathy. DME can develop in both types of diabetes (type 1 and type 2) and typically has no symptoms until vision is affected. Symptoms may include the appearance of floating spots and bleeding, highlighting the close connection between diabetes and eye damage.
Cataracts, a common eye condition, occur when the eye’s lens becomes cloudy or foggy. Individuals with diabetes are two to five times more likely to develop cataracts compared to those without diabetes. Cataracts can affect people with diabetes at an earlier age, and the progression of the condition is often more rapid. Symptoms include:
- Blurry vision
- Light sensitivity
- Halos around lights
- Double vision, especially in one eye
- A vision that remains unaffected by wearing spectacles
Glaucoma is a condition in which fluid fails to drain properly from the eyes, causing increased pressure within the eye. This pressure can lead to damage of the optic nerves, resulting in vision changes and, in severe cases, blindness. Individuals with diabetes are twice as likely to develop glaucoma compared to those without diabetes. Similar to other diabetic eye problems, glaucoma is often discovered only after vision loss occurs. Symptoms may include:
- Loss of peripheral vision
- Red eyes
- Eye pain
- Halos around lights
While it may not always be possible to control diabetes and prevent eye damage entirely, there are steps individuals can take to reduce the risk of vision loss and organ damage:
Manage Diabetes: The best approach is to prioritize diabetes management by adopting a healthy lifestyle, including a balanced diet, regular exercise, and medication adherence.
Regular Eye Tests: Regular visits to an ophthalmologist are crucial for individuals with diabetes, as eye damage often occurs without noticeable symptoms. Consult your doctor if you notice any changes in your vision.
Control Blood Pressure and Cholesterol: Maintaining healthy blood pressure and cholesterol levels can contribute to overall eye health and reduce the risk of complications.
Treatment for diabetic eye problems typically involves a combination of approaches, including eye drops, laser surgeries, medication, and surgical procedures. The management of blood sugar levels and blood pressure is crucial. Certain medications, such as anti-VEGF drugs, are administered through injections to reduce swelling in the macula and improve vision. There is also the possibility of injecting steroids into the eyes. Laser surgeries help seal off leaking blood vessels and reduce retinal swelling.
Regular eye checkups, early detection of vision problems, proper medical care, and consistent follow-up with the ophthalmologist are key factors in preventing diabetes-related eye damage. Managing diabetes through a healthy lifestyle and maintaining stable blood sugar levels can help delay vision loss. By taking these necessary precautions, individuals can minimize the risk of diabetic eye problems and preserve their vision for longer periods of time.