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Diabetic Eye Disease



Vision problems are very common among Diabetics.

In fact, many diabetics discover their diabetes after visiting a doctor about their vision problems. There are four common vision problems that you should be aware of as you learn to manage your diabetes:

  • blurred visionDiagram of Human Eye
  • cataracts
  • glaucoma
  • retinopathy

Blurred vision is a common symptom of diabetes that helps doctors arrive at a diabetes diagnosis. This condition occurs when your blood sugar level is higher than it should be. The increased level of sugar in your blood causes the lens of your eye to become enlarged. The problem is temporary and will pass as soon as your blood sugar levels return to a healthy level (about 90-130 mg/dL).

Most diabetics only experience blurred vision when they eat foods that are high in sugar, or in the first few weeks/months that they have diabetes and before they begin treatment. By eating low-sugar foods and taking appropriate medication, diabetics will be able to control the levels of sugar in their blood, thereby controlling the swelling of the lens.

Cataracts (cat-a-rakts) are spots on the lens of the eyeball that lead to cloudy and distorted vision. A normal lens is clear in order let light into the eye. Just like on a car windshield, when the lens gets foggy, it becomes difficult to see.

The eyeball consists largely of water and protein. Cataracts form when the protein clumps up because of poor circulation, malfunctioning, and high blood pressure that damages small blood vessels. Treatment for cataracts involves surgery and, in most cases, the use of glasses or contact lenses. Cataracts may never go away permanently, but they can be minimized with regular cataract treatment and by carefully maintaining your nutrition, medication and exercise routines.

Glaucoma (glaw-koh-ma) is caused when fluid builds up in the eyeball and puts pressure on the optic nerve. That pressure can lead to both temporary and permanent damage that reduces vision. Most people discover that they have Glaucoma only after they have experienced a loss of vision and complete blindness. In fact, Glaucoma is one of the leading causes of blindness in America.

However, if glaucoma is caught early enough, it can be treated before the damage is permanent. Early detection signs include: blurred vision, watering eyes, pain in the eyes, and halos around lights. The most popular treatment for glaucoma involves laser surgery and close monitoring of blood sugar levels.

Retinopathy (ret-n-op-uh-thee) is caused when high sugar levels damage small blood vessels in the eyes. The retina (see graphic) is a cluster of cells that convert light into images by using rods and cones, which are cells that are named for their unique shapes. The retina sends the visual message on to the brain through the optic nerve, where the brain then translates the stimuli into usable information. For example, the retina may register a cluster of red and the brain may translate the cluster into an apple.

When the small blood vessels within the retina are damaged, the diabetic will likely lose vision. Or have severely limited vision. This form of blindness is irreversible, but can be avoided by carefully monitoring your blood sugar levels. In order to manage your retinopathy, you need to first determine which kind you have (there are three kinds):

Background retinopathy (ret-n-op-uh-thee) occurs when the blood vessels are damaged, but the damage does not affect vision due to its location. Be aware that damage can spread. Therefore, it is important to closely monitor your diabetes treatment to ensure that the damage does not spread.

Maculopathy (mac-u-lop-a-thy) occurs when the damage is in the macula. The macula is the part of the retina that allows us to see details, such as words on a page. Naturally, damage to the macula can be difficult to overcome and will usually require some lifestyle adjustments, such as the use of large-print books or even Braille.

Proliferative retinopathy (pruh-lif-uh-reyt ret-n-op-uh-thee) occurs when the eye does not receive enough oxygen through the bloodstream. Without proper oxygen, small blood vessels develop towards the back of the eye, which cause other vessels to become thin or completely closed. Proliferative retinopathy often leads to bleeding, clotting, scarring of the eye and even a detached retina. However, the affects of the condition can be reduced by quitting smoking, managing blood sugar levels, controlling stress and reducing your cholesterol.


Retinopathy Affects Diabetics Differently

Retinopathy affects Type 1 and Type 2 diabetics differently. When a person is diagnosed with Type 2 diabetes, he or she will generally show signs of retinopathy at the time of the diagnosis. (Retinopathy may even lead to a diabetes diagnosis). By carefully monitoring blood sugar levels, Type 2 diabetics can slow the progression of the condition, even when retinopathy cannot be reversed altogether.

However, people with Type 1 diabetes generally take longer to get full-blown retinopathy than Type 2 diabetics. The good news is that Type 1 diabetics rarely get the condition before they reach puberty and usually only develop retinopathy after they have had diabetes for five or more years. Type 1 diabetics should know that as diabetes progresses; the risk of permanent damage to the retina also increases.

According to the Diabetes Control and Complications Trail (DCCT), Type 1 diabetics who control their blood sugar levels with intense medication reduce the risk of developing retinopathy and other complications (such as kidney disease and nerve damage) by 50-75%. 

You can do a lot to prevent diabetes eye problems.

  • Keep your blood glucose and blood pressure as close to normal as you can.
  • Have an eye care professional examine your eyes once a year. 
  • Have this exam even if your vision is OK. The eye care professional will use drops to make the black part of your eyes' pupils bigger.
This process is called dilating your pupil, which allows the eye care professional to see the back of your eye. Finding eye problems early and getting treatment right away will help prevent more serious problems later on.

Ask your eye care professional to check for signs of cataracts and glaucoma.What other eye problems can happen to people with diabetes?

You can get two other eye problems' cataracts and glaucoma. People without diabetes can get these eye problems, too. But people with diabetes get these problems more often and at a younger age.

A cataract is a cloud over the lens of your eye, which is usually clear. The lens focuses light onto the retina. A cataract makes everything you look at seem cloudy. You need surgery to remove the cataract. During surgery your lens is taken out and a plastic lens, like a contact lens, is put in. The plastic lens stays in your eye all the time. Cataract surgery helps you see clearly again.

Glaucoma starts from pressure building up in the eye. Over time, this pressure damages your eye's main nerve (the optic nerve.) The damage first causes you to lose sight from the sides of your eyes. Treating glaucoma is usually simple. Your eye care professional will give you special drops to use every day to lower the pressure in your eyes. Or your eye care professional may want you to have laser surgery.

If you are planning to get pregnant soon, ask your doctor if you should have an eye exam.

If you are pregnant and have diabetes, see an eye care professional during your first 3 months of pregnancy.

Don't smoke. 

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