“Diabetes And The Eye”- 5 ways Diabetes affects your eyes and your vision
Have you ever wondered why your diabetologist asks you to get your eyes checked? That’s because diabetes can affect your eyes and cause disturbances in your vision. Some of the eye conditions caused due to diabetes are irreversible and hence a regular eye check up is recommended once a year for all diabetics.
The most important step to keep your eyes healthy should be a strict control of your blood sugars. Various studies have proven that diabetes control is the single most effective way to postpone, if not control, eye problems in diabetes. Moreover, people with long standing diabetes (>10 years) have to be extra careful about their diabetes management in order to protect their eyes and vision.
So how does diabetes actually affect your eyes?
Glaucoma is optic nerve damage caused mainly due to increase in the eye pressure. Due to the pressure build up inside the eye, the damage caused to the optic nerve is irreversible and hence needs to be addressed before the damage starts. Unfortunately, Glaucoma does not cause any identifiable symptom to the patient in the very early stages and hence an annual eye examination helps identify any early signs or increase in eye pressure. This early detection may prevent end-stage Glaucoma.
2) Lid Infections:
Lid infections are more common in people with uncontrolled or fluctuating sugar levels. These are caused mainly by bacteria present in and around the lids and the conjuctiva and can be recurrent. The most common bacteria identified is the Staphylococcus bacteria. The acute condition needs to be treated with antibiotics and efforts need to be made to control diabetes to prevent recurrent infections.
3) Diabetic Retinopathy:
This is the 3rd most common eye condition seen in Diabetes. Diabetic retinopathy needs to be monitored regularly and any signs of proliferative disease needs urgent management. Changes caused in the retina due to retinopathy are irreversible and can be vision threatening. A good rule-of-the-thumb is strict diabetic control and an annual visit to an eye surgeon for a retinal examination. Most centers now provide patients with photographs of the retina, which can be used to evaluate progression of the retinal condition over the years.
Diabetes does not directly cause cataracts but hastens the cataractogenesis or cataract formation in the eyes. Patients with cataracts complain of blurry or diminished vision even with their glasses. Once cataracts are formed, surgery is the only treatment. We mostly see diabetics requiring cataract surgery earlier in life than their non-diabetic counterparts. The cataracts in diabetes are more tough and leathery in nature and sometimes can be quite challenging to operate. Also, due to a compromised retina, long term vision related complications are seen more frequently in diabetics, especially in people who have poor sugar control.
5) Dry Eye Disease:
Dry eye is the most common eye condition seen in diabetics. Almost every diabetic patient has some degree of dry eye. In this condition, it is the quality of the tear film which is affected which causes various symptoms such as irritation, watering, burning and even itching. Recent studies show that increased inflammatory markers in tears is one of the main reasons for dry eye, especially in Diabetes. Dry eye needs to be evaluated in every person suffering from diabetes and treated accordingly.
In conclusion, diabetes can affect any part of the eye, right from the eyelids and tear film in the front to the retina at the back. Most of the conditions can be vision threatening if left unchecked. A simple eye examination undertaken annually along with strict diabetes control is actually the single most effective way of detecting problems with the eye, even before there are any symptoms or complaints. Fortunately, the earlier the problem is detected in the eye, the easier it is to treat/control leading to better visual outcomes. Your annual visit to the eye doctor goes a long way to preserve your vision and monitor the health of your eyes.
MD MS FPRS (NN) FICO (UK) FAICO
Senior Consultant, Cataract & Cornea Refractive Surgeon,
Ghodbunder Road, Thane W