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Eye Complications of Diabetes

It’s true. Diabetics have a higher risk of blindness than those without the disease. That fact coupled with the superior prognosis of early intervention, makes it easy to understand why optometrists and doctors say routine eye care is absolutely essential. Below, we’ll discuss what your eye doctor is looking for during a diabetic eye exam.  

As the incidence of diabetes increases, it is important to spread awareness about the risks and proper preventative care for diabetes patients. November is Diabetes Awareness month, so read on!

Diabetics are at greater risk of for a number of eye problems.  

Diabetic Retinopathy:

Diabetic retinopathy is the term used for the disorders associated with diabetes that cause progressive damage to the retina.  The longer a patient has had diabetes, the more likely it is that he will develop these conditions which can be very serious, vision-threatening complications. 

There are two types of retinopathy: nonproliferative and proliferative. 

Nonproliferative retinopathy, which is the most common form, is when capillaries at the back of the eye become weakened and may start to leak blood and fluids. Nonproliferative retinopathy, which often has no symptoms, can be characterized as mild, moderate or severe, depending on how many blood vessels are affected and becoming blocked. This type of retinopathy usually doesn’t require treatment and doesn’t cause vision loss, unless the leaking fluid ends up in the macula where the eye focuses – a condition called macular edema. If this happens, vision can be blurred and even lost so preventative treatment is essential.  

Proliferative retinopathy is much more severe. This is when so much damage is done to the blood vessels that they begin to close off. New blood vessels begin to grow in the retina as a response to this deterioration. The new and weak vessels can leak blood, impairing vision, or can form scar tissue which can distort the retina or cause a retinal detachment.

Proliferative retinopathy requires urgent referral to an ophthalmologist for treatment. While it usually takes years to develop, some instances of proliferative retinopathy can occur within weeks or months if blood sugars are not well-controlled. Pregnancy can also accelerate proliferative retinopathy in known diabetics. Yet if detected early, treatment can be done successfully. 

Like high blood pressure, there are often no warning symptoms until advanced stages of diabetes. It is best to get checked each year by an optometrist. If you experience any changes in your vision such as spots in vision, flashes of light, blurred or double vision (rarely pain), make an appointment with your eye doctor immediately. Treatments do exists for retinopathy and many of them are successful in repairing damage and sometimes even restoring vision.

Cataracts: 

Cataracts are a clouding of the lens of the eye which blocks light from entering and impairs vision. While cataracts are a fairly common and treatable condition, people with diabetes are 60% more likely to develop the condition and often get them at a younger age. Those with the condition also may experience vision fluctuation which occurs from sugar levels affecting the lens of the eye. Cataracts often progress faster in diabetics as well. In serious cases of cataracts, a surgical procedure is done to remove the natural lens of the eye which can sometimes cause complications in diabetic patients that may already have symptoms of other conditions such as diabetic retinopathy.

Glaucoma:

Glaucoma is a serious condition where pressure builds up in the eye causing damage to the retina and optic nerve and eventually if left untreated, blindness.  Diabetics are 40% more likely to develop glaucoma and the risk increases with age and the amount of time the individual has had diabetes. There are treatments for glaucoma including medications and surgery but early detection and treatment are essential to prevent permanent vision loss. Glaucoma is often called the “silent thief of sight” because vision loss often doesn’t occur until significant damage is done. Therefore, yearly eye exams are essential. 

Cornea Alterations:

Diabetics may experience reduced sensitivity in their cornea. This means that contact lens wearers that are diabetics should be more cautious, as they develop higher tolerance if the lens irritates the eyes and may be at greater risk of infection. 

Eye Muscle Disturbance:

More advanced diabetes cases can show restriction of eye muscle movement due to nerve palsy. 

 

For diabetics, the key to early detection and treatment – and therefore preserving your vision – is to have your eye health monitored on a regular basis. Get your eyes examined every year by an optometrist and if you experience any changes in your vision such as spots, floaters, blurred vision or pain, make an appointment with your eye doctor immediately. 

Have you ever thought about how vision works? Seeing is an incredible gift made possible by a system in which the eye and the brain process visual information from the outside world. If any step of that process does not function properly, vision will be impaired.

Similar to a camera, the eye transmits light from the world around us into an image that we can perceive. Certain parts of the eye even function like the different parts of a camera such as the shutter, the lens and film (if we can hearken back to the days when we used film in cameras). Here is a quick breakdown of the fascinating way our eyes and brain enable us to see and experience the world around us:

The Vision Process

Light reflected from an object in our field of view is gathered by the cornea which is essentially the clear “window” to our eye. The cornea then refracts the light rays through the pupil (the center of the iris where light enters the eye). The iris, which like the shutter of a camera will enlarge and shrink based on how much light is coming in, then passes the image onto the crystalline lens. Just like a camera lens, the lens in the eye focuses the light rays, projecting them to a point at the back of the eye called the retina, where the image will appear upside down. The retina contains a thin layer of color-sensitive cells called rods and cones that perceive color.

From the retina, the visual signals travel to the brain via the optic nerve. The brain receives information from both eyes and must then converge the images (and flip them right side up) to get a complete picture.

Vision Problems

A breakdown in vision can happen at any point in this process. From the muscles that control the eyes, to the parts within the eye, to the pathway to the brain. Sometimes vision impairment is due to technical problems with the eye receiving the information and passing the signal on, such as convergence insufficiency (inability to coordinate the eyes to converge on one point), myopia (nearsightedness) or cataracts (clouding of the lens).

Other times, the eyes might work perfectly, but there is a problem with the brain interpreting the signals it receives. In these cases we can’t “see” in the traditional sense, because our brains aren’t able to properly “read’ the signals or we don’t know what we are looking at. This is the case for some learning disorders that are caused by the visual processes in the brain such as dyslexia.

As you can see, vision is quite a complicated process. A simple vision exam isn’t always able to determine vision problems, especially in children which is why it is so important to have regular comprehensive eye exams, to measure the health of the eye and all of its parts.

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