Diabetic Eye Disease

Patients with Type 2 diabetes are at increased risk for diabetic eye disease. Diabetic eye disease is a group of eye problems that can affect people with diabetes. These conditions include diabetic retinopathy, diabetic macular edema, cataracts and glaucoma.

How does diabetes affect your eyes

High blood glucose levels can change fluid levels in the eye or cause swelling in the tissues in the eyes that help you to focus causing blurred vision. This type of blurry vision may be temporary and goes away when your blood sugar levels get normal. But if the blood glucose stays high over a prolonged time, it can damage the tiny blood vessels in the back of your eyes. This damage can begin during prediabetes. These damaged blood vessels may leak fluid and cause swelling. New weak blood vessels may also begin to grow. These blood vessels can bleed into the middle part of the eye leading to scarring or cause dangerously high pressure inside your eye. Retina in your eye is what senses light and turns it into signals that your brain decodes so you can see the world around you. Damaged blood vessels can harm the retina causing diabetic retinopathy. When disease gets worse, some blood vessels close off and new blood vessels grow or proliferate on the surface of the retina which can lead to serious vision problems. 

What are the common symptoms of diabetic eye disease

Often, there are no early symptoms. When symptoms do occur, they include blurry or wavy vision in the centre of your field of vision, frequently changing vision, blank or dark areas in your field of vision, poor colour vision, floaters which are spots or dark strings that come and go, flashes of light. Diabetic retinopathy, if let untreated can ultimately lead to vision loss and can develop into diabetic macular edema. 

What are the most essential things one should do to protect your eyes

To prevent diabetic eye disease or to keep it from getting worse, first of all, you should need to  manage your diabetes well and keep it under good control. Try and keep your glycated hemoglobin levels below 6 as far as possible. You should also control your blood pressure and cholesterol levels. If you are a smoker, quit smoking as early as possible. It is compulsory that one must have a dilated eye examination at least once in a year. 

What are the various Treatment Options for diabetic retinopathy

You may need treatment for diabetic retinopathy if it has affected the central or macula area of the retina. If abnormal blood vessels have started to appear on the retina, which is called proliferative retinopathy or when your peripheral vision has been severely damaged. Treatment works very well to prevent delay or reduced vision loss. As soon as the condition is found, the easier it is to treat. In early stages of diabetic retinopathy, controlling your diabetes can help prevent vision problems developing. Treatment for advanced diabetic retinopathy include laser treatment or photocoagulation, eye injections, eye surgery etc.  

Laser treatment

Laser treatment is used to treat new blood vessels in the back of the eyes in the advanced stage of diabetic retinopathy. Laser treatment usually works well to prevent vision loss. If it is done before the retina is severely damaged, it may also help in macular edema. Severe proliferative retinopathy may be treated with a more aggressive laser therapy called the scatter or the panretinal photocoagulation. It limits the growth of new blood vessels across the back of your retina. Injection of anti-VEGF or the vascular endothelial growth factor slows the growth of the abnormal blood vessels in the retina. These injections may also shrink the new blood vessels in proliferative retinopathy. Commonest anti-VEGF medicines used are the aflibercept or the ranibizumab. It is also used in macular edema. Steroids may also be injected into the eyes in certain situations. Vitrectomy is the commonest eye surgery done in diabetic retinopathy. It is usually done when there is bleeding or vitreous hemorrhage or retinal detachment. Surgery is also done when severe scar tissue is formed. The key aspect is preventing occurrence of diabetic eye disease and this includes yearly eye examination, good blood sugar control, control of hypertension and lipids, quit smoking, and regular exercises. 

I conclude with the words of the famous American author Helen Keller. She once said, “Of all the senses, sight must be the  most delightful”. So your eyes are very precious, protect them.