Diabetes is the Leading Cause of Blindness in 20 – 74 Year Olds

The statistic that “diabetes is the leading cause of new cases of blindness among adults ages 20–74 years” is startling. Those recently diagnosed with diabetes mellitus may be overwhelmed with the level of care they must provide for their body, but being dismissive can lead to devastating eye problems.

High blood sugar increases the risk of diabetes related eye problems. It causes the lens of a person’s eye to swell, which can result in temporary blurred vision. Getting your blood sugar under control can restore your normal vision, but this can take months. It is imperative that before and after each meal you check your levels to keep the blood sugar in the correct range.

Blurred vision may, however, be a symptom of a more severe eye problem; one that might not go away with time. Cataracts and glaucoma are eye diseases that can result from diabetes mellitus if you do not go to regular ophthalmology visits.

Developing cataracts, a clouding of the lens, will make it very difficult to focus as it creates a blurred vision field. Although, cataracts are typically associated with older folks, diabetes doesn’t discriminate and anyone who doesn’t keep their blood sugar under control can develop cataracts. The treatment is typically surgery with a lens implant.

Glaucoma occurs when the fluid inside the eye isn’t able to drain properly. This causes pressure on the nerves, which can result in a change of vision. Unfortunately, there are no symptoms of glaucoma until the disease is advanced and there is an apparent loss of vision. Those who are diagnosed with diabetes will be under careful watch and continually monitored with glaucoma screenings during their eye doctor visits.

There are so many reasons to keep up with your diabetes management. There is no reason that anyone should suffer from eye disease because of their diabetes. Being attentive to your care, making and keeping eye doctor appointments will help you keep your eyes safe.

http://diabetes.niddk.nih.gov/dm/pubs/statistics/#Blindness

Diabetes – Effects on eyes. (diabetic retinopathy)

Eyes are profoundly affected in diabetes. Different manifestations of diabetic eyes are in the form of cataracts involving lens, retinopathy involving retina and glaucoma involving intraocular pressure and optic nerve.

Diabetic Cataracts :

Cataracts are white opacities in the lens of the eyes. Formation of AGEs (Advanced Glycation End products) in the eye lens causes premature formation of cataracts. This depends on the duration of the diabetes status. Manifested by halos around lights, blurred vision, vision problems at night, sensitivity to light and glare. The treatment to this is by surgery.

Diabetic Retinopathy :

This is the most common cause of blindness. As a part of microvascular disease process, retinal vessels are affected by thickening of the basement membrane and the number of pericytes around blood vessels which support them, are decreased making the blood vessel wall weak. This weak wall can’t withstand the blood pressure and leading to microaneurysms at one stage of retinopathy. It is divided in to two stages.

Background retinopathy – Presents with retinal edema, exudates, microaneurysms and hemorrhages in retina. Cotton-wool spots due to ischemia of retina. In 1 – 2 months, these cotton-wool spots resolve leaving retinal depression.

Dot and blot hemorrhages are intra-retinal and are due to increased vascular permeability. Splinter hemorrhages are in nerve fiber layer of retina. Macular edema is due to vascular permeability and more common in this phase of retinopathy than proliferative phase.

Proliferative retinopathy – Presents with proliferation of retinal blood vessels and blood vessels in iris and optic nerve. These blood vessel generation is said to be due to release of growth factors. The blood vessels in optic nerve and retina rupture easily giving rise to vitreous hemorrhages. When these hemorrhages become fibrotic, they pull the retina causing retinal detachment.

When to see an opththalmologist?

Every patient need to be their eyes checked as soon as diabetes was diagnosed. And every year checkups and follow-ups are necessary.

Ophthalmologist dilates the pupil and see the inside of the eyes. Diabetics need regular eye checkups. Sometimes other investigations like fluorescein angiography (where certain dye is injected in to blood and the retinal vessels are checked through an opthalmoscope) and optical coherence tomography (that gives high resolution images of retina) are conducted.

Treatment is by good glucose control, hypertention and cholesterol treatment and photocoagulation. Photocoagulation treats the retinal vessels to stop leakage of fluid and blood.  Sometimes vitreous is removed called vitrectomy. This is done to stop retinal detachment and improve the sight.

Glaucoma :

Usually it is of open-angle type. It is of slow nature and presents after significant visual loss occurs. So a high index of suspicion is necessary to diagnose this condition. Here the patient often assumes that he requires new reading glasses. And loss of peripheral vision leading to tunnel vision. Eye pain, blurred vision, halos around light and redness of eyes are some of the manifestations of glaucoma. Topical eye drops and surgery are considered.

[tags]diabetic retinopathy, diabetes, diabetic cataracts, diabetic[/tags]