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We will discuss how diabetes can affect your vision, the prevention, diagnosis, and treatments. Most weight is given for Diabetic Retinopathy; but other Diabetic eye conditions are also explained in this article.

How does Diabetes affect your eyes?

Diabetes affects the vision in many ways. Let’s begin the discussion with the least serious condition: Hyperglycemia induced blurred vision. Hyperglycemia is when you have high levels of blood glucose. It can cause swelling of the eye lens, which ultimately leads to blurry vision. This is only a temporary condition and can easily be reversed by lowering the blood glucose levels back to desired levels.

Moving on to the long term eye diseases, let’s learn about Diabetic retinopathy, Cataracts, glaucoma, and macular edema.

Diabetic Retinopathy

Light enters the eyes through the pupils, travels across the lens and lands on retina. Retina has the receptors that convert light waves into electric signals. The optic nerve carries these signals to the brain to create images. The retina has a rich blood supply to support this complex task.

eye cross section
eye cross section

When you have diabetes for a long period, it can damage these blood vessels and cause defects in the retina. This condition is called diabetic retinopathy. It has three stages.

The first stage is called Diabetes without retinopathy.

pericytes
pericytes

The second stage is called Non-Proliferative Retinopathy

micro-aneurysms
micro-aneurysms

The third stage is called Proliferative retinopathy

proliferative retinopathy
proliferative retinopathy

Diabetic Macular Oedema

We already know that retina is a collection of light receptors. The macula is the part of the retina that contains a vast majority of specialized light receptors called “Cons”.

macula
macula

Cons are sensitive only for certain wavelengths of light, such as green, blue or red, a trait that grants the ability to differentiate colors.

cons for colored vision
cons for colored vision

Therefore macular is the part of the retina responsible for central, high resolution, colored vision. When you have leaky blood vessels due to diabetic retinopathy, fluid can accumulate in the macula and cause blurred vision with floaters. Macular edema is usually treated with photocoagulation.

Glaucoma

anterior segment and posterior segments of eye
anterior segment and posterior segments of eye

Cataracts

The job of the eye lens is to focus the light beams onto the retina. To accomplish this task, a good functioning lens should be transparent.

Glucose is converted to a substance called Sorbitol in our body. The high osmotic properties of sorbitol can cause fluid accumulation within the tissues. To prevent this, sorbitol is broken down into fructose by an enzyme called sorbitol dehydrogenase.

sorbitol and cataract
sorbitol and cataract

Unfortunately, our eye lens hasn’t got much of this enzyme to breakdown sorbitol. Therefore in people with high blood glucose levels, sorbitol is accumulated in the eye lens and makes it swollen and opaque like a white cloud.

cataracts
cataracts

Cataract surgery is the treatment option when it causes vision impairment.

Symptoms of Diabetic Eye Diseases

Blurry vision, dark areas in the visual field, poor color vision, peripheral vision loss or floaters are the typical symptoms. Though its rare, complete vision loss can also occur in diabetes.

How to diagnose diabetic Eye Diseases?

How often should you undergo eye examination?

Yearly eye examinations are recommended for people with diabetes. This yearly screening should start right after the diagnosis in patients with type 2 diabetes and within 5 years of diagnosis in patients with type 1 diabetes.

How can you prevent or control diabetic eye disease?

Controlling blood glucose levels is the best way to prevent and control diabetic eye disease. Blood pressure and cholesterol levels should be optimized. And if you are a smoker, quitting smoking will markedly slow down the progression of diabetic eye disease.

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