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Diabetic patients are at a greater risk of eye ailments if they do not keep the blood sugar level under control.
In fact, Diabetes is the leading cause of blindness in adults between the ages of 20 to 74 years.
High blood sugar causes swelling in the lens of the eye which affects the patient’s vision and makes it blurred. The solution to this problem is to keep the blood sugar level under control.
The ideal blood sugar level is 70-130 milligrams per deciliter or mg/dL before meals, and less than 180 mg/dL, one to two hours after meals. Maintaining the blood sugar level will result in getting the vision back to normal. However, this would take as long as 3 months.
Diabetics: Importance of routine eye care
Apart from blurred vision, Diabetic patients are also susceptible to the following three major eye ailments:
- Diabetic Retinopathy
To prevent eye problems Diabetic patients should:
- Control Blood Sugar Levels and,
- Keep High Blood Pressure under control
Cataract and Diabetes
Diabetes increases the chances of Cataract, which is a clouding of the transparent lens of the eye. Cataract may cause hazy & impaired vision and glare sensitivity.
The symptoms of Cataract include:
- Blurred Vision
- Poor vision especially at night
- Double Vision
- Multiple Images
- Colors seem less bright
- Problems with glare, such as, headlights, sunlight and more
- Frequent change in eye power
The first treatment option for Cataract is to change the prescription and eyeglasses including bifocals & contact lenses. If this does not help, then the patient needs to undergo a Cataract Surgery, which involves removal of the clouded lens and its replacement with a clear artificial one. This surgery, conducted on an outpatient basis, is very safe.
Glaucoma and Diabetes
Glaucoma is the condition where the fluid inside the eye does not drain properly. This forms extra pressure on the eye which may damage nerves and blood vessels, causing damaged vision.
The symptoms of Glaucoma include:
- Seeing Halos around Lights
- Loss of Vision
- Pain and Redness in the Eyes
- Nausea or Vomiting
- Narrowing of Vision
- Watering Eyes
The treatment modalities for Glaucoma include:
- Medication: Eye drops help in reducing formation of the fluid in the eyes or increase its outflow.
- Laser Surgery: This surgery increases the outflow of the liquid from the eyes of patients suffering from Open-Angle Glaucoma. It also eliminates fluid blockage for patients with Angle-Closure Glaucoma.
- Microsurgery: This surgical procedure, known as Trabeculectomy, creates a new channel to drain the fluid in the eye and hence reduces the intraocular pressure.
Some Diabetic patients suffer from an uncommon type of Glaucoma, called Neovascular Glaucoma. New blood vessels grow on the iris of the eye, which block the normal flow of the fluid, increasing the eye pressure. This type of Glaucoma is difficult to treat, though Laser Surgery helps in reducing the vessels.
Diabetic Retinopathy is the leading cause of irreversible blindness. It occurs when there is damage to the small blood vessels that nourish the tissue & nerve cells in the retina of the eye.
The symptoms of Diabetic Retinopathy include:
- Blurred Vision
- Double Vision
- Blind or Blank Spots in the Vision
- Vision blocked by a Veil, Clot, or Red Streak
The treatment for Diabetic Retinopathy depends on the type of the disease and its stage. Nonproliferative Diabetic Retinopathy is the early stage of Diabetic Retinopathy which does not need any immediate treatment. Keeping the Blood Sugar level under control helps in this case. Severe Nonproliferative Diabetic Retinopathy may need surgery. Proliferative Diabetic Retinopathy is the advanced stage of Diabetic Retinopathy which needs immediate surgical treatment.
The treatment modalities available for Diabetic Retinopathy include:
- Focal Laser Treatment: Also known as Photocoagulation, this treatment stops or lowers the leakage of blood and fluid in the eye.
- Scatter Laser Treatment: Also known as Panretinal Photocoagulation, this treatment shrinks the abnormal blood vessels with the help of scattered laser burns.
- Vitrectomy: This procedure removes blood from the vitreous of the eye, as well as any scar tissue causing discomfort to the retina.
Ophthalmologist and Endocrinologist are the subject matter experts.
Tests and Investigations
Diabetic patients need to undergo various tests to keep a check on eye ailments. These tests include:
- A careful Refraction and Eye Examination by an Ophthalmologist or Optometrist
- Fluorescein Angiography Test by a Retinal Specialist and,
- Optical Coherence Tomography (OCT)
Prevention to Avoid Recurrence
Every Diabetic patient must undergo regular eye checkups. A thorough eye exam helps detect problems in advance, making it easy to treat. This also helps to prevent vision loss. It is important for the patient to control his blood sugar level and blood pressure level.
Since Diabetes is a lifelong disease, recurrence of eye ailments is possible, even after surgery. Hence, regular eye care is a must. Diabetic women when considering pregnancy should have an eye exam before and during pregnancy.