Diabetes and the Eyes

 
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DIABETES AND THE EYES

WHAT IS DIABETES?
Diabetes is a disease in which the body is unable to control its blood sugar levels. This can be due to the fact that your body does not produce insulin (Type I Diabetes) or the body becomes resistant to insulin (Type II Diabetes). Insulin is an important hormone produced by the pancreas which controls blood sugar levels within the body.

Individuals with Type I diabetes require constant injections with insulin to maintain a normal blood sugar level. It is less common than Type II diabetes and is usually diagnosed in children.

Type II diabetes is more common in adults. Individuals with Type II diabetes often rely on changes in lifestyle and weight loss to improve their condition.

 

HOW DOES IT AFFECT THE EYES?
Prolonged hyperglycemia (elevated levels of blood sugar) is a major cause of blood vessel complications in diabetes.  The eyes have a delicate system of small blood vessels that can be damaged by elevated blood sugar levels resulting in diabetic retinopathy.

Diabetic retinopathy describes several changes that can occur to the retina as a result of uncontrolled diabetes. In the early stages of diabetic retinopathy, damage to blood vessels in the eyes leads to haemorrhages, fluid accumulation, as well as the death of nerve cells. These subtle changes are not detected by an individual and are usually picked up in routine eye check-ups. As the disease progresses and further blood vessels are lost, this leads to a lack of oxygen being provided to the retina. Chemicals called Growth Factors are then released by the body to promote the growth of small leaky blood vessels (since there is a lack of oxygen), which can lead to further complications in the eyes. This final stage of diabetic retinopathy is called proliferative diabetic retinopathy and can lead to serious consequences to eye health and permanent vision loss.

Other regions of the eyes can also be affected by diabetes. For example, cataract formation occurs more frequently and at an earlier age in diabetic patients than in non-diabetics. [2]

 

WHAT HAPPENS WHEN SIGNS OF DIABETIC RETINOPATHY ARE DETECTED BY AN OPTOMETRIST?
Because signs of diabetic retinopathy indicate uncontrolled blood sugar levels, if subtle signs of diabetic retinopathy are present, a referral to your Doctor is required to get blood sugar levels under control. Follow up visits are scheduled with your Optometrist to monitor changes in the eyes.

If proliferative diabetic retinopathy is present, a referral is made to an Ophthalmologist who assesses the eyes and determines if further treatment is required. This can be in the form of intraocular injections in the eye with a medication that prevents the further growth of new blood vessels in the eyes.

 

WHAT CAN YOU DO?
Serious complications of diabetes can be avoided. If you are aware that you have diabetes it is important to:

  •  Monitor blood sugar levels and have regular check-ups with your doctor

  • Have regular eye examinations or be involved in a diabetic retinopathy screening

 

REFERENCES: 

[1] Ministry of Health Website: Diabetes. Reference here

[2] Kiziltoprak, H., Tekin, K., Inanc, M., & Goker, Y. S. (2019). Cataract in diabetes mellitus. World journal of diabetes, 10(3), 140–153. https://doi.org/10.4239/wjd.v10.i3.140

 
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