We all know how deadly diabetes could be. Unfortunately, India is the diabetic capital of the world. Most know that diabetes can affect most organs in the body if not all. Thus, it is critical to control blood sugar for most of our lives to prevent these complications.
One of the organs that diabetes impacts are the eyes. Ophthalmologists across the world continue to see advanced diabetic eye disease because patients did not get a timely eye examination or worse were not even aware that their eyes could go bad.
There are mainly two ways in which diabetes can affect the eyes:
1) The first and most important of the two is a condition called diabetic retinopathy. This is a disease that affects the retina of the eye. The retina is the light-sensitive layer situated at the back of the eye. Something like the film of the old cameras that we used to have. The blood vessels present in the retina get affected and start to bleed a little. The retina would show haemorrhages on the surface of the retina. At this time, your ophthalmologist would inform you that the retina is beginning to get affected and it’s important to control your blood sugar. However, there is no active treatment that your ophthalmologist will undertake to treat this bleeding.
As the disease progresses the blood vessels in the retina get more affected. Some stop supplying or reduce supplying blood to parts of the retina. These parts of the retina are now deprived of life-giving oxygen. The oxygen-deprived retina now starts suffocating and starts releasing a substance called VEGF, Vascular Endothelial Growth Factor. This substance promotes the formation of new blood vessels and these new blood vessels reach blood to the retina to supply oxygen.
But there’s one problem, these new blood vessels are fragile and bleed easily. This bleeding can lead to a sudden drop in vision in diabetics. These new abnormal blood vessels grow on the surface of the retina and sometimes contract or shrink. When they shrink, they occasionally pull the retina along with them causing a retinal detachment. These complications can lead to profound visual loss.
Treatment for these complications include eye lasers, eye injections and sometimes surgeries. The most important thing to remember is this, these changes are irreversible. When your ophthalmologist treats these conditions, it is to preserve the vision and not to improve it. If the vision improves because of treatment then everyone’s happy, but the purpose of treatment is to preserve what is left and not bring back what is lost. The other important thing to remember is that the earlier this condition is treated the slower it progresses.
Thus, routine eye examinations are a very important yearly appointment for all diabetics.
2) The second thing that diabetes causes in the eyes is the cataract. A cataract is something we have all heard off. Cataract too causes blurry vision but I have mentioned it as the second point because when a cataract is treated all of the vision, affected because of the cataract returns. Diabetics get cataract earlier than non-diabetics and these cataracts even though not very hard affect vision significantly.
Things which every diabetic should follow:
Control blood sugar
Daily exercise Yearly detailed and dilated eye examination
If someone has already developed diabetic retinopathy, then the eye examination should be done after every six months.
(Dr Deepak Garg is a Cataract and Squint specialist and Founder of
Eye Solutions, Mumbai)