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Diabetes Related Eye Conditions

Diabetes And Your Eyes

Diabetes can affect your eye in a number of ways:

  • The most serious eye condition associated with diabetes involves the network of blood vessels supplying the retina. This condition is called diabetic retinopathy.
  • The unusual changes in blood sugar levels resulting from diabetes can affect the lens inside the eye, especially when diabetes is uncontrolled. This can result in blurring of vision which comes and goes over the day, depending on your blood sugar levels.
  • A longer-term effect of diabetes is that the lens of your eye can go cloudy, this is called a cataract.
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Not everyone who has diabetes develops an eye complication. Of those that do, many people have a very mild form of retinopathy which may never progress to a sight threatening condition.

Diabetic retinopathy
The most serious complication of diabetes for your eye is the development of diabetic retinopathy. Diabetes affects the tiny blood vessels of your eye and if they become blocked or leak then the retina, and possibly your vision, will be affected. The extent of these changes determines what type of diabetic retinopathy you have. Forty per cent of people with type 1 diabetes and 20 per cent with type 2 diabetes will develop some sort of diabetic retinopathy.

Background diabetic retinopathy
This is the most common type of diabetic retinopathy and many people who have had diabetes for some time will have this early type. The blood vessels in the retina are only very mildly affected, they may bulge slightly (microaneurysm) and may leak blood (haemorrhages) or fluid (exudates). As long as the macula is not affected, vision is normal and you will not be aware that anything is wrong. Your retinal screening test will keep a close check on these early changes and ensure that any signs of progression to more serious stages of retinopathy are detected early.

Proliferative diabetic retinopathy
If diabetic retinopathy progresses, it can cause the blood vessels in the retina to become blocked. These blockages, when affecting a significant part of the retina, can result in areas of the retina becoming starved of oxygen. This is called ischaemia. If this happens your eye is stimulated into growing new vessels, a process called neo-vascularisation.

Diabetic maculopathy
Diabetic maculopathy means that your macula is affected by your diabetes. This may occur either with background, or proliferative retinopathy. If this happens, your central vision will be affected and you may find it difficult to see detail such as recognising people's faces in the distance or seeing detail such as small print. The amount of central vision that is lost varies from person to person. However, the vision that allows you to get around at home and outside (peripheral vision) is not affected. Some people develop a type of maculopathy called diabetic macular oedema. This causes fluid to collect in your macula which can cause further problems with your central vision. Most diabetic maculopathy can be treated with a laser, and more recently injections, with the aim of preserving as much vision as possible, although vision may improve in some treated eyes.

Reducing risk
Risk factors for developing diabetic retinopathy can be divided into those you are able to control and those you cannot. Good diabetic control significantly lowers your risk of retinopathy.
The following actions reduce your risk of developing retinopathy or help to stop it from getting worse:

  • Controlling your blood sugar (glucose levels).
  • Tightly controlling your blood pressure.
  • Controlling your cholesterol levels.
  • Keeping fit, maintaining a healthy weight and giving up smoking are all part of good diabetes control. Nerve damage, kidney and cardiovascular disease are more likely in smokers with diabetes. Smoking increases your blood pressure and raises your blood sugar level which makes it harder to control your diabetes.
  • Regular retinal screening. The most effective thing you can do to prevent sight loss due to diabetic retinopathy is to attend your retinal screening appointments. Early detection and treatment prevents sight loss.

Source: rnib

07-July-2014

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