How Does Diabetes Affect the Eyes?
Diabetes is a huge and rapidly growing public health issue, being quite common and causing many impacts on the body. It is especially a problem if it impacts the eyes.
Some patients with diabetes might not be fully aware of how important managing their blood sugar levels can be for maintaining their eyesight.
This article will explain the basics of diabetes, how it affects the eyes, and what can be done to prevent and treat this.
Introduction to Diabetes
Diabetes is an increased concentration of sugar or glucose in the blood owing to decreased amount or efficacy of the hormone insulin, which normally acts to shuttle glucose into cells or storage molecules.
While sugar is needed by all of our cells as energy for them to function, excessive sugar in the blood vessels damages them.
Type 1 diabetes mellitus comes on in childhood and results from autoimmune damage to the cells that produce insulin. Type 2 diabetes mellitus occurs later in life, usually middle age, and is a consequence of insulin having reduced effect on target cells.
Type 2 diabetes is associated with lifestyle health factors, like obesity, a high sugar diet, and lack of exercise. Diabetes is also associated with other systemic conditions like high blood pressure and high cholesterol.
Diabetes and the Eyes
Diabetes is a disease of blood vessels, which means it can affect any part of the body. Diabetes can also impact almost every part of the eye.
In the cornea at the front of the eye, excessive blood sugar concentration can damage the nerves that allow for sensation.
This reduces the ability of the patient to sense damage or irritation to this area, and also impedes the ability of the tissue to heal and regenerate, leading to chronic damage.
Excessive blood sugar also seeps into the fluids inside the eye and from there can enter the natural crystalline lens, which provides part of the refractive power of the eye.
This can cause large jumps in the prescription, leading to blurry vision that glasses will only fix part of the time.
Diabetes can also cause early cataracts, which are cloudings of the lenses within the eyes, or partial paralysis of certain muscles that move the eyes and eyelids.
The most damaging effects of diabetes, however, occur in the iris and the retina and are the result of blood vessel damage with resulting oxygen and nutrient deprivation of target cells.
Diabetic damage leads to bleeding and swelling in the retina at the back of the eye, leading to blurry vision. If this persists, new and leaky blood vessels will begin to grow in disordered ways.
At the back of the eye, these new blood vessels can burst and cause rapid decline in vision due to bleeding, but they can also cause scarring and pulling on retinal tissue and lead to retinal detachment, which is likely to cause profound vision loss.
In the iris, the colored part of the eye, these new vessels can grow and plug the drainage network of the eye, leading to increased eye pressure and damage as a result.
Management and Treatment
The primary way to prevent diabetic eye damage is to control blood sugars as best as possible, through lifestyle modifications and medications as directed by one’s family doctor or endocrinologist.
If diabetes is advancing in the eyes, treatments include laser and injections, along with managing any complications that occur.
Laser treatment aims to clear damaged tissue and decrease the nutrient need for retinal tissues.
Injections are used to deliver medications to the back of the eye that inhibit the growth of the new and fragile blood vessels, along with treating any swelling that has occurred.
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