Diabetic Eye Care

Cataract formation in patients with diabetes often occurs at a much quicker rate than in patients with age-related cataracts. In addition to the formation of cataracts, several other problems can arise in the eye as a result of diabetes. These include refractive shift, diabetic retinopathy, and diabetic macular edema.

Refractive Shift

One of the most common conditions affecting diabetics, a refractive shift, can occur before the patient knows that he or she has diabetes. The variations in an individual’s glucose level that are associated with diabetes can lead to fluctuating fluid levels in the eye’s crystalline lens.

When glucose levels are high, fluid levels rise and the lens thickens, causing a myopic (nearsighted) refractive shift.

When glucose levels drop, so do fluid levels, resulting in a thinner lens and a hyperopic (farsighted) refractive shift.

Because a diabetic’s glucose level can fluctuate widely without treatment, it can be extremely difficult to accurately diagnose a diabetic patient’s refractive error. Blurred vision can also occur if the blood sugar level increases suddenly, and can last for several weeks.

Diabetic Retinopathy

Diabetic retinopathy is a serious, but usually preventable, problem that can occur in patients who have had diabetes for many years.Retinopathy is defined as non-inflammatory damage to the retina. It is generally caused by circulatory problems with blood vessels in the eye. Eventually these vessels collapse and deteriorate.

Over time this deterioration affects blood flow to the macula, leading to loss of fine vision and finally blindness. In its early stages, it rarely causes vision problems and is only detectable by a trained physician. However, it can progress to a more severe form called proliferative diabetic retinopathy (PDR) and cause permanent vision loss.

Laser surgery and other procedures are very effective in treating diabetic retinopathy, and can reduce the risk of vision loss to less than 5 percent in conjunction with a good glycemic control strategy.

Diabetic Macular Edema

Diabetic macular edema, which is closely related to diabetic retinopathy, is defined as a swelling of the retina and macula as a result of blood leakage from damaged vessels in the eye.

As the macula and retina thicken with fluid, the patient’s vision becomes progressively distorted, and eventually long-term damage and vision loss will occur without treatment. Fortunately, there are effective laser treatments designed to address macular edema as well.

Because many types of diabetic eye conditions do not show symptoms until it is too late for treatment, it is crucial for patients with diabetes to have their eyes examined regularly by an ophthalmologist. Early detection and treatment is the only way to address these conditions without partial or total vision loss.

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