Diabetes Head On 4th Edition April 2021 | Page 66

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Diabetes – An Eye Opener

By Dr Nilüfer Köylüoğlu
After the first eye exam , all adults with diabetes should have a dilated eye exam every year ). Exams may be needed more often than once a year if you have eye problems .
References
The effect of intensive diabetes treatment on the progression of diabetic retinopathy in insülin dependent diabetes mellitius . DCCT . Arch Ophthalmol 1995 ; 113 ( 1 ): 36- 51 . Effect of intensive blood glucose controlwith metformin on complications in overweight patients with type 2 diabetes ( UKPDS 34 ). UK Prospective Diabetes Study ( UKPDS ) Group Lancet 1998 ; 352:854-65 .
Ismail AM . Refractive changes in diabetes . Bull OphthalmolSoc Egypt 1972 ; 65 ( 69 ): 477-80 .
Rosenberg ME , Tervo TM , Immonen IJ , Müller LJ , Grönhagen-Riska C , Vesaluoma MH . Corneal structure and sensitivity in type 1 diabetes mellitus . Invest Ophthalmol Vis Sci 2000 ; 41 ( 10 ): 2915-21 .
Schultz RO , Van Horn DL , Peters MA , Klewin KM , Schutten WH . Diabetic keratopathy . Trans Am OphthalmolSoc 1982 ; 79:180-99 .
Kim SI , Kim SJ . Prevalance and risk factors for cataracts in persons with type 2 diabetes mellitus . Korean J Ophthalmol 2006 ; 20 ( 4 ): 201-4 .

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Diabetes mellitus ( DM ) is one of the most prominent endocrine diseases ophthalmologists encounter . It affects all human body cells and all layers in a human eye . The treatment ' s success rate about this lifelong disease and its complications depend on when the treatment starts and how long it can be sustained .
Diabetes has effects on vision in different ways .
Managment of the refractive errors in diabetes .
A sudden vision change may indicate high blood sugars . If a middle-aged patient using plus eyeglasses for near suddenly has clear near-sight without glasses , it could result in ( i ) early-stage nuclear cataracts or ( ii ) high blood sugar . For adults that experience this scenario , eliminating the risk of diabetes is vital for successful early diagnosis and treatment .
All refractive surgeries ( PRK , LASEK , LASIK ) can be problematic for wound recovery due to diabetes .
Ocular Surface and Cornera in diabetes
People with diabetes may experience impaired tear quality and blurriness caused by dry eye syndrome , treated using artificial tears regularly . In severe cases , advanced treatment options need to be explored to prevent damage to the cornea .
Diabetes negatively affects the immune system . One can experience eyelid inflammation . Treatment should be meticulous , dealing with blepharitis , stye or conjunctivitis in diabetic patients ( Picture 2 ).
If one wears a contact lens , some risks are eye irritation ( not felt by the patient due to weakened cornea reflex ( 4 )). Checks for slightest abrasions or erosions ( Picture 3 ) may lead to permanent cornea inflammation ( Picture 4 ), equip patients with the necessary information and warnings ( 5 ).
Conjunctivitis
PICTURE 2
If one wears a contact lens , some risks are eye irritation ( not felt by the patient due to weakened cornea reflex . Checks for slightest abrasions or erosions may lead to permanent cornea inflammation , equip patients with the necessary information and warnings .
Diabetes effects on intraoculare pressure and glaucoma treatment .
Glaucoma develops due to damaged optic nerves due to high intraocular pressure . Measuring intraocular pressure based on cornea thickness is essential . As deemed necessary by the Ophthalmologist , patients have prescribed glaucoma medication based on various observations and considerations relating to intraocular pressure and cornea thickness measurements .
Diabetes and other conditions can affect medication choices .