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Normal eye Glaucoma
Cataracts
Eye with Retinopathy ( DR )
NOTE : Diabetic retinopathy ( a complication of diabetes ) can damage the blood vessels in your retina . It can cause abnormal blood vessels to grow in your eye , blocking your eye ' s natural drainage system and eventually lead to other types of glaucoma . Neovascular glaucoma is irreversible once you are diagnosed with it , so early treatment of diabetic retinopathy is very important .
Cataract Management in Diabetes
The eye lens gets oxygen and glucose from the aqueous humor , which is the fluid that fills the front of the eye . If someone does not control their glucose levels , then high sugars can cause the eye ’ s lens to swell .
People with diabetes may have cataracts at early ages and progress faster than non-diabetic patients .
If a cataract alters the patient ' s vision , it will be considered an indication for surgery . Postoperative eyesight is based on the retina ' s healthiness , analogous to the film in a camera .
Extraocular muscles , eye movements and diabetes
If metabolic control is poor , cranial nerves that regulate extraocular muscles ' movements might generally be damaged . It may cause conditions like ptosis , strabismus or diplopia .
Diplopia ( Double vision ) may impair daily activities such as walking and driving . The condition is temporary , rather than proceeding with a permanent solution like surgery . Strabismus ( eyes do not align with each other ); prismatic eyeglasses are used if strabismus is low , and botox should be applied if the degree of strabismus is high to maintain comfort in daily activities .
Diabetic Retinopathy
Early-stage diabetic retinopathy is called non-proliferative diabetic retinopathy ( NPDR ). The condition develops when capillary vessels of the retinal circulatory system are damaged . A normal vein never has leakage ; however , a damaged vein leaks blood plasma . It causes an increase in retina thickness and it leads to macular edema ( build-up of fluid in the macula , an area in the center of the retina ) and exudates ( a fluid that filters from the circulatory system into lesions or areas of inflammation ). If edema starts affecting the macula , then blurred eyesight will disrupt visual acuity , leading to permanent blindness if not treated early .
The advanced stage of diabetic retinopathy is called proliferative diabetic retinopathy ( PDR ). At this stage , capillary vessels feeding the retina are blocked , and ischemic ( restriction in blood supply to tissues , causing less oxygen to pass into cells ) has started . Cytokins ( proteins )
secreted by these areas contribute to ischemic depth and progression . New pathologic vein formations may lead to further bleedings if these ischemic areas are not closed using lasers ( applied immediately after diagnosis ). It might lead to permanent blindness due to retinal detachment . When tractional retinal detachment occurs , vitrectomy surgery is initiated to smooth the retina back into its place .
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 .
Take care of your diabetes and your eyes .
References
1 . Obrosova IG , Chung SS , Kador PF . Diabetic cataracts : mechanisms and management . Diabetes Metab Res Rev 2010 ; 26 ( 3 ): 172-80 .
2 . Watanbe K , Hagura R , Akanuma Y , Takasu T , Kajinuma H , Kuzuya N , et al . Characteristics of cranial nerve palsies in diabetic patients . Diabetes Res ClinPract 1990 ; 10 ( 1 ): 19- 27 . Pfeiffer KJ , Ropers SK , Short MW . Diplopia and ptosis . Diagnosis : Diabetic Third Nerve Palsy . Am Fam Physician 2010 ; 82 ( 2 ): 187-8 .
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