After kidneys and the heart, the eyes are the most important organs to be affected due to chronic diabetes. Because of this strong link, eye problems triggered by blood sugar are generally listed under the diabetic eye disease category.
“Around one-fourth of the diabetic population faces diabetic eye complications, including some young people with diabetes. The severity could be different — ranging from mild [to] moderate [to] severe retinal problems,” says Dr Rajeshwari Janakiraman, chief consultant diabetology, endocrinology, Manipal Hospitals, Yeshwanthpur, Bengaluru.
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Diabetic retinopathy, diabetic macular edema, cataract, and glaucoma are the main conditions usually listed under diabetes eye disease.
- Diabetic retinopathy
Diabetic retinopathy is one of the common microvascular complications, especially among people with chronic diabetes. Uncontrolled blood sugar damages blood vessels in the eyes and, if not treated properly, could even cause blindness. Some noticeable symptoms of diabetic retinopathy can be blurred vision and trouble in reading or in seeing distant objects. Experts point out that people living with diabetes, especially the elderly, should get their eyes tested on a regular basis. Retinal detachment occurs in the advanced stage of diabetic retinal disease. Retinal detachment is a serious eye condition that occurs when the retina is pulled away from its normal position at the back of the eye.
- Cataract
Cataract is one of the most common ocular complications, and diabetes is a major risk factor for this condition. According to the American Diabetes Association, though cataract generally manifests in the elderly, diabetes could trigger its early onset. Cataract is basically a condition when the retina becomes thick and loses its transparency with age, which could lead to vision loss. Doctors say high blood sugar can affect the retina and retinal nerves.
- Glaucoma
Glaucoma is one of the main reasons for vision loss globally. Experts say that diabetes doubles the risk of glaucoma – a condition where the neural link between brain and eye gets disrupted or completely severed. Uncontrolled blood sugar and diabetes-induced nerve damage are among the main reasons for glaucoma.
“In glaucoma, the higher pressure builds up in the eyes. People with diabetes are more likely to get glaucoma, especially when the sugar is not controlled,” says Dr Janakiraman.
- Diabetic macular edema
Macular edema is a condition of swelling in the retina. In this condition, blood vessels leak into a part of retina, and make the macula swell. Macula is located at the centre of the retina and plays a major role in enabling people to see objects in front of them. It can affect the eye’s vision, resulting in partial blindness or vision loss. Macular edema could be triggered due to multiple reasons, but diabetic retinopathy is one of its most common precursor conditions. Managing diabetes is one of the most crucial aspects of managing this condition which also could result in vision loss.
5) Diabetes dry eye
One of the most common yet rarely talked about eye complication due to diabetes is dry eye syndrome. The eyes become dry due to lack of tear secretion, which is vital to keep them moist and avoid any accidental scratches. The ADA says that people with diabetes are more prone to get dry eyes since it affects the functioning of the lacrimal and oil glands that ensure that tears have enough water and oil content to protect the eyes.
Diabetes and eye care
“Family history can be a high-risk factor,” says Dr Janakiraman. “People who have kidney complications due to diabetes also have a high chance of developing eye complications. Nowadays, even in young people who have diabetes, eye problems progress very fast, and within five to ten years, they start having eye damage in the retina.”
People with high blood sugar tend to get blurred vision, which can be normalised with good control of sugar. However, a retinal problem or glaucoma may not show symptoms till a very late stage. Only routine eye check-ups can detect and prevent the problem.
“Controlling blood sugar well and keeping the Hb1Ac in the recommended range, along with good control of blood pressure and cholesterol will prevent or delay diabetes complications,” says Dr Janakiraman.
According to her, adopting a healthier lifestyle with adequate physical activity would be the best way to tackle diabetes. “If blood sugar is not controlled, you might need medication after a few months to bring the blood sugar level down,” says Dr Janakiraman.
