Diabetes can cause eye complications from diabetes

November is American Diabetic Month and Diabetic Eye Disease Month, and I thought you might want to know a little about eye diseases that are associated with diabetes.

Diabetes is a disease that affects more than just your blood sugar; it impacts your whole health and the delicate tissues of your eye are not immune to diabetes damage.

People with diabetes are 40 percent more likely to have glaucoma than those without diabetes. The longer length of time someone has diabetes, the more likely it is that they will develop glaucoma. Glaucoma occurs when pressure builds up within the eye and it most often is when the fluid (the aqueous humor) in the front of the eye doesn’t drain quickly. The pressure from the build-up of fluid pinches the blood vessels that feed blood to the retina and the optic nerve so vision is gradually lost because the retina (the screen at the back of the eye where images are focused) and optic nerve are damaged.

Although many people who do not have diabetes also get cataracts, those with diabetes are 60 percent more likely to develop them. People with diabetes also tend to develop cataracts at an earlier age and experience a more rapid development of them.

Cataracts cloud the eyes’ usually clear lens and block light. To deal with mild cataracts, people should wear sunglasses and use glare-control lenses in regular glasses. For cataracts that impair vision, doctors remove the lens of the eye, and transplant a new lens. For those people with diabetes, retinopathy can worsen after the removal of the lens and glaucoma may develop as well.

Retinopathy is a general term for all disorders of the retina caused by diabetes. The two major types of retinopathy are non-proliferative and proliferative. In non-proliferative retinopathy, the most common form of retinopathy, capillaries (tiny blood vessels where the exchange of oxygen and carbon dioxide and nutrients and waste products between the cells takes place) walls lose their ability to control the exchange of substances between the blood and the retinal cells. Fluid can then leak into the part of the eye where visual focusing takes place — the macula.

When the fluid leaks into the macula, it swells. This is called macular edema, which causes the vision to be blurry and can cause permanent loss of vision. Macular edema must be treated and fortunately treatment usually is effective at arresting vision loss.

Proliferative retinopathy is a more serious form that usually is a progression that arises after several years of retinopathy. In this form, the blood vessels are so damaged that they close off and new blood vessels start growing into the retina. The new vessels are weak and can leak blood, blocking vision — a condition called vitreous hemorrhage. The new blood vessels also can cause scar tissue to grow and when the scar tissue shrinks it can distort the retina or pull it out of place — a condition called retinal detachment.

The sooner retinopathy is diagnosed the more likely treatment will be effective. The best results occur when the vision is still normal. Treatments can be photocoagulation in which an eye specialist will cause tiny burns on the retina with a laser to seal the blood vessels off. Surgery is called for once the retina is detached or if a lot of blood has leaked into the eye. Cleaning the blood out is usually effective, but re-attaching a retina is only effective in about half the cases.

Several factors influence whether you will get retinopathy. You must control your blood sugar levels and your blood pressure levels, and work hard not to get diabetes in the first place by exercising and eating good, low glycemic foods.

The longer you have diabetes the more likely you are to get retinopathy. People with diabetes who keep their sugar under control and close to normal are less likely to develop retinopathy. Unfortunately the retina can be damaged before you notice any changes to your vision, so it is important to have your eyes examined regularly by an eye care professional. Be well!

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Jane Riley, M.S., B.A., C.P.T., Certified Nutritional Adviser, can be reached at janerileyfitness@gmail.com, 212-1451 or www.janerileyfitness.com.