Diabetes and eye problems: everything there is to know!

Diabetes is a chronic disease caused by a defect in the production of insulin, or its functioning. There are various complications and co-morbidities associated with this disease. Diabetes may affect many organs, including the eyes.

Anyone with diabetes has a higher risk of developing eye conditions. However, certain patients may be at even greater risk. For example, people who have had diabetes for a long time, those with poor blood sugar control and those with high blood pressure are all at a higher risk of complications.

What kind of eye problems can be caused by diabetes? How can they be treated? 

Poorly controlled diabetes affects the blood flow and can lead to a number of eye problems and even to vision loss. It is therefore essential to be aware of the symptoms and to seek treatment as soon as possible.

Diabetic retinopathy 

In the case of hyperglycemia, i.e. abnormally high blood sugar levels, the small blood vessels in the retina can become damaged, weakened or swollen. Diabetes-related damage to the retina is better known as diabetic retinopathy. It is the most common eye disease caused by type 2 diabetes.

It can lead to vision loss or even blindness. Symptoms may include blurred vision, spots, or decreased night vision. Treatment for diabetic retinopathy includes:

• Laser treatment, to seal off bleeding blood vessels,
  
• Surgery, which is needed to remove scar tissue or repair damaged blood vessels,
  
• Drug treatment, to help control blood sugar levels,
  
• Lifestyle changes, such as regular exercise and a healthy diet.

Glaucoma

This condition occurs when the pressure in the eye increases, thus damaging the optic nerve. The increased eye pressure is due to high blood sugar levels, which cause an abnormal build-up of fluid in the eye. The symptoms are pain in the eyes, headaches and loss of vision.

Glaucoma is usually treated with medication in order to reduce the production of fluid and thus decrease the eye pressure. In some cases, surgery may be necessary.

Cataracts

Cataracts develop rather early in diabetic patients. The proteins in the lens are prematurely altered by changes in blood sugar levels. The crystalline lens is a transparent lens located inside the eye, behind the iris. Due to diabetes its opacity causes blurred or distorted vision, increased glare, sensitivity to light and double vision.

Treatment consists of surgery, the aim of which is to replace the opaque lens with a clear artificial lens.

Dry eyes

Diabetes often causes dry eyes, also known as the dry eye syndrome. Because of its impact on blood flow, there can be a lack of blood supply to the eye, which can damage the nerves around it. If it is the nerves that control the lacrimal glands, tear production is not effectively controlled and may be insufficient.

The eyes of diabetics are more susceptible to infections such as conjunctivitis. Symptoms include itchy or burning eyes, sensitivity to light, redness and blurred vision.

Treatment for dry eye syndrome includes the use of artificial tears, warm compresses and massage of the eyelids; it is also advised to avoid smoke and other irritants.

Diabetic macular edema

This is a condition where fluid accumulates in the macula, the center of the retina. The blood vessels in the retina leak fluid, including small amounts of blood, and sometimes, but rarely, fatty deposits, causing inflammation of the macula.

Symptoms may include blurred vision, reduced night and color vision, and dark blotches or gaps in the vision. These lesions must be treated before they become irreversible.

Treatment consists of eye drops, intravitreal and periocular injections, laser photocoagulation or microsurgery, depending on the degree of severity.

Other eye disorders can be related to significant variations in blood glucose levels. These are refractive disorders, which are the result of either excessive absorption or excretion of glucose by the lens, so that the eye usually becomes hyperopic, but sometimes also myopic. These changes are transient.

Diabetes can also cause the development of another disorder: the risk of oculomotor paralysis which, conversely, can also indicate the presence of diabetes. This condition is called focal mononeuropathy, a relatively rare diabetic neurological complication.

In contrast, diabetes does not increase the risk of age-related macular degeneration (AMD).

How can you protect your eyes from complications caused by diabetes? 

Since diabetes can cause serious damage to the eyes, it is essential for people affected to protect their eyes.

Indeed, as was mentioned above, the consequences of these eye problems can be vision loss and even blindness. Diabetes must be well managed, blood sugar levels carefully monitored and the patient's lifestyle must be healthy.

Here are some tips to prevent diabetes-related eye problems:

• See your eye specialist regularly to check your eyesight; a complete eye examination is recommended at least once a year to detect any changes in vision and prevent potential vision loss,
  
• Keep blood sugar levels under control to minimize the risk of long-term complications, 
  
• Monitor cholesterol and blood pressure levels, as high levels increase the risk of diabetic retinopathy for example,
  
• Stop smoking: smoking increases the risk of developing eye problems,
  
• Eating a healthy diet, low in saturated fat and cholesterol and high in fiber, fruit, vegetables and whole grains can help protect your eyes from diabetes-related problems,
  
• Wear sunglasses: they will block UV rays and protect your eyes,
  
• Wear safety glasses: if there is a risk of developing diabetic retinopathy, safety glasses should be worn during risky work-related activities or during sports, for example, to protect the eyes from injury.
  

Vision problems are a serious concern for people affected with diabetes. Early detection, treatment and regular follow-up are therefore essential to maintain good vision. These preventive measures are an important part of diabetes management.