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Your Healthy Family: The most common eye problems that can be caused by diabetes

Posted at 4:57 PM, Nov 20, 2020
and last updated 2020-11-20 18:57:58-05

COLORADO SPRINGS — While there is considerable and appropriate focus on COVID-19 as we head into the Thanksgiving holiday, it’s important to remember there are many other deadly and debilitating chronic health issues that we and our loved ones will continue to struggle with long after the pandemic ends.

Diabetes is one of the more important of these issues.

November is Diabetes Awareness Month. To help inform the public about diabetes and its effects on eyesight, I interviewed Dr. David Davis, MD FACS, a board-certified ophthalmologist with Haas Vision Center in Colorado Springs.

Previously, Dr. Davis talked about the overall importance of having your eyes checked regularly, especially if you have diabetes. YHF: Don’t let diabetes rob you of your eyesight

To clarify, type one diabetes is also called insulin dependent or juvenile onset diabetes, while type two diabetes is also known as non-insulin dependent or adult onset diabetes. Type one diabetics require insulin, whereas type 2 diabetics often are treated with pills, although they may also be given insulin. With the advent of things like the insulin pump and pancreatic islet cell transplants, type one diabetes is becoming better controlled than it has been in the past. Type two diabetics also have benefited from a plethora of newly developed medications.

Dr. David says there are several significant problems diabetes can cause with your eyes.

After fifteen years of having diabetes, about 98% of people with type one diabetes will have damage to the retinal blood circulation, whereas about 78% of people with type two diabetes will have damage to the retinal vessels. This impaired retinal circulation can cause death of cells in the retina, bleeding, tiny aneurysms in the retina, swelling or retinal edema, hemorrhage in front of the retina and other problems.

Dr. Davis explains, “The macula is the center of the retina and the center of your vision. When you are looking directly at something, you're using your macula - it's particularly important. If your macula swells due to blood vessel damage causing leakage of fluid into the macula, then everything becomes bent and blurry. As the surface of your retina is distorted, the picture you're going to see is going to look distorted like a fun-house mirror. This can be treated by shots in the eye, sometimes with steroids and other times with hormone inhibiting factors.”

In the most serious cases, lack of circulation stimulates the growth of new abnormal blood vessels on the retina and sometimes the iris. These can cause a detached retina and sometimes a very aggressive form of glaucoma, and these both can lead to blindness.

Preventing this is paramount because after it occurs, vision usually can never be fully restored.

A problem that arises earlier in the course of the disease occurs when your blood sugar rises and you get sugar in the fluid in your eye. This can enter the lens of the eye and cause it to swell, resulting in temporary changes in the optics and resulting in blurring and clearing over and over again as the sugar levels rise and fall.

Having higher levels of sugar in your body will cause the proteins in your lens to cross-link earlier and cause you to develop cataracts earlier in life. Cataracts can only be repaired with surgery. The results of modern cataract surgery are very good with a success rate over 98%, but having surgery is still less fun than going out to eat.

Diabetics are roughly twice as likely to develop glaucoma. In glaucoma, pressure inside the eye causes permanent and irreparable damage to the optic nerve. Glaucoma is sometimes called the silent thief of sight. It usually has no symptoms you can detect until there is already quite a lot of permanent eye damage. Optic nerve damage cannot be improved but only prevented. Regular exams by eye-care professionals allow glaucoma to be detected and controlled long before it gets to the point where you would otherwise notice it.

If you have diabetes or have been recently diagnosed, your primary care doctor will routinely refer you to an eye doctor to have your vision closely monitored for these issues. An ounce of prevention really can be worth a pound of cure – especially in situations where there is no cure.

If you have any questions about eyesight and diabetes you can follow up with Dr. Davis and the team at HAAS Vision Center in Colorado Springs, by visiting their website (HERE)

Haas vision center is a proud sponsor of Your Healthy Family