April 15, 2020
Most people have heard of diabetes, which is a metabolic condition characterized by the presence of too much sugar in your blood. However, far fewer people are aware that uncontrolled diabetes has the potential to affect our sight and even lead to permanent vision loss. There are two different types of diabetes, known as Type I and Type II, but both can have significant consequences for your vision.
Type I diabetes occurs when your body’s immune system is a little haywire, causing it to attack and destroy the cells that are responsible for insulin, which is the substance that keeps our blood sugar levels in check.
Type II diabetes occurs when your body doesn’t produce enough insulin or doesn’t react to the insulin that you have. It most often occurs in patients who are overweight and lead to poor lifestyles and is much more common than Type I.
It seems impossible that blood sugar levels can affect vision, but this is most certainly possible. This is because, when someone has persistently high levels of sugar in their blood, it causes damage to the various blood vessels in the body, including those which can be found at the back of the eye.
Our vision is a fairly complex thing and involves several key structures within the eye. One of these is known as the retina. This is an area of cells that are light-sensitive, right at the very back of the eye. The purpose of the retina is to receive the light that passes through our eyes and send it as a signal, up the optic nerve to the brain, which then tells us what we can see. The retina is served by a network of blood vessels that help to keep it healthy. When the blood vessels become damaged by persistently high sugar levels, they can bulge and leak, causing damage to the retina and affecting the quality of our vision. This condition is known as diabetic retinopathy.
If you have a diagnosis of either type of diabetes, you will be offered diabetic eye screening. This may be included in your usual comprehensive eye exams, or as a separate appointment. However, since your eyesight may be blurry for a few hours afterward, it is a good idea to make sure that you have someone who can drive you home after. You should be sure to take any glasses or contact lenses that you wear, along with your contact lens solution. You may also be advised to bring sunglasses as everything can appear bright for a few hours following the exam.
The exam itself involves several elements. Firstly, you will be asked to read letters off a chart to determine your visual acuity. Then drops will be placed into your eyes to make them blurry. This may sting for a few seconds but won’t cause any lasting pain. Once your vision is blurry, you will be asked to look into a camera that captures images of the back of your eyes. Each image will cause a bright flash. These images will be used to check out the condition of the blood vessels to determine if you are developing diabetic retinopathy. However, it is unlikely that you will get the result of your test on the day and will instead be contacted in due course.
Being diagnosed with diabetic retinopathy increases your risk of developing a range of other eye diseases as well as causing damage to your vision. As such, early detection, diagnosis and treatment are essential.
Diabetic retinopathy usually only requires treatment if it reaches an advanced stage and your eye doctor feels that there is a significant risk to your vision. This is sometimes referred to as stage 3 retinopathy.
The most obvious and easiest treatment for advanced retinopathy is to get your diabetes under control. Patients who have controlled diabetes from the outset may never develop diabetic retinopathy, but if you do and your diabetes isn’t properly managed, now is the time to take control of your condition. Your doctor and eye doctor will be able to help you with this and suggest lifestyle changes and treatments that can help.
For some patients, gaining control of their diabetes isn’t enough and they will need further treatment to prevent their vision from worsening or experiencing permanent vision loss. Some of the possible treatments include:
Laser treatment. This is used to prevent the growth of abnormal blood vessels serving the retina so that they can no longer bleed into the eye and cause damage.
Injections. These injections contain a medication called anti-VEGF that works by preventing the formation of new blood vessels at the back of the eye. They are usually given around once a month initially, and then their frequency is reduced in line with the effects that the medication is having on your vision.
Surgery. This process involves the surgical removal of some of the vitreous humor from the eyes – a transparent, jelly-like substance that fills the space behind the lens of the eye. This process also removes any scar tissue and excess blood that may have collected in the back of the eye.
If you are diabetic and have concerns about your vision, our expert eye care team would be delighted to help. Please contact our office in Rockport, ME to schedule an appointment.