Diabetes takes its toll on vision

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The eyes often are referred to as the “window to the body.” This is very true because the eye often can be the first place many systemic diseases are seen. Diabetes and its complications is one of the most common diseases that can affect the eye. Diabetes is the leading cause of blindness in the United States.

Most people diagnosed with diabetes will experience some type of change in the eye; however, these changes may or may not affect the vision initially. Diabetes can cause a person’s prescription to change; for example, they may become more nearsighted or farsighted. Cataracts and glaucoma are more common in people with diabetes. People can develop strabismus, which is an eye turn or lack of eye alignment with poorly controlled diabetes. Dry-eye syndrome also is common in people with diabetes. Although these problems are significant, the most common form of diabetic eye disease involves the retina.

The retina is located inside the back of the eye; it acts much like film in a camera. The retina contains blood vessels. Blood carries oxygen to all parts of the body as it travels through blood vessels. In people with diabetes, the retinal blood vessel walls become weaker and can balloon and form pouches called micro-aneurysms. The damaged vessel can begin to leak blood and fluid in the retina. This can be seen in a dilated eye exam by an optometrist or ophthalmologist. This is called non-proliferative diabetic retinopathy and it is the first stage of diabetic eye disease. The fluid leakage also can cause diabetic macular edema, which is swelling in the highly specialized portion of the retina used for detailed central vision. This leads to decreased vision and can occur at any stage of retinopathy.

As the blood leaks from the vessels, it can cause the retina to become starved of oxygen because the blood isn’t making it to the proper places in the eye. The eye then tries to compensate for the oxygen decrease and it will try to grow more blood vessels to try to bring in more oxygen. This seems like a good thing; however, it is very bad because the blood vessels that the eye grows are more leaky then the ones that are damaged from the diabetes. This state is called proliferative diabetic retinopathy. This type of retinopathy often can be treated with laser and retinal surgery in more advanced cases; however, it also often leads to irreversible vision loss and even blindness.

Controlling blood sugar with a balanced diet, regular exercise and medication, if necessary, is the best way to try to avoid these ocular complications from diabetes. Eye doctors recommend yearly dilated eye exams to monitor patients with diabetes. Eye exams are often the first place that the effects of diabetes can be seen and even can help lead to the initial diagnosis of diabetes.

Young is a local optometrist and plans to open a new practice called ­Premier Family Eye Care this summer in Indian Trail, in the Union West Medical Development on Route 74. Call 704-821-EYES to schedule an appointment.