Diabetes is known to be a silent killer and affects a number of organs of the human body, including the eyes. A diabetic eye disease is a group of medical conditions that can affect people with diabetes. Cataract, Diabetic Retinopathy, and Glaucoma are some of the few eye diseases that may affect a diabetic individual during the course of his life.

Cataract:

A cataract is a clouding of the lens in the eye which leads to a decrease in vision. Cataracts cause half of all cases of blindness and thirty-three percent of visual impairment worldwide. Cataracts are one of the earliest complications of diabetes mellitus and one of the most common causes of visual impairments in these subjects.

Symptoms of Cataracts:

➢ Clouded, blurred, or dim vision

➢ Increasing difficulty with vision at night

➢ Sensitivity to light and glare

➢ Need for brighter light for reading and other activities

➢ Seeing “halos” around lights

➢ Frequent changes in eyeglass or contact lens prescription

➢ Fading or yellowing of colors

➢ Double vision in a single eye

➢ Need for frequent change in prescription glasses

Prevention:

Although there is significant speculation over whether cataracts can be prevented at all, a number of studies have suggested that certain habits may reduce the risk factors. They are:

➢ Have regular eye examinations which can help detect cataracts and other eye problems at their earliest stages

➢ Quit smoking

➢ Manage other health problems

➢ Choose a healthy diet that includes plenty of fruits and vegetables

➢ Wear sunglasses

➢ Reduce alcohol use

➢ Adequate intake of antioxidants such as Vitamin A, C, and E

➢ Manage UVB exposure

➢ Take diabetes medicines as prescribed by the doctor regularly

Diabetic Retinopathy:

Diabetic retinopathy, also known by the name of diabetic eye disease, affecting almost up to eighty percent of the population who have had diabetes for over twenty years is a medical condition concerning the retina, where damage is caused to the same as a result of complications of diabetes mellitus. The condition is a result of blood vessel damage in the retina and is reportedly the leading cause of blindness.

Diabetic retinopathy can be of two types: the first is non-proliferative diabetic retinopathy which is usually the milder and mostly the symptomless form while proliferative diabetic retinopathy is the more advanced and serious stage with the growth of excess and abnormal blood vessels in the retina, causing the retina to leak fluid and cause bleeding inside the eye.

Symptoms Of Diabetic Retinopathy:

Typically presenting almost no symptoms at the early stage, the symptoms of this condition affecting both the eyes of the individual become noticeable at the more advanced stage with sudden and complete loss of vision being the only detectable symptom in certain cases. Some other symptoms include:

➢ Blurry vision

➢ Weakened color vision

➢ Poor nighttime vision

➢ Streaks or patches impairing the individual’s vision

Causes And Risk Factors:

Diabetic retinopathy usually affects those who have been affected by diabetes (diagnosed or undiagnosed) for a significant number of years. However, the risk of developing this condition is greater in the case of High blood sugar level, High blood pressure, High cholesterol, Pregnancy & Smoking.

In the advanced stage of this condition, the blood vessels can be completely blocked, leading the eye to then produce excess and abnormal blood vessels and these new vessels break easily and leak fluid causing blurry patches of vision. This bleeding, on occasion, may be accompanied by tractional forces that can separate the retina and the eye, leading to a detached retina. As symptoms develop, a person with Diabetic retinopathy becomes increasingly likely to experience complete vision loss.

Prevention:

Although one cannot prevent diabetic retinopathy completely as for the majority of people with diabetes, diabetic retinopathy is an almost inevitable consequence. For a diabetic person the risks of developing the advanced stages can be reduced by doing the following:

➢ Frequent Eye Check-Ups

➢ Managing diabetes

➢ Monitoring of blood sugar level

➢ Taking a glycosylated hemoglobin test with the goal of A1C is below 7%

➢ Quitting the use of tobacco

➢ Paying close attention to vision changes

Glaucoma:

Glaucoma is a medical condition that affects the optic nerve of an individual’s eyes and gets worse over time building up pressure inside one’s eyes. It is often considered inherited and may not show up until later in life. Glaucoma is of two types: open-angle which is the most common type and angle-closure which is a medical emergency and must be treated immediately.

If one is above the age of forty and has a family history of the disease, a complete eye exam is recommended. Further, if the person concerned is diabetic or has a family history of glaucoma, they should go for more frequent checkups.

Symptoms:

Most people with glaucoma have no early symptoms or pain. Regular eye checkups can help in getting diagnosed and treated at the earliest.

The two most common types of Glaucoma: open-angle and angle-closure have completely different symptoms.

Symptoms of open-angle are:

➢ Slow or peripheral loss of vision, mostly in both eyes

➢ Tunnel vision in the advanced stages

Symptoms of angle-closure are:

➢ Severe eye pain

➢ Nausea and vomiting (accompanying the severe eye pain)

➢ Sudden onset of visual disturbance, often in low light

➢ Blurred vision

➢ Halos around lights

➢ Reddening of the eye

Prevention:

Although there is no way to prevent Glaucoma, having it diagnosed early means it can be treated better and more effectively. Medical experts also recommend a healthy lifestyle that incorporates regular exercise and a nutritious diet.

Some ways by which Glaucoma may be prevented are:

➢ Maintaining a healthy weight.

➢ Keeping blood pressure at a normal level and control other medical conditions.

➢ Not smoking

➢ Limiting caffeine intake to moderate levels, because some evidence suggests that high amounts of caffeine may increase eye pressure.

➢ Trying to exercise daily by doing physical activities such as walking, swimming, or working in the yard.

➢ Getting regular, comprehensive eye exams, and consult your doctor if you notice changes in your vision.

Thus, diabetes can affect a person’s sight in an adverse manner and so it is important that people who are diabetic plan regular checkups. As diabetes can cause damage to one’s eyes over time and may even lead to blindness, one must take steps to prevent diabetic eye disease or at least keep it from getting worse.

About the author- Dr.Saptorshi Majumdar MBBS, MD-Ophthalmology (AIIMS), Department of Vitreo Retinal Services, Disha Eye Hospitals, Kolkata