Diabetic Eye Problems
All diabetics should have an annual eye test done. This will pick up any damage that may have already occurred and show if it has progressed and what treatment may be needed.
In the UK these annual tests are offered free - lucky us.
The fact that you have some problem, and it's severity, may indicate an increased risk of developing a number of other diabetic complications.
Temporary Blurring.
This is often one of the first eye problems one develops when your blood sugars are uncontrolled. The high BG causes the lens to swell.
I can remember lying in hospital just after diagnosis and being absolutely terrified because suddenly I could no longer see the printed page with my normal glasses and the television was a total blur.
I was convinced I was going blind but was to scared to tell anyone about it. Silly, but I was just so afraid of getting confirmation of this.
Eventually I did speak to the diabetic nurse only to discover it was quite normal (what a relief!).
My eyes had been distorted by the high blood sugars and now the sugars were being brought back to normal levels my eyes needed time to adjust. They would improve by themselves in a couple of weeks.
I was advised not to go and get new glasses for at least 3 months to give my eyes time to settle. I am pleased to state that this is exactly what happened, so if you suffer from the same thing don't panic, just wait.
Note
- if desperate to read, and one often is at this stage because we are frantically trying to find out all about this new disease - buy one of those pairs of reading glasses sold in pharmacies, or sometimes even at markets, for folk who just need magnification.
They are reasonably cheap and come in a number of strengths and you can try different ones on until you find one that works for you now.
Be warned, they will soon become too strong and you will have to abandon them or pass them on to a more visually impaired friend, but they can be a genuine frustration saver just when you need one most.
I thought mine were worth every penny of the 5 they cost me!
Glaucoma.
When the pressure in your eyes is greater than normal it can cause damage to the optic nerve. A bit of a problem this as that is the nerve that sends messages from your eye to your brain. The folk who say that we see, not with our eyes, but with our brains, are partially right.
If the optic nerve is damaged the message does not get through and blindness can result.
There is no cure as yet for glaucoma but if caught early it can be controlled. However as the early stages are symptomless people are unaware that they have it.
The first symptom is a loss of peripheral vision and if not treated the field of vision shrinks until you are left with what is known as 'tunnel vision' and this then progresses on to total blindness.
Treatment via drops, laser treatment or surgery, if done early enough, can often slow down or halt the further loss of vision.
Cataracts.
To see properly light has to pass through the lens of the eye to the retina at the back.
When the lens becomes cloudy (cataracts form) light cannot pass through and your vision may get dim or out of focus.
Though common in non-diabetics as they get older, diabetics can develop them when they are younger.
Treatment is an operation to remove the cloudy lens and replace it with a plastic one that cures the problem.
Retinopathy.
This is a disease of the eye only found in diabetics. To understand what happens we need to know a little about how the eye works.
The retina is the layer of light sensitive tissue at the back of the eye which also contains small blood vessels and the very tiny macula, right in the middle, which is the bit that lets us see fine detail and colours.
The parts of the retina around the macula are responsible for our peripheral vision.
For you to be able to see light has to be able to reach the retina. In front of the retina is the vitreous gel - as you can gather from the name it is a jelly like substance.
Retinopathy affects the network of small blood vessels within the retina. When your blood sugar levels are high it causes these to become leaky or blocked.
There are three stages of retinopathy.
1st stage or Background Diabetic Retinopathy.
Also known as nonproliferative retinopathy.
This is the earliest stage and commonly found in people who have had diabetes for a long time, usually more than 8 years.
As there are no obvious symptoms, ones vision being fine, it is usually picked up by an optician during an eye examination.
They may see microaneurysms (bulges in the blood vessels), haemorrhages or exudates, which are hard fatty deposits formed when the capillaries leak fluids.
At this stage there is no danger to ones sight but it is a warning sign that the more severe stages may develop.
2nd stage or Maculopathy.
This is where the macula is affected.
As it is the part of the eye dealing with detail it causes blurring and distorted vision.
Fine print becomes difficult to see and distant things are hard to make out properly. Your peripheral vision, however, remains normal.
Exudative maculopathy occurs when fluids, proteins and fats leak into the retina and cause swelling. In this type, improvement may possibly be seen with the control of cholesterol or laser treatment.
Ischaemic maculopathy is where there is an inadequate blood supply due to blockages of the capillaries.
This also results in blurred vision and there is no treatment for this.
That is a good reason to prevent it by controlling your diabetes properly.
3rd stage or Proliferative Retinopathy.
When the capillaries become blocked the eye tries to repair the damage by growing new blood vessels.
However these are not as good as the old ones. They are often very fragile and so bleed very easily. They also grow in the wrong place, often on the surface of the retina and into the vitreous gel.
When they bleed into the vitreous gel they can cloud your vision and cause scar tissue to form.
This scar tissue can result in distortion of the retina causing it to be pulled out of position, away from the sclera or wall of the eye.
This is what is known as retinal detachment and can lead to sudden and severe sight loss.
Treatment of retinopathy.
If caught early enough the first two stages of retinopathy can benefit from laser treatment, which is used to seal the leaking blood vessels.
It will not make your sight better but it may stop it from getting any worse.
If new blood vessels are growing, more extensive laser treatment can be used to remove them. This is a more complicated procedure than the simple one for sealing old blood vessels.