Monday 29 April 2013

Eye Care Tips for Diabetics

Diabetic is a very well known disease and everyone knows that the diabetic patients have high blood sugar levels. Insulin present in the body converts the sugar level in blood into energy that is required for day-to-day work. This insulin reduces the blood sugar levels but with diabetic people there is either low insulin or lack of insulin that prevents the sugar in blood from getting converted into energy. Diabetic patients are prone to getting various eye diseases.

Eye care is especially important for people with diabetes, because they are at increased risk of developing eye complications from the disease. In fact, diabetes is the leading cause of blindness in adults age 20 to 74.

All people with diabetes should take precautions to help reduce their risk of developing eye problems. Various presentations of diabetes in eyes are given in the previous article. Here are some eye care tips:
  1. Schedule regular appointments with your eye doctor so that any eye problem can be detected early and treated.
  2. Maintain control of your blood glucose levels.
  3. Keep your blood pressure under control. High blood pressure by itself can lead to eye disease, so if you have high blood pressure as well as diabetes, it is especially important that you take steps to control both conditions.
  4. Get your blood cholesterol levels under control.
  5. Eat a healthy diet.
  6. Avoid smoking.
  7. Exercise regularly.

When should I see eye doctor?

When you are diagnosed with diabetes one complete eye check up is advisable. You should make an appointment to see your eye doctor if you experience any visual problems or notice any changes in your vision. You should seek medical care for your eyes immediately if you experience any of the following symptoms:
  • Blurring of vision
  • Black spots
  • Flashes of light
  • Partial or complete loss of vision, in one or both eyes.

What are diabetes problems?

Too much glucose in the blood for a long time can cause diabetes problems. This high blood glucose, also called blood sugar, can damage many parts of the body, such as the heart, blood vessels, eyes, and kidneys. Heart and blood vessel disease can lead to heart attacks and strokes. You can do a lot to prevent or slow down diabetes problems.

High blood glucose can cause eye problems.

What should I do each day to stay healthy with diabetes?

  1. Follow the healthy eating plan that you and your doctor or dietician have worked out. Antioxidant rich diet can slow down diabetic damage in the eye.
  2. Be active a total of 30 minutes most days. Ask your doctor what activities are best for you.
  3. Take your medicines as directed.
  4. Check your blood glucose every day. Each time you check your blood glucose, write the number in your record book.
  5. Control your blood pressure and cholesterol.
  6. Don't smoke.

What can I do to prevent diabetes eye problems?

You can do a lot to prevent diabetes eye problems.

Keep your blood glucose and blood pressure as close to normal as you can.

Have an eye care professional examine your eyes once a year. Have this exam even if your vision is OK. The eye care professional will use drops to make the black part of your eyes-pupils-bigger. This process is called dilating your pupil, which allows the eye care professional to see the back of your eye. You experience mild blurring of vision as eye dilates; it recovers back to normal as the effect of eye drops wears out. Finding eye problems early and getting treatment right away will help prevent more serious problems later on.

Ask your eye care professional to check for signs of cataract and glaucoma. See what other eye problems can happen to people with diabetes see article eye presentations in Diabetes? Learn more about cataracts and glaucoma.

If you are planning to get pregnant soon, ask your doctor if you should have an eye exam.

If you are pregnant and have diabetes, see an eye care professional during your first 3 months of pregnancy.

Don't smoke.

How can diabetes hurt my eyes?

High blood glucose and high blood pressure from diabetes can hurt four parts of your eye:
  1. Retina - The retina is the lining at the back of the eye. The retina's job is to sense light coming into the eye.
  2. Vitreous - The vitreous is a jelly-like fluid that fills the back of the eye.
  3. Lens - The lens is at the front of the eye. The lens focuses light on the retina.
  4. Optic nerve - The optic nerve is the eye's main nerve to the brain.
A side view of the eye. Antioxidant rich diet or supplements can help slow down diabetic damage, as guided by your doctor.

How can diabetes hurt the retina of my eyes?

Retina damage happens slowly. Your retinas have tiny blood vessels that are easy to damage. Having high blood glucose and high blood pressure for a long time can damage these tiny blood vessels.

First, these tiny blood vessels swell and weaken. Some blood vessels then become clogged and do not let enough blood through. At first, you might not have any loss of sight from these changes. Have a dilated eye exam once a year even if your sight seems fine.

One of your eyes may be damaged more than the other. Or both eyes may have the same amount of damage.

Diabetic retinopathy is the medical term for the most common diabetes eye problem.

What happens as diabetes retina problems get worse?

As diabetes retina problems get worse, new blood vessels grow. These new blood vessels are weak. They break easily and leak blood into the vitreous of your eye. The leaking blood keeps light from reaching the retina.

You may see floating spots or almost total darkness. Sometimes the blood will clear out by itself. But you might need surgery to remove it.

Over the years, the swollen and weak blood vessels can form scar tissue and pull the retina away from the back of the eye. If the retina becomes detached, you may see floating spots or flashing lights.

You may feel as if a curtain has been pulled over part of what you are looking at. A detached retina can cause loss of sight or blindness if you don't take care of it right away.

Call our eye care professional right away if you are having any vision problems or if you have had a sudden change in your vision.

Sunday 14 April 2013

Eye Presentations in Diabetes


Ocular (eye) involvement in diabetes is very common. Since diabetes is a very common condition found in every part of world.
Structure-wise eye lesions with symptoms & presentations (simplified) are as follows:

  1. Lids. Xanthelasma (yellow whitish lesion found most commonly on upper eyelid) and recurrent  style (small lid nodules) or internal hordeolum.
  2. Conjunctiva. Telangiectasia, sludging of the blood in conjunctival vessels (pink or bleary eyes) and subconjunctival hemorrhage (fresh bloody red irregular spots noted in the white area of eye).
  3. Cornea. Pigment dispersal at back of cornea, decreased corneal sensations (due to trigeminal neuropathy), punctate kerotapathy, Descemet’s folds, higher incidence of infective corneal ulcers and delayed epithelial healing due to abnormality in epithelial basement membrane (presenting as watering , pain and blurring of vision)
  4. Iris. Rubeosis iridis (neovascularization i.e new leaky vessels of iris)
  5. Lens. Snow-flake cataract in patients with IDDM (insulin dependent diabetes mellitus). Posterior sub capsular cataract.  Early onset and early maturation of senile cataract.
  6. Vitreous. Vitreous haemorrhage (sudden dimension of vision, multiple floaters) and fibre- vascular proliferation secondary to diabetic retinopathy.
  7. Retina. Diabetic retinopathy and lipaemia retinalis (painless progressive visual loss).
  8. Intraocular pressure. Increased incidence of POAG (primary open angle glaucoma), neovascular glaucoma. Hypotony(low Intraocular pressure IOP) in diabetic ketoacidosis (due to increased plasma bicarbonate levels)
  9. Optic nerve. Optic neuritis(sudden decrease of vision over few days).
  10. Extraocular muscles. Ophthalmoplegia(weakness or paralysis of eye muscles) due to diabetic neuropathy(visual doubling, lid drop, pupil dilatation & squint).
  11. Changes in refraction. Hypermetropic (increased plus number in glasses) shift in hypoglycemia(low blood sugar levels), myopic shift(increased minus number in glasses) in hyperglycemia(high blood sugar level) and decreased accommodation(difficulty in near work or  reading).
Regular & complete eye check up by an ophthalmologist is sincerely advised to all diabetic patients.