Diabetes and your eyes

Among the many problems uncontrolled diabetes can contribute to are diseases of the eye.

August is Eye Awareness Month, a time when we bring awareness to various eye conditions. Uncontrolled diabetes causes several eye problems. The main point to remember is all forms of diabetic eye disease have the potential to lead to blindness. That alone seems motivation enough to keep blood sugar at safe levels.

Dr. Shawn C. Wilker, with Mid-Florida Eye Center, specializes in diabetic eye care and is board-certified in ophthalmology. He says eye diseases caused by uncontrolled or untreated diabetes are the leading cause of blindness in America.

“There was a major study not long ago that proved maintaining blood-sugar levels and keeping them consistent can prevent complications from diabetes,” Dr. Wilker says. “The two factors that contribute to possible complications are how long the person has had diabetes and how controlled the blood-sugar levels are. I find it very frustrating that people wait too long to get help when they know something is wrong.”

Diabetes testing must be done when the patient is fasting. That means no food or drink for at least eight house prior to the test. A blood-sugar level of less than 100 mg/dL is normal; 100-125 indicates prediabetes; and blood sugar at 200 mg/dL or higher is diabetes. Unfortunately, there are no tangible symptoms of prediabetes, and the main symptoms of diabetes are abnormal thirst and frequent urination.

Sometimes, damage to organs has already begun by the time diabetes is diagnosed, especially with Type 2. Type 1 diabetes usually begins early in life and occurs because the body produces no insulin. With Type 2 diabetes, the body doesn’t use its insulin properly. This often can be controlled with proper diet and exercise. However, there also are oral medications and injections that help the body use glucose properly and keep blood-sugar levels normal.

Though diabetic retinopathy is mentioned most often, there are a number of diseases related to having uncontrolled blood sugar. Among them are macular edema, neovascularization, and neovascular glaucoma.

Macular edema is swelling in the macula, which is in the center of the retina. This fluid build-up causes the macula to swell and thicken, which distorts vision. “The blood vessels start to die off,” Dr. Wilker says. “This means there is no blood flow and the area dies.”

Neovascularization occurs when new blood vessels are created as with diabetic retinopathy. “The body responds by creating new blood vessels, which sounds good. However, they are abnormal and cause bleeding and scar tissue and even blindness,” Dr. Wilker says.

Retinal neovascularization is a tangle of new blood vessels on the retina surface. They bleed spontaneously or with minimal trauma, creating fibrovascular stalks, which eventually may cause the retina to detach.

Neovascular glaucoma is blood vessels growing in the drainage system and fluid continues to increase with no place to go. This will result in the need for major surgery.

“These days, we’re treating more problems with eye injections, like we do with macular degeneration, and they have been shown to reverse damage or improve the problem,” Dr. Wilker says.

“There are still conditions we can’t do a lot about, but that’s not the situation with diabetes. With good care and controlling blood sugar, these things may never happen.”