HEALTH MATTERS AUGUST 28, 2015 CONTACT: LYNN SCRIBNER 903-731-5329 Diabetic Eye Problems: Detect Them Early Mary noted that her vision was blurry from time to time and thought she needed new eyeglasses prescription. A visit to her eye doctor led eventually to a diagnosis of type 2 diabetes...and diabetic eye disease. Her cousin Sidney had been diagnosed with diabetes many years before and never had any visual symptoms. At Mary’s urging, he scheduled an exam with his eye doctor and discovered that he too had diabetic eye disease that needed prompt attention. Eye disorders–retinopathy, cataracts and glaucoma–are common among persons with diabetes. If you have diabetes or have a high risk of the disease, it’s important that you have a dilated eye examination with an ophthalmologist at least once a year. It’s mostly about uncontrolled blood sugar. A high level of sugar in the blood can by itself cause the lens of the eye to swell, causing temporary blurred vision. This was what Mary experienced. Over time, high blood sugar also damages blood vessels and makes them less effective. DIABETIC RETINOPATHY: When tiny blood vessels in the eye swell and leak fluid and blood, vision can become blurred. As the disease progresses, an increasing number of blood vessels become blocked, making it difficult to nourish cells in the retina, the image-producing lining of the eye. In the most advanced stage, proliferative retinopathy, the nutrition-deprived cells of the retina send messages, requesting new blood vessels. These new blood vessels are fragile and tend to leak blood, often causing severe vision loss or even blindness. MACULAR EDEMA occurs when fluid from these abnormal blood vessels leaks into the macula, the central part of the retina that is essential for sharp, detailed vision. The macula swells, again causing blurred vision. Macular edema can occur at any stage but usually during the most advanced stage of retinopathy. All of this may occur without any symptoms. You might see a few spots or specks floating in your vision or experience mild to severe blurring. If you have diabetes, eye symptoms of any kind should not be taken lightly. CATARACTS are common among persons age 60 and over. They appear earlier in persons with diabetes, and the disease progresses more rapidly. Excess blood sugar increases the water content of the lens, stretching the fibers. When blood sugar goes down, and the water content returns to normal, the fibers are then relaxed. But the constant stresses on the fibers of the eye can result in the premature discoloration and clouding of the lens that characterize a cataract. GLAUCOMA is a build-up of pressure within the eye that damages nerves and blood vessels and creates a risk of severe vision loss. It is generally caused by poor drainage of fluids from the eye. And, again, fluid levels in the eye can be affected by the rise and fall of blood sugar. A diabetic has a risk of glaucoma three times that of a person without diabetes. And the longer a person has diabetes, the greater the risk of glaucoma. Glaucoma often causes no symptoms until the patient notices a loss of peripheral vision. Prompt action is needed, however, to prevent complete vision loss. TREATMENT: Glaucoma can be treated with eye drops, laser procedures, medications and surgery. Cataract surgery today can be performed in a half hour or less and is typically uneventful. The cloudy lens is removed and replaced by a man-made lens that does the job very well. Laser procedures are often used to treat diabetic retinopathy and macular edema. In some cases, a vitrectomy is required. Usually performed at a hospital or outpatient surgical center, this involves removing the gel-like fluid (vitreous) and blood from the inside of the eye and replacing it with a salt solution. With prompt treatment, severe vision loss can be prevented. Prevention of diabetic eye disorders mainly involves doing what is needed to head off other complications of diabetes: controlling blood sugar, as recommended by your doctor, through monitoring of blood sugar and glycosylated hemoglobin; taking diabetes medications as prescribed; exercising regularly–at least two and a half hours a week; following a heart-healthy diet that includes plenty of fruits, vegetables and omega-3 fatty acids to control cholesterol and blood pressure; not smoking; and maintaining a normal weight. The key, though, is early detection. Most of these conditions are painless and cause few, if any, symptoms until the disease is advanced. Among American adults age 20 to 74, diabetes is the number one cause of new cases of blindness. The message is clear: schedule regular dilated eye examinations, at least once a year, with an eye care professional.