Top Ophthalmologist’s opinion on how to protect your eyes from diabetes
Dr. Sugandh Goel
Senior Medical Content Writer, BDS, MS (Healthcare Management), Carnegie Mellon University, USA.
- Posted On October 05, 2021
The moment you have been diagnosed with diabetes, you would have been hearing about the threat it poses to your eyes. Sometimes those lectures and warnings feel constant, leaving you feeling as though diabetes-related eye problems like blurry vision, cataracts, glaucoma, and diabetic retinopathy are inevitable.
Although the threat is real, there’s more story to it. That is — you can prevent, reduce, and manage diabetes-related eye problems. To shed light on this matter, Team Diabefly (A Digital Diabetes Management Program) spoke to a renowned expert — Dr. Vandana Jain, Director & Head of Advanced Eye Hospital and Institute (AEHI), Navi Mumbai. She is an internationally trained Cornea, Cataract, and Lasik Surgeon with 20+ years of experience in Ophthalmology.
Here are answers to the 7 FAQs on how you can keep your eyes healthy if you have diabetes.
- Team Diabefly: How do patients with diabetes keep their eyes healthy?
Dr. Vandana Jain: These are the few things I recommend to patients with diabetes on how to take care of their eyes:
- First and foremost, they must keep their blood sugars under control because raised blood sugars damage the retinal blood vessels, leading to vision loss and other eye complications.
- Secondly, if these patients have high blood pressure or kidney problems, these conditions must be appropriately managed. Otherwise, uncontrolled high blood pressure and kidney problems can further worsen diabetic retinopathy.
- Keep a tab on their vision, and if they notice any vision-related issues, they must get their eye checkup done immediately. But even if they don’t have any eye-related problems, regular eye checkups are a MUST for patients who have diabetes.
- Lastly, if a patient is diagnosed with diabetic retinopathy, then regular follow-up and proper treatment as recommended by his/her eye doctor is necessary.
- Team Diabefly: What is diabetic retinopathy?
Dr. Vandana Jain: It is a disease that impacts the blood vessels of the retina. Diabetic retinopathy causes damage to the retina/eye in multiple ways:
- The smaller blood vessels of the retina swell and become leaky. They can leak fluid, lipid, cholesterol on the surface and into the substance of the retina. If the swelling involves the main part of the retina that is the macula, it results in macular edema. Macular edema poorly affects the vision and requires treatment.
- Apart from this, blood vessels can also get blocked in diabetic retinopathy. If the blood vessels get blocked, it leads to ischemia. Ischemia means that some parts of the eye don’t get sufficient blood and oxygen supply. As a result, ischemia leads to new blood vessel formation. The new blood vessels formed are abnormal. These aberrant blood vessels grow on the surface of the retina or into the vitreous cavity (eyeball). They can leak blood and pull on the retina because they may have fibrous tissue that can contract.
All these changes in the retina that are seen in patients with diabetic retinopathy are due to raised blood sugar levels.
- Team Diabefly: How to prevent Diabetic Retinopathy?
Dr. Vandana Jain: Diabetic retinopathy, if left untreated, will progress from a mild to a more severe stage. It can be prevented by keeping the blood sugars in check by adopting a healthy lifestyle, taking the medications as advised by the Diabetologist, maintaining adequate nutrition, and exercising regularly.
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- Team Diabefly: How does keeping the blood sugars in control prevent eye problems in patients with diabetes?
Dr. Vandana Jain: As mentioned earlier, in diabetic retinopathy, the blood vessels of the retina get damaged. The retinal blood vessels get impacted — either they swell up and become leaky or get blocked. It is due to the constantly raised blood sugar levels or the fluctuations in the blood sugar levels.
So to prevent the progression of eye disease, patients with diabetes should keep their sugar levels under control. It is only not about achieving normal HbA1c levels, but the blood sugar levels should be kept in a particular healthy range throughout. Therefore patients should follow all the recommendations given by their Diabetologist religiously and also follow a healthy lifestyle.
- Team Diabefly: Do all patients with diabetes get diabetic retinopathy?
Dr. Vandana Jain: Not all patients with diabetes will get diabetic retinopathy. It depends on the duration of diabetes and how well-controlled the blood sugars are. If blood sugars are well under control, 22% of patients will develop diabetic retinopathy after the first 10 years of diabetes diagnosis.
As the duration of diabetes keeps on increasing, the risk of diabetic retinopathy increases. So after 15 years of diabetes diagnosis, 60% of patients will develop diabetic retinopathy.
In earlier stages of diabetic retinopathy, patients will not notice any changes in their vision. However, as long as patients get their regular eye checkups done, keep their blood sugars under control, and get timely treatment, diabetic retinopathy can be managed.
- Team Diabefly: What should be the routine for eye testing for a person with diabetes? How frequently should they get their eyes tested, and what should they do?
Dr. Vandana Jain: Anybody who has got diabetes requires a retinal evaluation or a dilated fundus examination. First eye checkup should be done at the time of the diagnosis of diabetes, irrespective of whether the patient has visual complaints or not.
This is because the majority of the patients who get diagnosed with diabetes are unaware that they have been living with diabetes for quite some time - it could be months or years. Eye checkup at the time of diabetes diagnosis will help in the early diagnosis of diabetic retinopathy and prevent further damage.
If the retina is healthy, then subsequent checkups should be done every year without fail. But suppose a patient is diagnosed with diabetic retinopathy at the first retinal evaluation. Then, how frequently the follow-up needs to be will be determined based on the stage and severity of diabetic retinopathy. In that case, a Retina Specialist can guide the patient.
- Team Diabefly: It is a widespread belief among patients that if they have diabetes, they will lose their vision. Is it always true? How can it be prevented?
Dr. Vandana Jain: Not really. Diabetes can affect vision in many ways, and the severest form of it is diabetic retinopathy. It can lead to vision loss if diabetic retinopathy is not treated in its early stages.
Patients will not have any symptoms at the initial stages of diabetic retinopathy unless they get themselves checked. In moderate stages, patients will experience some visual symptoms. And if they still ignore and allow the disease to progress to the last/end-stage diabetic retinopathy, they can lose their vision. But somebody will rarely let the disease progress to the end-stage where they can lose their vision.
So if patients are diligent, get their regular checkups done, control and treat diabetic retinopathy, then losing the vision is not something that will happen to everybody.
Patients can prevent vision loss caused due to diabetic retinopathy by maintaining a healthy lifestyle, keeping blood sugars in control, going for regular eye checkups, and getting the eye treatment recommended by the Ophthalmologist. In a nutshell, they should follow the recommendations of their Diabetologist, Nutritionist, Exercise Specialist, and Retina Specialist.
Don’t take diabetes lightly. Diabetes in its early stages may not lead to problems, but depending upon how the control has been and the duration of diabetes, it will lead to complications. These include diabetic retinopathy (eye problem), diabetic nephropathy (kidney disease), peripheral neuropathy (involving nerves), and cardiac disease (heart problems).
The only thing under your control is to keep your diabetes well-controlled. However, merely having a pill or using insulin injections to control your diabetes is not enough. Instead, follow a holistic approach that includes proper nutrition, exercise routine, stress management, and more.
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