1. True or False? People who have good control of their diabetes are not at risk for diabetic eye disease.
2. True or False? Diabetic eye disease usually has early warning signs.
3. True or False? Cataracts are common among people with diabetes.

Complications from diabetes can affect many systems in the body, such as the heart and kidneys. Diabetes-related eye diseases can also affect vision. Diabetic retinopathy accounts for 12 % of all new cases of blindness each year for people between 20 and 74 years of age. While there are other eye complications associated with diabetes, I am discussing diabetic retinopathy here because patients are often not aware of it until quite late in its progression. By then vision can be lost permanently.
In diabetic retinopathy the blood vessels in the back of the eye leak fluid or blood, which seeps into the retina and causes it to swell. Retinal blood vessels may also close, preventing blood and nutrients from reaching areas of the retina. This causes those areas to die. New blood vessels may grow to compensate for the closed blood vessels, but they always bleed and create scarring. The scarring may even cause the retina to detach or wrinkle.
Early detection and appropriate treatment significantly reduces the risk of vision loss from diabetic retinopathy. Diabetic patients should perform an easy vision test every day to detect subtle changes in their vision. However this is not a complete guarantee that the eyes are healthy. Symptoms of diabetic retinopathy are usually not obvious until the advanced stages. Pain, blurred or shadowy vision, and redness may only occur when treatment is more difficult and less successful. A variety of laser treatments and injections may be used in order to prevent further vision loss. Treatment is more successful if started early at the first signs of retinopathy. These signs are detected with a dilated eye examination.
Not everyone with diabetes develops diabetic retinopathy, but the chances increase after being diabetic for several years. In fact, sometimes the diagnosis of diabetic retinopathy leads to the diagnosis of diabetes. Evidence also suggests that such factors as pregnancy, high blood pressure and smoking may cause diabetic eye disease to develop or worsen.

To help prevent the development of diabetic retinopathy and minimize vision complications:
 Take prescribed medications as instructed.
 Follow a proper diet
 Exercise regularly
 Perform a simple visual test daily
 Have your eyes examined annually

Answers to quiz:
1. False; good control of blood glucose is very important in over-all management of diabetes, but may not prevent diabetic eye disease. All people with diabetes should have an eye examination through a dilated pupil.
2. False; often there are no early warning signs of diabetic eye disease. Vision may not change until the disease becomes severe.
3. True; people with diabetes are twice as likely to develop cataracts and to develop them at an earlier age than those without diabetes.

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