Eye complications that you should know about, if you live with diabetes.

Take the NetraSuraksha Self Check here.

When you have diabetes, your mental checklist is a long one: check blood sugar levels at this, this and this time, calculate carbs at each meal, take medication, restock the glucose monitor’s strips, check blood pressure… the list goes on. It’s easy to lose track of things that don’t need your daily attention – like diabetes complications that lead to eye problems and vision loss. Or, for that matter, any diabetes complications that are gradual in nature. They creep up on you, and you only notice them when you can’t ignore them… and by then, the damage is done.

We don’t want to add to your mental burden. But, we do want to inform you. So let’s put your mind at ease. You need to do just one thing after you read this article – mark your calendar for your annual eye exam (at the ophthalmologist, not the spectacle shop!) on your phone calendar, and follow through. No complicated list of instructions, no need to play doctor with yourself and no hypervigilance around symptoms.

The list below may look scary, but it doesn’t need to be. Diabetes creates complications in the eyes that are easily detected, and easily treated when caught early. Most are even preventable, but most people with diabetes don’t know it. This is a knowledge gap we can fix.

Network18 has launched the ‘Netra Suraksha’ – India Against Diabetes initiative, in association with Novartis, to bring together the best minds in medicine, policy making and think tanks to bear on the problem of Diabetic Retinopathy, a known complication of diabetes that is the top reason for blindness in the working age population worldwide. The initiative disseminates information through telecasts of round table discussions, explainer videos and informative articles, with the aim of empowering you to take better care of your own and your family’s health and vision.

To that end, let’s first understand how the eye works.

The eye is covered with a tough outer membrane. The clear, curved covering in the front of they eye is called the Cornea. It’s main function is to focus light, while also protecting the eye¹.

After light passes through the cornea, it travels through a space called the anterior chamber (which is filled with a protective fluid called the aqueous humor), through the pupil (which is a hole in the iris, the colored part of the eye), and then through a lens that performs more focusing. Finally, light passes through another fluid-filled chamber in the center of the eye (the vitreous) and strikes the back of the eye, the retina¹.

The retina records the images focused on it and converts those images into electrical signals, which the brain receives and decodes. One part of the retina is specialized for seeing fine detail. This tiny area of extra-sharp vision is called the macula. Blood vessels in and behind the retina nourish the macula¹.

Now let’s look at the ways in which diabetes can cause problems in the eye.

Glaucoma

Glaucoma is a group of eye diseases that can damage the optic nerve—the bundle of nerves that connects the eye to the brain. Diabetes doubles the chances of having glaucoma, which can lead to vision loss and blindness if not treated early².

Glaucoma occurs when pressure builds up in the eye. The pressure pinches the blood vessels that carry blood to the retina and optic nerve. Vision is gradually lost because the retina and nerve are damaged³.

Cataracts

The lenses within our eyes are clear structures that help provide sharp vision—but they tend to become cloudy as we age. People with diabetes are 2- 5 times more likely to develop cloudy lenses, called cataracts. People with diabetes can also develop cataracts at an earlier age than people without diabetes – in fact, the risk goes up 15-25 times than their counterparts who do not have diabetes⁴. Researchers think that high glucose levels cause deposits to build up in the lenses of your eyes. People with diabetes also tend to get cataracts at a younger age and have them progress faster⁵.

Retinopathy

Diabetic Retinopathy is a general term for all disorders of the retina caused by diabetes. There are two major types of retinopathy: nonproliferative and proliferative. In nonproliferative retinopathy, the most common form of retinopathy, capillaries in the back of the eye balloon and form pouches. Nonproliferative retinopathy can move through three stages (mild, moderate, and severe), as more and more blood vessels become blocked. In proliferative retinopathy, the blood vessels are so damaged they close off. In response, new blood vessels start growing in the retina. These new vessels are weak and can leak blood, blocking vision. The new blood vessels can also cause scar tissue to grow. After the scar tissue shrinks, it can distort the retina or pull it out of place, a condition called retinal detachment⁶.

Macular Edema is another disorder that is considered part of the Diabetic Retinopathy cluster. We now know that the part of your retina that you need for reading, driving, and seeing faces is called the macula. Diabetes can lead to swelling in the macula, which is called Diabetic Macular Edema. Over time, this disease can destroy the sharp vision in this part of the eye, leading to partial vision loss or blindness. Macular edema usually develops in people who already have other signs of Diabetic Retinopathy².

The chances of developing retinopathy and having a more severe form increase when⁶:

• You have had diabetes for a long time.
• Your blood sugar (glucose) has been poorly controlled.
• You also smoke or you have high blood pressure or high cholesterol.

But, as promised, all that is asked of you is an annual eye exam with your eye doctor – it is a routine and painless eye exam, and will help you stay ahead of Diabetic Retinopathy and vision loss. Here’s how you can get started – take our online Diabetic Retinopathy Self Check Up to assess your risk. Then, read up on the Netra Suraksha initiative page on News18.com, where all the materials (round table discussions, explainer videos and articles) are available to you.

Take a proactive role in your health. Just as in the treatment of diabetes, small actions add up. So don’t hesitate. Make today the day you take the first step towards preventing Diabetic Retinopathy, and protecting your vision.

References:

1. https://socaleye.com/understanding-the-eye/ 18 Dec, 2021
2. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/diabetic-eye-disease 18 Dec, 2021
3. https://www.mayoclinic.org/diseases-conditions/glaucoma/symptoms-causes/syc-20372839 18 Dec, 2021
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3589218/ 18 Dec, 2021
5. https://www.ceenta.com/news-blog/can-diabetes-cause-cataracts 18 Dec, 2021
6. https://www.mayoclinic.org/diseases-conditions/diabetic-retinopathy/symptoms-causes/syc-20371611 18 Dec, 2021

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