Diabetes and the eye
- Diabetes mellitus (Type 2 Diabetes) affects the eye through premature cataract formation, fluctuating refraction (spectacle requirements) and so called retinopathy. Retinopathy implies malfunction of the nerve and sensory layer of the eye due to damaged small blood vessels and manifests in three basic forms:
- early background changes which seldom affect vision and are relatively innocuous.
- maculopathy which impairs vision.
- proliferative retinopathy, the complications of which may have catastrophical visual consequences.
- Optimal control of diabetes through diet, oral medication or insulin injection is very important and may delay, but not necessarily prevent the onset of retinopathy.
- Systemic hypertension (high blood pressure) should be well controlled, as should high blood cholesterol levels.
- Complete ophthalmic evaluation shortly after the initial diagnosis of diabetes is advised. Depending on the findings at this stage, regular follow-up visits will be scheduled to monitor progression. Since treatment may be required in the presence of absolutely normal vision, these follow up examinations are most important.
- Once vision threatening retinopathy is noted, different forms of laser treatment are employed to improve vision or prevent further complications.
- Some of these complications (e.g. vitreous haemorrhage, membrane formation or retinal detachment) may require surgical treatment.
- The keys to preservation of vision are:
- early base line evaluation.
- regular follow-up examination (as scheduled or promptly when new symptoms appear) to monitor any progression.
- optimal control of the diabetes