Dr. Ibrahim Dunia
Associate Professor of Ophthalmology
Lebanese American University (LAU)
Generally, when people talk about “diabetes” they are speaking about diabetes mellitus. Monitoring the HbA1c is a crucial issue in patients with diabetes. Acutely if a person’s blood glucose is very high, the glucose can enter the lens within the eye and temporarily cause blurred vision. Therefore blurred vision can be an initial sign of diabetes in a person with very high glucose levels. This type of blurred vision will resolve after the blood glucose level is normalized. In advanced and usually chronic cases diabetes may cause blood vessels in the retina (the light sensitive lining of the eye) to become damaged (leaky or blocked) or grow abnormally. Retinopathy is rare before the age of 10 and the risk increases with the length of time a person has diabetes. Treatments such as laser, intraocular injections, or other surgery may be helpful to prevent visual loss or restore sight. Cataract may occur at a younger age in diabetic patients.
Retinopathy is usually due to damage to the tiny blood vessels in the retina. Retinopathy is commonly caused by diabetes, but is sometimes caused by other diseases and factors such as very high blood pressure. Over several years, a high blood sugar (glucose) level can weaken and damage the tiny blood vessels in the retina. This can result in various problems, which include:
- Small blow-out swellings of blood vessels (micro-aneurysms)
- Small leaks of fluid from damaged blood vessels (exudates)
- Small bleeds from damaged blood vessels (hemorrhages)
Retinopathy is a common complication of diabetes. It is more common in people with type 1 diabetes. The risk factors for diabetic retinopathy include:
- duration of diabetes
- poor glucose control
- high blood pressure
- high cholesterol level
You are less likely to develop retinopathy if your blood sugar (glucose) level is well-controlled.
Treatment can prevent loss of vision and blindness in most cases. Therefore, if you have diabetes, it is vital that you have regular eye checks to detect retinopathy before your vision becomes badly affected. You should have an eye check at least once a year over the age of 11.
Even if your check shows you do not have any retinopathy, you should still look after your diabetes and have a healthy lifestyle to reduce the risk of developing retinopathy in the future.
The treatment of diabetic retinopathy is a developing area of medicine. Some studies have shown benefits with various newer treatments.