Diabetic Eye Disease
Diabetic eye disease includes a wide range of problems that can affect the eyes in people living with diabetes. Diabetes may cause a reversible, temporary blurring of the vision, or it can cause a severe, permanent loss of vision or even blindness.
Diabetes mellitus increases the risk of developing retinopathy, cataracts and glaucoma.
1. In Diabetic retinopathy blood vessels in the retina of the eyes are damaged.
2. In Cataract the lens of the eye becomes cloudy and opaque disallowing light from passing through and as such leading to poor vision or blindness. Cataracts are known develop at an earlier age in people with diabetes.
3. Glaucoma-is a group of diseases that leads to optic nerve damage and loss of vision. Persons with diabetes are nearly twice as likely to get glaucoma as other adults.
Diabetic Retinopathy – is the most common diabetic eye disease which affects retina. The retina is the light-sensitive tissue at the back of the inner eye. A healthy retina is necessary for good vision. In diabetics, increase blood-sugar and other abnormalities in metabolism causes damage to the blood vessels in the eye and every other part of the body. This damage to the blood vessels leads to poor circulation of the blood to various parts of the body and the eye. Since the function of the blood is to carry oxygen and other nutrients, this poor circulation causes decreased oxygen delivery to tissues in different parts of the body including the eye and subsequent damage to those tissues. In some people with diabetic retinopathy, blood vessels may swell and leak fluid. In other people, abnormal new blood vessels grow on the surface of the retina. if the retina of the eye is swollen, wrinkled, or otherwise structurally damaged, the vision in that eye will be blurry. Depending on the type, location, and extent of damage in the retina, the change in vision will range from minimal to severe and be temporary or permanent. Diabetic retinopathy usually affects both eyes.
Who is at RISK?
Everyone with diabetes should get a comprehensive dilated eye exam at least once a year because all people with diabetes either type 1 or type 2 is at risk. Studies have shown that the longer someone has diabetes, the more likely he or she will get diabetic retinopathy.
If you have diabetic retinopathy, you may need an eye exam more often. People with proliferative retinopathy can reduce their risk of blindness by 95 percent with timely treatment and appropriate follow-up care.
What do I do if I have already lost vision from DR?
If you have lost some sight from diabetic retinopathy or other ocular diseases, ask your eye care professional about low vision services and devices that may help you make the most of your remaining vision. Ask for a referral to a specialist in low vision.
Hypertensive Eye Diseases
High blood pressure popularly called hypertension contributes to a number of vision-threatening eye conditions know as hypertensive eye disease. These eye diseases include retinal microaneurysm, retinal vascular occlusion, and non arteritic anterior ischaemic optic neuropathy. In addition, it has been implicated in the pathogenesis of age-related macular degeneration and may also exacerbate the vision-threatening effects of diabetic retinopathy.
The effects of uncontrolled hypertension are directly visible in the eye as hypertensive retinopathy (HR) and choroidopathy. Hypertensive retinopathy is retinal vascular damage caused by hypertension. Our close collaboration with other health providers especially physicians is geared towards ensuring that hypertensive patients are identified and treated. Timely intervention in these patients has shown to reduce the risk of both vision-threatening and systemic complications.
Symptoms of Hypertensive Retinopathy
1. Reduced vision.
2. Eye swelling.
3. Bursting of a blood vessel.
4. Double vision accompanied by headaches.
Signs of Hypertensive Retinopathy
Hypertension causes retinal vascular damage. Signs usually develop late in the disease. Funduscopic examination shows arteriolar constriction, arteriovenous nicking, vascular wall changes, flame-shaped hemorrhages, cotton-wool spots, yellow hard exudates, and optic disk edema.
How is hypertensive retinopathy treated?
The treatment for malignant hypertensive retinopathy once detected can be treated by the physician by reducing the systemic blood pressure below 140/90 mmHg. This can be accomplished by assemblage of medical treatments for hypertension. Medical treatment can only treat the acute changes of hypertension from vasospasm and vascular leakage. Laser and other intravitreal injection of corticosteroids or antivascular endothelial growth factor drugs may be useful in treating retinal edema arising from chronic hypertension.
Can hypertensive retinopathy be cured?
The condition can lead to symptoms including double or dim vision, loss of vision and headaches. Treating hypertensive retinopathy typically involves controlling high blood pressure through lifestyle changes, medication and careful monitoring. Through this, the condition can be halted, and the damage may slowly heal.
Age-Related Macular Degeneration
AMD is an acronym for Age-Related Macular Degeneration. It is a progressive disease associated with aging that gradually destroys central vision and impairs ability to perform common daily tasks such as reading, driving or watching television. AMD is one of the leading causes of severe vision loss in adults over the age of 50. There are two forms of AMD- Dry AMD and Wet AMD.
- Dry AMD is caused by accumulation of cellular debris in the macula which leads to damage in the light sensitive cells. This eventually leads to distortion of central vision. Although Dry AMD progresses fairly slowly for most patients, treatment options still exists that may delay and possibly prevent dry AMD from advancing to a point where severe vision loss occurs. One of the treatment options includes nutritional supplementation in the form of very specific high-dose vitamin therapy (AREDS).
- The wet form of AMD is characterized by spontaneous leakage of blood and other fluids into the macular by tiny blood vessels. This destroys the ability of the macular to function properly. Wet AMD is more serious than the Dry type because it can progress very rapidly, sometimes in a matter of weeks, causing loss of vision. Wet AMD may be treated using drug therapy through injections in the eye and/or laser surgery.
Factors affecting risk of developing AMD:
Increasing age, family history of AMD, smoking, UV light exposure, obesity, blood pressure, eye color, and gender.
You should expect better visual outcome if AMD is detected or diagnosed early. Therefore it is important to understand if you are at risk, as this will help you and your eye care provider to develop a personalized program to manage the disease. It is of note that AMD cannot be reversed; however, vision loss associated with it can be prevented or delayed through early detection, monitoring, diagnosis and treatment. You stand at a better chance to save your sight if you understand your risk level early.