Retina:
The retina is a layer of cells that lines the back wall inside the eye. This layer senses light and sends signals to the brain so we can see.
Macula Lutea Retinae (Macula Retinae):
It is a part of the retina located in the center of the retina responsible for acute anterior vision (reading, writing, and seeing faces).
Impact of Diabetes on the Eye:
Diabetes can affect the eye when the blood glucose (glucose) level is high, as it leads in the near term to a change in fluid levels or to swelling in the eye tissues that help focus, resulting in blurred vision, as people sometimes experience blurry vision for a few days or weeks when the treatment plan or medications are changed , this type of blurred vision is temporary and disappears when the glucose level near to the normal range.
Eye diseases that can affect a diabetic's eyesight:
If the blood glucose level remains high over time, high glucose may cause damage to the tiny blood vessels in the retina. This damage can begin when a person is pre-diabetic. Eye diseases include:
- Diabetic retinopathy: One in three people with diabetes over the age of 40 already have some signs of diabetic retinopathy and it is the most common cause of vision loss in diabetics, its early detection and treatment reduces the risk of blindness by 95%.
- Macular oedema: Diabetes mellitus can leak fluid from damaged blood vessels, resulting in macular edema, which can destroy acute vision in this part of the eye causing partial or complete loss of vision.
- Glaucoma: occurs when fluid in the eye is not properly excreted, increasing pressure within the eye and optic nerve (which carries visual images to the brain and it contains too many nerve fibers), it can lead to vision loss if not detected and treated early.
- Cataract: It is the opacity that affects the eye lens, where the vision is cloudy and somewhat similar to looking at a frozen or disturbed window. When white water is formed, the lens begins to lose its transparency gradually until it becomes opaque, which prevents the light passage through it, then vision becomes blurred (such as: difficulty reading, etc.).
Diabetic Eye Disease Risk Factors:
Anyone with diabetes can develop diabetic eye disease but the risk of developing it increases if:
- Blood glucose is too high and has not been treated.
- Blood pressure is high and untreated.
- High cholesterol and smoking may also increase the risk of diabetic eye disease.
- Older people are at greater risk of vision loss or blindness due to diabetes.
- Pregnancy: If a patient has diabetes and becomes pregnant, she can develop eye problems very quickly during pregnancy also if she already has diabetic retinopathy, it may get worse during pregnancy.
- Increased duration of diabetes.
Symptoms:
Often there are no early symptoms of diabetic eye disease as the patient feels no pain and no change in vision, the damage begins to grow inside the eye, especially with diabetic retinopathy. When symptoms occur, it may include:
- Blurry or undulating vision.
- Change vision frequently from day to day.
- Dark areas or loss of vision.
- Achromatopsia (Poor color vision).
- Dark spots or threads.
- Flashes of light.
When to see a doctor:
See a doctor right away if you notice:
- Sudden changes in vision such as flashes of light
- Seeing many more stains than usual
- If you start to see a dragged curtain on the eyes.
Diagnoses:
Diagnosis is made by an extended eye examination, where dilated pupil drops are used before the examination to be able to see the whole eye. A vision test and eye pressure measurement were also performed.
Treatment:
Treatment options are determined by the type of eye problems and may be either medication, laser therapy, surgery, or a combination of options.
Prevention:
To prevent diabetic eye disease or to prevent its worsening, you should:
- Controlling diabetes by controlling glycated hemoglobin in the target range, controlling blood pressure, cholesterol, and smoking cessation.
- Maintain the eye examinations dates determined by the health care provider according to the type of diabetes and the time since the initial diagnosis of the disease.
Diabetes Eye Screening Guidelines:
- Type 1 diabetes: Annual eye exams should begin within 5 years of diagnosis.
- Type 2 diabetes: Annual eye exams should begin immediately after diagnosis.
- Pregnancy: Women with type 1 and type 2 diabetes need an eye exam before pregnancy or during the first trimester, the exam can be revisited later in pregnancy until the baby is 1 year old.