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Management of Ocular Diseases

Cataract, a clouding of the eye’s lens, is commonly diagnosed at an earlier age and tends to progress more quickly in patients who have diabetes.  With a cloudy lens, light cannot pass to the retina properly and vision becomes blurred. Very often, the first signs of cataract are difficulties with night vision that progresses gradually over the years.  As cataracts worsen, there is a subtle loss of contrast so that more light is required for reading and colors may not seem as vibrant. Other symptoms such as halos around lights, starburst effects, double vision, or ghost-like shadows can also be indicators of cataracts.  Once cataracts start to affect your vision significantly, your optometrist may recommend cataract surgery to improve your vision.

In addition to maintaining good blood sugar control, the best way to prevent the development and progression of cataracts is by minimizing sun damage to the eye’s lens with sunglasses.  Patients with diabetes should look for sunglasses with UVA and UVB protection and make sure to wear them whenever outdoors.

Glaucoma is an eye disease in which the internal eye pressure rises to a point that can cause damage to the optic nerve.  As the optic nerve becomes damaged it causes a permanent irreversible loss of peripheral vision that may lead to blindness.  Patients with diabetes are at a higher risk for developing glaucoma than the average population. The process in which glaucoma develops is generally very gradual occurring over years to decades and usually has no significant symptoms until the disease has become severe.  In the early stages, glaucoma will not cause a noticeable change in vision. As the disease progresses, the patient’s side vision will become gradually less sensitive. Left unchecked, the side vision will continue to deteriorate and a “tunneling” effect will occur with vision appearing as if looking through binoculars.  Ultimately, the central vision can become involved and blindness is possible.

The diagnosis of glaucoma can only be made after a comprehensive eye exam and patients with diabetes are carefully screened for any changes related to glaucoma during their annual diabetic eye exams.  If diagnosed with glaucoma, prompt treatment (generally with prescription eye drops) is initiated to preserve good vision.

Double vision is a rare but serious symptom that can occur in patient with diabetes.  Double vision in patients with diabetes is often caused by damage to one of the nerves responsible for eye movement.  Out of the 12 cranial nerves, 3 of them are dedicated solely to eye movement. When one of these nerves is damaged, it results in the inability of one eye to move in one or more directions.  This leads to one eye viewing one image while the other eye is viewing another image which causes double vision. If a patient notices a sudden onset of double vision, it is important to call our office immediately.  Your optometrist will need to determine the cause of your symptoms and rule out other possible causes, including a stroke.

Dry eye syndrome is the number one ocular complication in patients with diabetes.  In fact, over 50% of patients with diabetes experience symptoms of dry eye disease.  Diabetes causes insulin insufficiency, triggers inflammation, and damages nerves all over the body including the eye.  The combination of these factors leads to decreased tear production and a dry ocular surface. Patients with dry eye syndrome may experience the following symptoms:  dryness, burning, redness, tearing, grittiness/sandiness,

Changes in glasses prescription is a common finding in patient with diabetes, especially in patients with poorly controlled glucose levels.  As blood sugar fluctuates, is causes changes to the shape of the lens in the eye, leading a shift in prescription.  These fluctuations may happen within days or weeks, so if your blood sugar is too high, your optometrist may not be able to get an accurate reading of your prescription for glasses or contact lenses until blood sugar levels improve.  The best way to avoid frequent changes in your prescription is to make sure your blood sugar levels are well controlled with diet, exercise, and medications as prescribed.

The best thing you can do to prevent ocular complications from diabetes is maintain good control of your blood sugar.  Good control of your diabetes can lower your risk of developing diabetic retinopathy by as much as 76%. See your physician regularly and follow instructions about diet, exercise, and medication.  See your optometrist as recommended for your comprehensive eye exam when you are first diagnosed with diabetes. Continue to have a thorough eye exam at least annually thereafter or more often as recommended by your eye doctor.

Read more

  • Nutrition is a vital part of maintaining vision and overall eye health, with many expert studies suggesting that up to 25% of all nutrient intake goes to supporting our invaluable visual system.
  • Glaucoma is a common eye condition in which your optic nerve, the bundle of nerves at the back of the eye, which feeds visual information to the brain, is damaged because of high inner eye pressure, known as intraocular pressure.