About Author: Dr Ajay Aggarwal is senior consultant and incharge, Department of Endocrinology, Fortis hospital, New Delhi. His major areas of interest include diabetes, parathyroid disorders and thyrotoxicosis. He has published many papers in various journals and delivered talks at many national and international conferences. He is also working as principal investigators (PI) in various multinational clinical trials. He is a member of many national and international medical societies.
A quarter of the world’s blind population is estimated to be in India, about 12 to 15 million. This is bound to increase as diabetes is one of the leading causes for loss of vision in India. With an estimated 51 million people currently living with Diabetes, India leads the world in the prevalence of diabetes, and this is predicted to go worse by 2030. This is true that people with diabetes do have a higher risk of blindness than people without diabetes, but it is equally true most people with diabetes can keep these problems to minor. It is very important to realize that good blood sugar control; regular and timely check-up, proper testing and eye care can often save vision by up to 90%.
Effect on diabetes on eyesight
Uncontrolled diabetes can affect the eyes and vision in a number of ways. The most significant complication that can cause blindness in people with diabetes is diabetic retinopathy. Diabetes may also cause frequent fluctuations in vision, cataract at younger age, Glaucoma, decreased vision due to involvement of optic nerve, temporary paralysis of the muscles of eyes and thus double vision.
Retina is the layer at the back of the eye that is sensitive to light. Diabetic retinopathy is a term used for abnormalities of the small blood vessels of the retina caused by uncontrolled diabetes. Early form of diabetic retinopathy may not lead to any decrease in vision or symptom. If the care is not taken, then eventually the blood vessels close off. As the disease progresses, new blood vessels form. These vessels are quite fragile and bleed into the eyes causing severe vision problems and blindness. The other risk factors for diabetic retinopathy are high blood pressure, anemia, kidney diseases, and pregnancy.
Symptoms of diabetic retinopathy
Retina can be badly damaged before any noticeable change in vision; therefore it is essential to have periodic evaluation of eye by an ophthalmologist. Pupils need to be dilated with eye drops, so that ophthalmologist may have a good look at the back of eye. When eye checkup is done annually, doctor is able to catch retinopathy in the early stages. In this stage, the condition is easily treatable. Women with diabetes who are pregnant should have a comprehensive eye examination in the first trimester and close follow-up throughout pregnancy.
Preventive measures for diabetic retinopathy
High blood glucose levels are responsible for all forms of diabetic eye disease.Maintain blood sugar level within normal range. HbA1C level should be tested at least twice a year and be aimed at less than 7 percent.
Work with your physician regarding medicines, meal planning, physical activity, and blood glucose monitoring for optimal blood sugar control. Your doctor may advise insulin if your HbA1c level is above 7.5% even after taking OAD’s or 9% at the time of diagnosis. The landmark Diabetes Complications and Control Trial proved that each 10% reduction in average blood glucose levels, as reflected by HbA1clevel, lowers the risk of developing diabetic retinopathy by roughly 60% and lowers the risk of preexisting diabetic retinopathy getting worse by 43%.
Don’t miss appointments with doctor. When a person is diagnosed with diabetes, it becomes imperative that one has annual vision tests and eye fundus examination.
It is better to abstain from alcohol and stop smoking