Eyes and Diabetes

Dr Sudipo Pakrashi
Do You Know…
India is soon set to emerge as diabetic capital of the world As per World Health Organization data, there were 31.7 million diabetics in India in 2000, and this number is estimated to rise to 80 million by 2030 After 20 years of diagnosis, 75% of diabetic patients develop some form of diabetic retinopathy, of which 10% have sight threatening disease.
Here are some frequently asked question and their answers with regard to diabetes
Can diabetes affect the eye?
Yes. Diabetes can affect various parts of the eye and cause significant loss of vision in the long term.
In what ways can diabetes affect the eye?
Ans: Diabetes can cause early onset of cataract. There is higher probability of glaucoma occurrence in patients with diabetes. The most significant eye problem in diabetes is diabetic retinopathy.
What is diabetic retinopathy? Why is it so dangerous?
Ans: The retina is a thin sheet at the back of the eye, which is akin to the film of a camera. Just like images in a camera are formed on its film, images of whatever we are seeing are formed on the retina of the eye. The retina can develop hemorrhages, swelling, and abnormal blood vessels in diabetic patients. All of these can significantly hamper vision. In some cases, vision cannot be restored fully with treatment.
How will I know that my eyes are affected?
Ans: Diabetic retinopathy remains silent for many years before vision gets affected. However, diagnosis in the initial silent phase is important. So, if you have diabetes, do not wait for any symptoms to develop. Get a periodic eye check up done.
I have been diagnosed with diabetes only recently. Could my eyes still be affected?
Ans:  Yes. Diabetes typically has been present for many years before it gets diagnosed. In this time, it may have affected your eyes. You need an eye checkup as soon as possible.
My blood sugar levels are always well controlled. Can my eyes still be affected?
Ans: Good blood sugar control goes a long way in preventing eye damage from diabetes. But you may have mild forms of retinopathy in spite of good sugar control. It is always advisable to get periodic eye checkups done.
I recently got my eyes checked and was prescribed glasses. Do I still need to visit an eye doctor?
Ans: Yes. Getting eye power checked at an optical shop, and getting eye checkup by a doctor are two different things. Your eyes need to be checked for signs of cataract, glaucoma and diabetic retinopathy, all of which are not done at the optical shop.
I got new glasses made 15 days ago. Now my number has changed again. Could it be because of diabetes?
Ans: Yes. Fluctuating blood sugar levels cause the refractive error (i.e. the power of glasses required) to change frequently. It is advisable to control blood sugar adequately before getting the refractive error tested.
Can I visit any eye doctor for a routine checkup?
Ans:  While it is advisable to visit a retina specialist regularly if you are a diabetic, do not defer your eye checkup if a retina specialist is not available in your area. Get a dilated eye examination done by any certified eye doctor.
Is it necessary to dilate my eyes for evaluation?
Ans: Absolutely. Minor findings may be missed by even retina specialists if retina evaluation is done without dilating the eyes. This can delay the initiation of treatment and can be disastrous in the long run.
How frequently should I get my eyes checked?
Ans: All diabetic patients should get a thorough eye checkup done atleast once a year. Once diabetic retinopathy sets in, more frequent checkup is required. You will be informed the frequency of checkup by your doctor.
Can diabetic retinopathy be cured?
Ans: There is no definitive cure for diabetic retinopathy. However, a number of treatment options are available to medical science today that can keep the disease under control and prevent or reduce the chances of vision loss.
What are the treatment options for diabetic retinopathy?
Ans:  Depending on the stage of the disease, you may not require any treatment at all. Just a periodic checkup may suffice. In more advanced stages of the disease, retinal laser or injections of medicines into the eye may be required. Sometimes, surgery is required to manage some complications of diabetic retinopathy.
(The author is (Chairman-Medanta Division of Ophthalomology “Medanta The Medical Sector)