Sugar Matters
September 13, 2011
Eyes revisited

As we continue talking about complications, this week we address diabetes and its effects on your eyes. I wanted to revisit this important topic because eye disease is one of the saddest complications of diabetes. Even though it is usually painless, it takes so much away from us.{{more}}

Many of you know my father, Dr Krishniah Ramsetty. Many years ago, my father worked here in St.Vincent as an eye doctor. I recall seeing patients come to their appointments with poor vision and leaving with improvements that brought the world back into their lives again. What I did not know at the time was that many of my father’s patients had diabetes, and now we in fact share many of the same groups of patients.

Diabetes is one of the leading causes of adult blindness in the world. It is difficult to try to imagine a world where everything is not clear. Or shadows where you used to see your son or daughter. Or complete darkness where you used to see your wife or husband.

Blindness results mainly from diabetic retinopathy, a situation where high blood sugars cause damage to the retina. The retina is an area at the back of the eye, where many cells are responsible for receiving light that is later converted into a picture in your brain. In poorly controlled diabetes the blood vessels in the retina start to leak. Sometimes, you grow new vessels to help out, but they end up growing on top of cells that need to receive light. These two situations lead to loss of vision, because the retina becomes damaged. Often diabetic retinopathy is in BOTH eyes, so you can lose vision all around. Retinopathy often requires laser treatment to effectively stop the bleeding in your eyes.

Cataracts are often seen in other conditions as well, including simply getting older. But it happens in younger folks who have diabetes, especially if those blood sugars are wildly out of control. As you recall, cataracts are basically when the lens in your eye, which is responsible for filtering light on its way to the retina, gets cloudy. If it gets too cloudy to allow good function, the cataract must be taken out. This can affect one or both eyes. Cataracts certainly affect vision a great deal, and I find most patients have trouble mainly at night, because of the glare of light. If you see lots of shadows, a spot somewhere that isn’t really there, or see lots of white rings around things at night, then it’s time for a visit to your eye doctor, because you may have cataracts.

Glaucoma can cause slow or quite rapid vision loss. In glaucoma, the amount of pressure builds up in your eyes and stops good blood flow from getting to the cells. Your doctor may prescribe several types of eye drops to help control this disease. Please, USE THE DROPS. The drops do not work if they sit in your cabinet or fridge, instead of your eyes.

As always, an ounce of prevention is better than a pound of cure. There are two main ways that you can help prevent diabetic eye disease:

1) Keep your sugars under control.

2) Be sure to have an eye exam every year, and more often, if you are having trouble with eye disease already.

Until next week, stay safe and healthy Vincies.

Anita Ramsetty, MD
Medical Director Endocrine Care Group
Tel: 843-798-4227