Don't Let Diabetes Blindside You: Importance of Regular Eye Exams

Dr. Sneha Shah is an Eye and Aesthetic Surgeon. She works as a consultant at Breach Candy Hospital and Lilavati Hospital in Mumbai. In an exclusive conversation with Deccan Chronicle, she discusses the connection between diabetes and eye health and also explains how diabetes affects vision and the importance of diabetic eye exams.

What are the most common eye-related complications associated with diabetes?

The most common eye-related complications associated with diabetes are those that affect the retina, as diabetes can impact every part of the eye.

So diabetic retinopathy is one of the most alarming, most vision and sight-threatening complications. So, is there a way to prevent or manage this?

Diabetic retinopathy is the number one preventable cause of blindness. To avoid it, simply take care of your diabetes. Two factors affect how diabetes impacts the eye: control of diabetes and duration. While duration isn't in your hands, controlling blood sugar levels can significantly delay or prevent eye complications.

How does high blood sugar levels affect the eyes? And what are the signs of diabetic eye disease?

Diabetes affects the body by making blood vessels leaky, like a corroded pipe. This impacts organs with small blood vessels, such as the kidneys, nerves, and eyes. In the eyes, fluid leaks from the vessels, causing complications like diabetic maculopathy, where fluid accumulates in the retina, blurring vision. Imagine having fluid on your glasses - you can't see clearly. The retina is like a photographic film, so fluid accumulation distorts vision. Another issue is new vessel formation, which can lead to hemorrhages inside the eye if they can't handle blood pressure.

How important are regular diabetic eye exams and how frequently should they be done?

Regular diabetic eye exams are crucial. Norms by the Diabetic Association, Ophthalmic Association of India, and American Academy of Ophthalmology recommend the following: -

• For Type 1 diabetics, eye checkups should start 5 years after diagnosis.

• For Type 2 diabetics, exams should be done every 2-3 years, depending on sugar control.

• If sugars are not well-controlled, exams should be done every year.

• Once signs of retinopathy appear, exams become more frequent (every 3-4 months or 2 months).

• The goal is to intervene before permanent damage occurs.

Can you discuss the relationship between diabetic retinopathy, macular edema, vision loss, and available treatment options?

Diabetes increases the risk of other eye conditions like cataracts, glaucoma, and retinal detachment. It accelerates cataract development, with diabetics developing cataracts at a younger age than non-diabetics. Diabetes can also affect vision by changing the refractive error of the lens, causing fluctuating vision due to blood sugar level changes. This is something people should keep in mind and inform their ophthalmologist about, so we can consider sugar level control when prescribing glasses.

Diabetes affects the retina in two main ways: -

Macular edema: fluid accumulation in the retina. -

Formation of new vessels: can cause bleeding, traction, or retinal detachment. Treatment options are available, but early detection through regular eye exams is key to preventing vision loss.

What lifestyle changes can someone with diabetes make to prevent eye vision loss? To prevent eye vision loss, two main things are crucial. Firstly, controlling diabetes is a must - there are no shortcuts. Keeping blood sugar levels under control minimizes the risk of eye complications. Secondly, regular and routine screenings can detect problems early, nipping them in the bud and avoiding dramatic complications.