The eyes are said to be the windows of the soul but they may also present early signs of diabetes
USUALLY THE average person begins to wonder if he has developed diabetes when he is urinating too frequently, becoming thirsty too often and increasingly feeling hunger pangs. However, Dr. Maynard McIntosh, ophthalmologist, says that far too often in his experience, sudden vision problems are the first signs that trouble is on the lurk with the blood sugar levels.
"When a patient walks in and says that he has not been able to see well in the past month and he has never worn glasses before and when you check his eyes, the prescription is a high plus, usually when they are referred for a blood-sugar test, it turns up that he has diabetes. Eye problems can therefore be a presenting symptom of diabetes," he said.
These patients may complain of blurred vision or spots floating in front of the eyes; diabetes can present as an eye problem whether in the early stages or as partial blindness.
Diabetic eye disease (diabetic retinopathy) is usually the result of damage to the blood vessels in the retina, the light-sensitive layer of the eye. Dr. McIntosh points to different stages in the progress of diabetic eye disease. In the earlier, less severe stage, the retina's blood vessels become porous and leak fluid into the retina -- this causes the blurred vision experienced by some patients. He said that pictures taken of eye will actually clearly show blood leaking into the naked eye.
In the more advanced and severe stage of the disease (proliferative retinopathy), there is, Dr. McIntosh explained, an abnormal growth of blood vessels in the eye that can bleed causing loss of vision.
Most of the early vision problems usually resolve themselves as soon as the diabetes is brought under control, but more serious eye problems could be on the horizon for patients with diabetes mellitus. Dr. McIntosh said that usually five years into the diabetic encounter, patients and their physicians would be on the alert for the beginning of any eye problem.
Most persons with diabetes, however, can survive even 10 years without having any eye disease associated with the diabetes but Dr. McIntosh said these patients would have kept their eye troubles at bay by putting diabetes under early control.
"To prevent this happening too early you must control the sugar and the blood pressure because blood pressure is very much linked to diabetics developing eye disease early. The blood circulation, blood pressure and control of diabetes are all tied in together, so all these indicators have to be monitored very carefully," he said.
Insulin-dependent diabetics are more prone to eye disease. Dr. McIntosh said that juvenile diabetics can develop diabetic eye disease but in his experience it is far less common, perhaps because children are less likely to have the other associated risk factors such as high blood pressure and high cholesterol levels.
LASER TREATMENT
Dr. McIntosh says that the aim of treatment is to control the diabetes and the associated high blood pressure. Although this treatment protocol doesn't usually reverse damage already done to the eye, it will slow down the progression of the disease.
Laser surgery is available in Jamaica and may be used by specialists to seal leaks in blood vessels or get rid of abnormal fragile vessels that will leak blood into the eye. Surgical treatment (vitrectomy) is used in cases of haemorrhage into the eye. It may also be used to repair retinal detachment caused by haemorrhage and subsequent scarring.
Risk factors
You are at higher risk for type 2 diabetes if you:
- are overweight with a body mass index (BMI) of 25 and greater
- have accumulated fat around the waist and stomach
- lead a basically sedentary lifestyle
- are older than 45 years old (with risk increasing even further when one
is older than 65 years old)
- are a woman who had pregnancy-related diabetes or had a baby weighing nine
pounds or more
- measure less than 35 for high-density lipoprotein (HDL) cholesterol level
- have high triglyceride level (250 or above)
- have high blood pressure
