DIABETIC EYE DISEASE
What is Diabetic Retinopathy?
People living with diabetes can suffer from an eye disease called diabetic retinopathy. The disease occurs when hyperglycemia (high blood sugar) damages blood vessels in the retina. These blood vessels in the retina swell, leak, or become obstructed. In some instances, abnormal blood vessels develop on the retina. These changes can result in blindness.
Diabetic retinopathy has two stages:
- Non-proliferative (early stage of eye disease) and
- Proliferative (advanced stage of eye disease)
Development of Diabetic Retinopathy
Prolonged high blood sugar (hyperglycemia) and other abnormalities in metabolism found in people living with diabetes may damage the blood vessels in the body. This damage to the blood vessels leads to poor circulation of the blood to various parts of the body, and reduced supply of oxygen and nutrients to sensitive parts like the eyes. This, coupled with the fact that this damaged blood vessels tend to leak blood and other fluids in the retina of the eyes causing the retinal tissue to swell resulting in cloudy and blurred vision, is the main cause of Diabetic retinopathy. High lipid levels, anaemia and uncontrolled hypertension can make the situation worse.
Signs and symptoms of Diabetic Retinopathy?
During the early stages, diabetic retinopathy is asymptomatic (lacks symptoms). However, as the condition worsens, the following symptoms can affect both eyes:
- Presence of a high number of floaters (specks)
- Blurred vision
- Fluctuation between blurred and clear vision
- Poor night vision
- Vision of colours as faded or washed out
Prevention Measures for Diabetic Retinopathy Patients?
- Blood sugar control
- Management of high blood pressure and kidney problems
- Regularly visits to an ophthalmologists
- Prompt treatment of diabetic retinopathy upon diagnosis
Optimum Glycemic control – Ensuring one’s blood glucose is as close to the normal range as possible is particularly important for managing retinopathy. This can be done through a combination of following the right diet; being physically active and taking diabetic medications as prescribed. See the interventions listed on the next page!
Intervention; Nutritional Therapy
Nutritional therapy for diabetic retinopathy should be geared towards tight blood sugar control to improve the symptoms and delay the progression of retinopathy.
The nutritional diet should include fruits and vegetables with a low glycemic index and high fibre content. Through consuming food with antioxidant properties patients will benefit from minimal oxidative stress in the retina. Besides, the fibre and vitamins found in fruits and vegetables will improve blood flow and insulin sensitivity in the retina. Some of the antioxidant micronutrients that are suitable for retinopathy patients include vitamin E, Vitamin C, and β-carotene.
High levels of homocysteine is toxic to blood vessels through facilitating formation of free radicals. This can lead to worsening of diabetic retinopathy. Diabetic patients suffering from high levels of homocysteine should get enough Vitamin B12 and folic acid. The latter is important because hyperglycemia interferes with the expression of folate transporter.
Diabetic retinopathy patients should consider increasing consumption of oily fish such as tuna and sardines to boost the concentration of n-3 omega oils that will prevent lipid oxidation. The oily fish also contains Vitamin D that boosts the immune system.
Intervention 2; Physical Activity
Physical activity is equally important because it helps with the reduction of body weight, blood pressure, and cholesterol. Management of the blood pressure and cholesterol can help in the development of healthy blood vessels. Therefore, patients should avoid leading a sedentary lifestyle and engage in exercise, which also helps in carbohydrate metabolism and eventually, managing weight.
Intervention 3. Managing blood pressure and Blood cholesterol levels. Medical Interventions
Apart from instituting the appropriate lifestyle changes like diet and physical activity to
manage blood pressure and cholesterol levels, medication is also important when it comes to managing these conditions. Work with your doctor to get the treatment that works best for you.
Please see a doctor to recommend the medicine; do not self-prescribe!!!! The commonly used medications are the Anti-Vascular Endothelial Growth Factor (Anti-VEGF) medicines. The medication, usually given through injections, minimise macula swelling and subsequent loss of vision. Steroid medicines are also helpful when it comes to macula swelling. If the blood vessels are leaking then laser surgery becomes necessary. The laser surgery intervention is popular because it reduces macula swelling and shrinks blood vessels thereby halting their growth. Advanced proliferative diabetic retinopathy is treatable through vitrectomy.
Vitrectomy surgery involves the removal of the vitreous gel, blood from leaking vessels, and scars from the retina.
Get an eye exam at least once a year. This is because the earlier diabetes retinopathy is diagnosed and treated, the better. In mild cases and those treated early, the person might not even notice any problem with their vision. In severe cases, relentless and progressive irreversible vision loss may occur despite the best treatment.