Common Eye Conditions

Diabetes

Diabetes is a vascular condition that at times can affect the eyes and so the vision. There are two main effects that can take place.

If the sugar level in the blood rises then the sugar level in the aqueous humour (the fluid bathing the lens in the eye) will also rise and it will be more readily absorbed into the lens. This causes the lens to change and it’s power decrease making the eye relatively longsighted. When the blood sugar level returns to normal it also does in the aqueous, the lens goes back to it’s natural shape and the vision returns to normal. This fluctuation in vision can be frustrating but it is not more serious than that. It is not uncommon for this variance in the vision to be one of the symptoms patients notice when diabetes is first diagnosed.

It is when diabetes affects the back of the eye that more serious changes take place. Diabetes stops the vessels being as efficient at transporting the blood and leakages can occur. When we look at the back of a diabetic eye (retina) it is not uncommon to see some tiny leaks or abnormalities to the vessels. Theses small changes are not generally a cause of concern and are known as a ‘background retinopathy’ (retinopathy is the name given to a change on the retina). Sometimes however these changes can increase and can cause concern due to their size and/or position. Thses changes show that the balance between the supply needed by the retina and the ability of the vessels to supply that demand have moved too far out of balance. Help is required to redress this balance, at this point referral to a hospital department is necessary.

Not many years ago diabetes was a common cause of blindness but over the last 20 years there have been wonderful improvements in the visual expectancy for diabetics. The main reason for the improvement is because the blood sugar control has become much better and there is no doubt that the better the sugar control the less likely are problems. Many years ago laser treatment was not an option but these days the hospitals have a variety of treatments to help and patients are presenting at a much earlier stage of change when help is more successful, due to better screening systems being in place.

In a nutshell the better the diabetic control the less likely there are to be problems but even with good control regular check ups should be undertaken. Our practice is one of the practices that is committed to the local diabetic screening programme and both our optometrists are accredited to carry out the screening having undertaken extra, specialist training in diabetes. We also find that our fundus camera is a great help when used in conjunction with the indirect ophthalmoscopy that is the pre-requisite for the scheme.