Published: Thursday June 19, 2014 MYT 12:00:00 AM
Updated: Friday June 27, 2014 MYT 4:05:42 PM

Diabetes: Sugar in the eyes

Diabetic eye disease is a result of damage to the small blood vessels that nourish the eyes.

MY mother has suffered from diabetes for over 20 years. Recently, her doctor says that her eyes have developed some problems related to her diabetes. How can the eyes develop problems from diabetes? I always thought diabetes was a disease affecting blood sugar levels.

Diabetes mellitus is indeed a disease that results in high blood sugar.

It is this high blood sugar that produces a lot of complications everywhere in your body if it is untreated and uncontrolled.

If you have too much sugar in your blood, this can damage the small blood vessels that nourish your eye, among other organs.

This damage leads to a lot of leakage into the surrounding areas, and also blockage – at first partial, and then even complete. As more and more blood vessels get blocked, the blood supply to your retina – which is the “projection screen” of your eye – is affected. This eventually leads to loss of vision.

Danger point: The most advanced stage of diabetic retinopathy, the advanced proliferative stage, when the new blood vessels rupture, causing further scar formations. The scar tissues can then pull the retina away from its normal position at the back of the eye.
Danger point: The most advanced stage of diabetic retinopathy, the advanced proliferative stage, when the new blood vessels rupture, causing further scar formations. The scar tissues can then pull the retina away from its normal position at the back of the eye.

In addition, due to the lack of oxygen and blood supply, your eye attempts to compensate by growing new blood vessels. Unfortunately, these new blood vessels are not properly developed and they leak easily, further obscuring vision.

The resultant scar tissue formation also doesn’t help matters.

This sounds like a whole lot of bad things happening to the eye! Is the retina the only part of the eye affected by diabetes?

No. Diabetes can also cause complications in the lens of the eye, leading to swelling in that area. It can also result in the early development of cataracts.

Additionally, diabetes can also increase the risk of glaucoma – a disease in which the fluid pressure inside your eye is increased, leading to nerve damage and loss of vision. In fact, a person with diabetes is twice as likely to get glaucoma compared to other people.

When I brought my mother to the doctor, he mentioned that she was still at the early stage of diabetic eye disease. What are the stages?

Diabetic retinopathy has four stages:

Stage 1: Mild nonproliferative retinopathy – This is the earliest stage. Don’t be alarmed by the Latin words. The term merely means that the blood vessels have not proliferated (or grown new vessels) yet. In this stage, you can see small balloon-like swellings on the retina’s tiny blood vessels. These are called micro-aneurysms.

Stage 2: Moderate nonproliferative retinopathy – The disease has progressed. Some blood vessels to the retina are blocked.

Stage 3: Severe nonproliferative retinopathy – Many more blood vessels are blocked, and areas of the retina are now deprived of blood supply. But there is still no new blood vessel growth at this stage.

Stage 4: Proliferative retinopathy – This is a very advanced stage. The retina has sent out signals for new blood vessel growth. By themselves, the new blood vessels do not cause symptoms or visual loss. But their walls are very weak and they tend to leak easily. Once they leak blood and other proteins, this can really impair your vision.

Do all diabetics get diabetic eye disease?

No. It depends on how well-controlled your blood sugar level is. Damage to the blood vessels only occurs when the sugar levels are not controlled.

If you are a diabetic, you are more at risk to get diabetic retinopathy if:

  • You have had diabetes for a long time
  • Your blood sugar levels are poorly controlled
  • You have high blood pressure in addition to diabetes
  • You have high cholesterol in addition to diabetes
  • You smoke
  • You are pregnant

What will happen to my mother if she doesn’t get her eyes treated?

The new blood vessels at Stage 4 may then bleed into her eye. If the bleeding is small, she will see a few dark spots or “floaters”. But if the bleeding is severe, it may completely block her vision.

This is called vitreous haemorrhage. It does not in itself cause permanent vision loss because the blood often clears from the eye within a few weeks or months.

The new blood vessels may also grow with scars, which can pull the retina away from the back of her eye. This is retinal detachment.

Eventually, if untreated, diabetic retinopathy and glaucoma can lead to blindness.

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, e-mail The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

Tags / Keywords: Health, diabetes, eye complications


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