When diabetes can make you go blind

It is crucial for patients with diabetes to get their eyes checked regularly in order to detect and manage problems early to avoid blindness. — Freepik

My aunt, who is a diabetic, has been told that she is going blind because of her uncontrolled diabetes. Can diabetes cause blindness?

Yes, diabetes can cause a plethora of eye issues; some of them can make you go blind.

The diabetic eye diseases include diabetic retinopathy, ­diabetic macular oedema, ­glaucoma and cataracts.

Why does diabetes affect the eyes? I thought diabetes has something to do with high blood sugar.

It does, but uncontrolled ­diabetes means you keep on having high blood sugar.

High blood sugar itself does not cause vision loss immediately, though some people complain that they have blurred vision.

This type of temporary blurred vision happens because high glucose causes tissue fluid levels to change, leading to swelling in the eye tissues.

It goes away when your blood sugar normalises.

That is why some patients complain about blurred vision when they are changing their diabetic medications or starting a new one.

Nevertheless, what we are more worried about is the chronic complications of high blood sugar as a result of ­uncontrolled diabetes.

If your blood sugar stays high for a long period of time, it starts to damage the small blood ­vessels at the back of your eyes.

These vessels start to leak, leading to fluid accumulation and swelling outside your blood vessels.

This is diabetic retinopathy.

Then new blood vessels start to grow, but they are poor versions of your old blood vessels as their walls are weak and easily damaged – this is called neovascularisation.

These new blood vessels damage easily and leak blood into the middle part of your eye (diabetic macular oedema), causing scarring or high pressure within your eyeball (glaucoma).

These new blood vessels can also “pull” your retina, causing retinal detachment.

Constant high blood sugar levels can result in the growth of weak blood vessels in the eye, which cause the multiple eye problems associated with diabetes. — Handout

Will this diabetic retinopathy make my aunt blind? Can’t she see with these ‘new blood vessels’?

It can make you go blind, especially if it affects the parts of your retina that you need for vision, like your fovea – the little part of your eye that gives the highest visual acuity for you to see things.

At first, you will have no symptoms and be able to see things clearly.

You don’t even know the changes that are happening in your eye.

Then, with ongoing uncontrolled blood sugar, you may develop:

• Floaters in your eye

   

  These are like dark spots or strings that “follow” your vision when you look from left to right, or up to down.

  You may even describe them as shadows.

• Vision that fluctuates

   

  Sometimes you can see clearly and sometimes you cannot.

  You may pass this off as deteriorating eyesight and needing new glasses, but this is something that can be diagnosed only by an ophthalmologist (eye doctor) with proper equipment, and not by an optician who operates from a shop.

• Blurring of vision
• Empty spaces or dark spots in your vision
• And finally, loss of vision.

Will people get this with only type 1 diabetes? I heard there are 2 types of diabetes, the one people get from childhood and the one people get with obesity and old age.

There is diabetes mellitus type 1, where your body’s own immune system attacks the islet cells in your pancreas that make insulin.

It is true that type 1 diabetes tends to be diagnosed earlier on during childhood.

Then there is diabetes mellitus type 2, where your pancreas starts making less insulin than it used to and your tissues start to get resistant to your own insulin.

Type 2 tends to be caused by your own unhealthy habits, such as eating unhealthy foods and lots of refined carbohydrates, lack of exercise and obesity.

Yes, this tends to pile up as you age!

You can get diabetic retinopathy and other related eye diseases with both types of diabetes.

Will all diabetics get these eye diseases then? Is it their fate?

It is possible, if you are a diabetic, to prevent all this from happening as much as possible.

These are the steps.

Firstly, you need to control your blood sugar.

You have to follow a healthy eating plan that is given to you by your doctor and dietician.

You need to eat more vegetables and avoid sugar or sugared foods.

A lot of diabetes cannot be controlled by diet alone.

So you have to consult a doctor and be prescribed diabetic drugs, such as oral medications or insulin jabs.

You need to exercise.

You, like everyone else, are recommended to do at least 150 minutes of moderate physical activity a week.

Moderate physical activity is the type of activity that gets your heart pumping so that you can still talk while you are doing that activity, but you cannot sing.

If you wish to do more vigorous activity, well and good, but always consult your doctor first.

Secondly, you need to monitor your own blood sugar; you cannot just depend on going to the doctor’s clinic once every four months to do so.

If you can afford it, get your own glucometer to monitor yourself at home.

Lastly, you need to go for ­frequent doctor check-ups.

This includes eye examinations.

Also alert your doctor if you have any type of vision issues.

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, email [e-mail]. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. 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.