Question: What does diabetes have to do with the eyes?

Answer: Diabetes is a very complex disease that can affect numerous parts of the body, including the eyes. When you have this disease, your body does not use and store sugar properly. High blood sugar levels can damage blood vessels in the retina, which is the nerve layer at the back of the eye that senses light and helps to send images to the brain. The retina functions much like the film in a film camera or the card in a digital camera.

The damage to the retinal vessels and the retina from the effects of elevated blood sugar in diabetes is called diabetic retinopathy. Vision can become blurred when the retina – and especially its focusing point, the macula – become swollen from the leaking retinal blood vessels.

At its worst, these vessels can become closed off, preventing adequate blood flow. The retina responds by growing new blood vessels in an attempt to supply blood to the area where the original vessels closed. The new vessels are abnormal, however, and can bleed significantly inside the eye or be accompanied by scar tissue that may cause wrinkling or detachment of the retina.

When this happens, it can cause permanent damage that causes loss of straight-ahead as well as peripheral vision. Fortunately, this kind of vision loss is largely preventable.

It is extremely important for people with diabetes to maintain strict control of their blood sugar and to see an eye care specialist at regular time intervals. Prompt referral to a retina specialist, who uses highly specialized cameras, can help detect damage to the retina at an early stage. The retinal specialist might then perform treatments that include laser surgery to the retina or injections of special medications that may reverse the effects of diabetic damage.

In more advanced cases, especially when the diabetic eye becomes filled with blood, the retina specialist may perform a procedure called vitrectomy. This involves removing the blood-filled vitreous (the clear and jelly-like substance that fills the center of the eye) and replacing it with a clear solution.

Dr. Nikolaos Trichopoulos is a board-certified ophthalmologist and retinal specialist at Marshfield Clinic Wausau, Stevens Point and Minocqua Centers.


Read or Share this story: