Diabetic Disease Awareness Month aims to increase the awareness of diabetes, and diabetic eye disease.

Diabetes is the leading cause of blindness in adults, therefore it is important to seek treatment for vision impairment that are related to diabetes.

As the number of people living with diabetes grows, so does the number of people with impaired vision.

High blood sugar levels damages the blood vessels of the retina, and can cause permanent vision loss.  Vision impairment caused by Diabetic Retinopathy (DR) may be prevented by regulating blood sugar and blood pressure levels as well as regular eye examinations at your local Smart Vision Optometry.

Jacquie Gattengo, a Smart Vision Optometrist at Eyes InDesign Bondi, explains the four stages of DR and what preventable measures can be taken to reduce the disease from advancing, and causing permanent vision loss.

There are two types of DR; Non proliferative retinopathy – which refers to the bleeding of the retina or leakage of blood – and proliferative retinopathy whereby abnormal blood vessels grow on the retina. The blood may bleed in the centre of the eye, causing vision problems.

Micro aneurysms (MA) occurs in patients with non-proliferative diabetic retinopathy (NPDR) when the capillary walls leak fluid due to the haemorrhage of blood vessels.

Stage one: Mild NPDR

The first stage consists of mild non-proliferative retinopathy, which is an early stage of DR. In this stage, “small areas of swelling or bulges occurs in the blood vessels of the retina,” says Jacquie.

Vision may not be affected yet during this stage.

Mild NPDR has at least one MA. Such findings are elusive, therefore close monitoring and inspection are crucial.  Patients should have an extensive eye examination once a year.

It is also essential that “patients diagnosed with diabetes monitor their blood sugar level and diet,” says Jacquie.

Stage 2: Moderate NPDR

As the disease progresses, it results in moderate non-proliferative diabetic retinopathy, where some of “the blood vessels that nourish the retina becomes blocked and damage the retina,” says Jacquie.

Blood and other fluids build up in the small central part of the retina causing diabetic macular edema. Vision may be affected in this stage.

Patients with moderate NPDR should have an eye examination at least twice a year.

Stage 3: Severe NPDR

The third stage consists of an additional blockage of the blood vessels, “this disrupts the blood supply to the retina,” says Jacquie. The damaged retina signals the body to produce new blood vessels. The development of new blood vessels grows in the retina and fills the interior of the eye. “The obstructed blood vessels may lead to blurred vision with dark spots visible,” says Jacquie.

Multiple haemorrhages occur in the retinal quadrants. During this stage, retinal detachment may occur.

“Patients with severe NPDR should have a dilated fungus examination three or four times a year,” advises Jacquie. These patients are at high risk of disease progression and permanent vision loss

Stage 4: Proliferative Diabetic Retinopathy (PDR)

During this stage, “the new blood vessels are abnormal and rupture causing a flow of blood to the retina,” says Jacquie.

The growth of abnormal and fragile new blood vessels advance during this stage. “These blood vessels have fragile walls and can leak blood in the retina, causing severe vision loss and blindness,” says Jacquie.

Patients exhibit either neovascularisation of the eye or pre-retinal haemorrhage. Until the disease stabilises, it is required that they visit a retinal speciality once a month.

Eye examinations

There are usually no warning signs of Diabetic retinopathy (DR), however early signs of DR can be detected up regular eye examinations. The procedure of such examination includes near and distant eye tests, a dilated eye exam (which allows the examiner to see through the pupil to the retina), and a tonometry test to measure the fluid pressure in the eye.

Patients with type 1 or type 2 diabetes, are at risk of developing neurovascular complications that can lead to Diabetic Retinopathy (DR). It is advised that “patients with diagnosed type 1 and type 2 diabetes should have a comprehensive dilated eye examination,” says Jacquie.

Smart Vision Optometry clinics are located in Sydney. Book a Smart Vision Comprehensive Vision Skills Assessment or Advanced Eye Health Test for any child or adult by calling the Bondi clinic (02) 9365 5047 or the Mosman clinic (02) 9969 1600, alternatively book an appointment online.

Written and syndicated by: YDMA News, YDMA Group

Chronic conditions can cause eye symptoms, such as dry eye, damaged blood vessels and blindness. Many eye problems are preventable and treatable.

Jacqueline Gattengo, a Smart Vision Optometrist at Eyes InDesign Bondi, explains common illnesses that cause many eye problems.

Diabetes

People with diabetes often have problems with the blood vessels in their body, and the eye is no exception. Diabetes causes many complications, including Diabetic Retinopathy (DR).

DR is caused by the onset of diabetes. “High blood sugar and high blood pressure levels can damage the blood vessels in the back of the eye, that supply blood to the retina,” says Jacquie. A lack of blood supply can affect vision and cause permanent blindness. DR can be prevented by regulating blood sugar and blood pressure levels.

High blood sugar levels increase the risk of dry eyes. “Dry eye causes significant eye discomfort and impaired vision,” says Jacquie. The symptoms include redness, a scratchy sensation of the eye, and blurry vision. The cause of dry eye is typically a lack of tears to keep the eye moist and healthy.

People with diabetes are also at higher risk of developing cataracts and glaucoma.

Nutritional deficiency

Vitamin A deficiency can cause severe dry eye and lead to ulcers of the cornea. A lack of vitamins can increase the risk of developing cataracts.  

“Cataracts are caused by the build-up of protein which clouds the lens of the eye, causing blurry vision and blindness,” says Jacquie. If left untreated, this condition will worsen and lead to blindness.

Jacquie says, “cataracts can also be caused by diabetes, smoking, high blood pressure and a history of cataracts in blood relatives.” 

“Many people are not aware of the effects of smoking on their vision,” says Jacquie. Smoking is associated with many health problems, including eye health. Smoking contributes to cataracts by “altering the cell of the lens through oxidation,” says Jacquie, and the “heavy metal like cadmium accumulates in the lens.”

Regular eye examinations are important to “test, diagnose and treat eye deficiency before they become progressively worse,” says Jacquie. Cataracts are more prominent in people who are diabetic. Therefore, it is important to “maintain high and low blood sugar levels,” says Jacquie.

Corneal Ulcer

A cornea ulcer is a common eye condition that is often caused by bacterial infections. This causes an ulcer to form in the front part of the eye.  People with “vitamin A deficiency and those who wear contact lenses are at a higher risk of cornea ulcers,” says Jacquie, as infectious agents are trapped behind the lens.

Jacquie identifies symptoms of cornea ulcer that include, “pain, intense redness, a scratchy sensation of the eye, light sensitivity and blurred vision.”

If you suspect you have a cornea ulcer, visit your local Smart Vision Optometry for an eye examination.

High blood pressure

High blood pressure can cause a change in the retina as it damages the blood vessels that supply the eye.

Controlling high blood pressure levels is fundamental for the vision of the eyes. “The longer the blood pressure levels remain high, the more an individual is at risk of having permanent eye damage,” says Jacquie.

High blood pressure may be diagnosed during a regular eye examination.

Autoimmune disease

Autoimmune disease is a condition whereby the immune system mistakenly attacks healthy cells of the body. The autoimmune attack causes inflammation of the optic nerve that damages the eye and affects vision.

People with autoimmune disease experience common symptoms such as “dry, red and itchy eyes, light sensitivity, eye pain, and change in vision,” says Jacquie. Treating the autoimmune disease will help control eye problems caused by the condition.

Rheumatoid arthritis

Rheumatoid arthritis, a collagen vascular disease, increases the risk of dry eye, as infections with bacteria or viruses affect the eye.

This condition can be treated with eye drops

Infectious diseases

Infections can affect the condition of the eye as well as one’s eyesight. Pink eye or conjunctivitis is a common form of eye infection. Common symptoms include redness and swelling of the eyelids and eye pain.

Trachoma

Trachoma begins with a bacterial infection, similarly to conjunctivitis (pink-eye), and can be easily treated.

However, if the condition is left untreated, “the condition will worsen as it causes scarring to the eyelid that pulls the eyelashes inwards,” says Jacquie. This causes tremendous pain as every blink scrapes the eye.

Advanced trachoma is called trichiasis, which occurs when the eye is inflamed. “Scar tissue builds up inside the eyelid, making the eyelid tight, pulling the eyelashes inward,” explains Jacquie.

Symptoms of trachoma include discharge from the eye, irritated eyes and redness. This causes immense pain as the eyelashes scrape against the cornea. This can lead to blindness.

Trachoma can be treated with cleanliness and hygiene, regularly wash your bedding, clothes and face to prevent infection.

It is important to be aware of other diseases that affect the eye, as if left untreated and undiagnosed, it can result in permanent blindness and vision impairment.

Smart Vision Optometry clinics are located in Sydney. Book a Smart Vision Comprehensive Vision Skills Assessment or Advanced Eye Health Test for any child or adult by calling the Bondi clinic (02) 9365 5047 or the Mosman clinic (02) 9969 1600, alternatively book an appointment online.

Written and syndicated by: YDMA News, YDMA Group