Diabetic eye: When vision is at risk for one in three people suffering from diabetes
In Spain, one in seven adults suffers from diabetes, a disease whose prevalence has increased in recent years to 14.8%, the second highest rate in Europe, and which can cause serious visual complications that significantly reduce quality of life. In fact, one in three people with diabetes will develop some kind of vision loss and, if we compare this figure with the rest of the population, this group is 25 times more likely to develop blindness. This is why our specialists remind us of the visual consequences this disease may entail and stress the importance of monitoring it.
Lack of eye check-ups
Despite the risks the disease entails for eyesight, as much as 40% of people with diabetes have never had an eye check-up, which is just as important as other routine checks that people with diabetes should undergo.
High blood glucose levels also have an impact on the eye microvessels and, in particular, damage the cells and blood vessels of the retina, a highly vascularised tissue that is essential for vision. The most common complication affecting it, linked to the metabolic decompensation of diabetes, is diabetic retinopathy, which is considered one of the leading causes of blindness in Spain.
Main complications of diabetic eye
According to Dr José García-Arumí of IMO Grupo Miranza, almost half of all patients suffering from diabetes develop diabetic retinopathy: “This is the leading cause of irreversible blindness in working-age people. Furthermore, as with other eye diseases, it can go unnoticed, as it has no obvious symptoms in its early stages. However, as it progresses, the patient notices a gradual vision loss and may develop proliferative diabetic retinopathy, a severe stage of the disease featuring abnormal growth of blood vessels in the retina, leading to bleeding in the eye or even retinal detachment“.
Dr Francisco Gómez-Ulla, a specialist in retina and vitreo-retinal surgery at Miranza Instituto Gómez-Ulla, warns that “both people with type 1 and type 2 diabetes are at risk of suffering from diabetic retinopathy, which affects 4 out of 10 patients with type 1 diabetes and 2 out of 10 with type 2 diabetes”.
Diabetic macular oedema is another eye complication of diabetes that is often associated with diabetic retinopathy and can occur at any stage of the disease. It consists of swelling and fluid accumulation in the macula, the area in the centre of the retina that allows for clearer and more detailed central vision.
Other relevant visual complications are cataract, glaucoma or paralysis of the eye muscles. According to Dr Gómez-Ulla, “cataracts can occur more frequently and earlier in diabetic patients than in the rest of the population of the same age, as can glaucoma, which is why a diabetic person has twice the risk of suffering from it compared to a healthy adult”.
Advances in medical and surgical treatments
Diabetic retinopathy is a chronic disease and cannot be cured, but it can be kept at bay so that the patient does not continue to lose vision. In fact, progression is avoidable in 90% of cases, where the disease has been treated properly at the right time. Milder stages can be treated with less aggressive, sometimes combined therapies, such as laser and intraocular injections. The latter involve the regular application of drugs, which are administered inside the eye in the consulting room and act directly on the retina, thus preventing the disorder’s progression. Currently available injections with drugs are increasingly more effective and have a longer lasting effect, thus reducing the number of injections and improving the quality of life and sight of patients.
Another major development is the early management of type 1 diabetes, which usually affects young people. “In these cases, we opt for increasingly earlier surgeries with high success rates, as we have seen that, if we take too long to perform the surgery, the patient’s visual recovery is not as good,” says Dr García Arumí.
Surgical treatment is also performed when the disease is highly advanced, in cases of proliferative diabetic retinopathy or if there are associated complications, such as vitreous haemorrhages or retinal detachments.
How to prevent diabetic eye issues
For Dr García-Arumí, “good metabolic monitoring by the endocrinologist is essential to control blood glucose and blood pressure levels, which are key to prevent the progression of diabetes in the eyes”. He also emphasises the importance of adopting healthy habits, as it has been proven that avoiding obesity, a sedentary lifestyle and smoking improves the prognosis of this and other diseases and their consequences on eye health.
Along these lines, Dr Gómez-Ulla concludes that “it is very important for people to be aware that untreated diabetes leads to blindness, which is why ophthalmology professionals are so adamant about regular check-ups, as early diagnosis is key to preventing it”.
