Deterioration and loss of vision in diabetes - treatment and prevention

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Patients with diabetes should visit an ophthalmologist regularly to avoid vision problems. A high concentration of glucose (sugar) in the blood increases the likelihood of developing eye diseases caused by diabetes. In fact, this disease is the main cause due to which there is a loss of vision in the adult population aged 20 to 75 years.

In the presence of diabetes mellitus and a sudden problem with the eyes (foggy visibility), you should not immediately go to the optics and buy glasses. The situation may be temporary, and it may cause an increase in blood glucose levels.

A high blood sugar in diabetes can cause lens edema, which affects the ability to see well. To restore vision to its original state, the patient should normalize the level of glucose in the blood, which should be 90-130 mg / dl before meals, and 1-2 hours after a meal, it should be less than 180 mg / dl (5-7.2 mmol / l and 10 mmol / l, respectively).

As soon as the patient learns to control blood sugar levels, vision will begin to slowly recover. It may take about three months to fully recover.

Blurred vision in diabetes can be a symptom of another eye problem - a more serious one. Here are three types of eye diseases that occur in people with diabetes:

  1. Diabetic retinopathy.
  2. Glaucoma.
  3. Cataract.

Diabetic retinopathy

A group of specialized cells that turn the light that passes through the lens into a picture is called the retina. Optical or optic nerve transmits visual information to the brain.

Diabetic retinopathy refers to complications of a vascular nature (associated with impaired activity of blood vessels) that occur in diabetes mellitus.

This eye lesion occurs due to damage to small vessels and is called microangiopathy. Microangiopathies include diabetic nerve damage and kidney disease.

If large blood vessels are damaged, the disease is called macroangiopathy and includes severe illnesses such as stroke and myocardial infarction.

Numerous clinical studies have proven the association of high blood sugar with microangiopathy. Therefore, this problem can be solved by normalizing the concentration of glucose in the blood.

Diabetic retinopathy is the main cause of irreversible blindness. Too long a duration of diabetes is the main risk factor for retinopathy. The longer a person is sick, the greater the likelihood that he will develop serious vision problems.

If retinopathy is not detected in a timely manner and treatment is not started on time, this can result in complete blindness.

Retinopathy in children with type 1 diabetes is very rare. More often, the disease manifests itself only after puberty.

In the first five years of diabetes, retinopathy rarely develops in adults. Only with the progression of diabetes does the risk of retinal damage increase.

Important! Daily monitoring of blood glucose levels will significantly reduce the risk of retinopathy. Numerous studies in patients with type 1 diabetes have shown that patients who achieved a clear control of blood sugar using an insulin pump and insulin injection reduced the likelihood of developing nephropathy, nerve damage, and retinopathy by 50-75%.

All these pathologies are related to microangiapathy. Type 2 diabetes patients often already have eye problems when diagnosed. In order to slow down the development of retinopathy and prevent other ocular pathologies, you should regularly monitor:

  • blood sugar
  • cholesterol level
  • arterial pressure.

Maculopathy

In the stage of maculopathy, the patient experiences damage in a critical area called the macula.

Due to the fact that disturbances occur at a critical site, which is of great importance for vision, eye function can be greatly reduced.

Proliferative retinopathy

With this type of retinopathy, new blood vessels begin to appear on the back of the eye.

Due to the fact that retinopathy is a microangiopathic complication of diabetes, the proliferative type of the disease develops due to a lack of oxygen in the damaged eye vessels.

These vessels become thinner and begin to remodel.

Cataracts are a clouding or darkening of the lens that, when healthy, is completely clear. With the help of the lens, a person sees and focuses the image. Despite the fact that a cataract can develop in a healthy person, in diabetics, similar problems occur much earlier, even in adolescence.

With the development of diabetic cataract, the patient's eye cannot be focused and vision is impaired. Symptoms of cataract in diabetes mellitus are:

  • glare-free vision
  • blurred vision.

In most cases, the treatment of cataracts requires the replacement of the lens with an artificial implant. In the future, for the correction of vision there is a need for contact lenses or glasses.

Glaucoma for diabetes

In diabetes mellitus, physiological drainage of intraocular fluid ceases. Therefore, it accumulates and increases the pressure inside the eye.

This pathology is called glaucoma. High pressure damages the blood vessels and nerves of the eye, causing visual impairment.

There is the most common form of glaucoma, which until a certain period is asymptomatic.

This happens until the disease becomes severe. Then there is already a significant loss of vision.

Much less often glaucoma is accompanied by:

  • pain in the eyes
  • headaches
  • lacrimation
  • blurred vision
  • halos around light sources,
  • complete loss of vision.

The treatment of diabetic glaucoma may consist in the following manipulations:

  1. taking medication
  2. the use of eye drops,
  3. laser procedures
  4. surgery, vitrectomy of the eye.

Serious eye problems with diabetes can be avoided by annually screening with an ophthalmologist for this pathology.

Deterioration and loss of vision in diabetes - treatment and prevention

Diabetes mellitus is a disease that has become widespread among children and adults. Every year the number of people with this pathology increases. The disease has a chronic course and inevitably leads to complications.

One of the dire consequences is visual impairment in diabetes. With all its types, sooner or later, the vast majority of patients have a decrease or loss of vision.

Causes of visual impairment in diabetes

The decrease in vision in this disease is overwhelmingly due to diabetic retinopathy - damage to the retina.

Diabetes mellitus is a severe chronic endocrine disease. It can appear at any age. Its essence lies in impaired glucose metabolism and metabolism in general. In this regard, damage to blood vessels and nerve fibers occurs. Damage to the eyes, kidneys, nervous regulation and blood circulation of the extremities is a natural and formidable component of the progression of the disease.

Depending on the cause of the appearance and characteristics of the clinical course, the following types are distinguished:

  • 1st type. It develops when damaged special pancreatic cells, which are responsible for the formation of insulin. Insulin is a hormone that affects all types of metabolism, but mainly glucose metabolism. This type of diabetes often develops in childhood and adolescence. Most often, when this diagnosis is established, damage to the vessels of the retina is still absent, and develops after 10-20 years.
  • 2nd type. It occurs in violation of the interaction of insulin with the cells of the body. It develops due to genetic factors or the presence of risk factors, the main of which is obesity. This type of disease develops mainly in people after 40 years. A third of these patients already have signs of diabetic retinopathy at the time of diagnosis.

Diabetes mellitus can develop with other endocrinological diseases, genetic syndromes, general damage to the pancreas, during pregnancy.

The presence and degree of vision loss depends on the following factors:

  1. Type of diabetes
  2. Duration of diabetes. The more diabetic experience, the greater the likelihood of decreased vision.
  3. The degree of compensation and glycemic control,
  4. The age of the patient. Retinal vascular damage develops in middle and old age,
  5. The presence of previous eye diseases, arterial hypertension and other concomitant diseases.

The effect of diabetes on vision

The main sign of diabetes is an increase in blood glucose (hyperglycemia). In this regard, the inner layer of the small vessels of the retina is affected, as well as the functioning and interaction of the cells of the retina of the eye. The structure of the proteins of the formed elements of the blood is disturbed, which leads to increased adhesion of platelets and a decrease in the elasticity of red blood cells.

As a result of numerous negative processes caused by hyperglycemia and metabolic disorders, a violation of the fundus microcirculation develops. There is an expansion and blockage of blood vessels, an increase in vascular permeability. This leads to a violation of the circulation of oxygen and nutrition of the retina of the eye. These processes are included in the concept of the non-proliferative stage of diabetic retinopathy.

Further, a more severe proliferative stage develops. It is characterized by the appearance and growth of new, pathologically organized blood vessels. Thus, the body tries to compensate for the lack of oxygen metabolism. However, the new vessels do not have a full-fledged structure and grow on top of the retina, where they cannot realize useful properties and only interfere with vision.

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Symptoms of visual impairment in diabetes

The manifestations of retinal damage are diverse. This may be blurring of vision, “flies” before the eyes, but as a result, the clarity of vision decreases. This pathology affects both eyes. In severe cases, complete visual function may occur. The reason for this may be retinal detachment, extensive hemorrhage.

Diagnostics

After the diagnosis of diabetes is established, it is necessary to undergo an examination with an ophthalmologist twice a year.

If any signs of visual impairment appear, you should immediately consult a doctor. He will conduct a thorough examination of the fundus, that is, establish pathological processes in the retina. Such a study is called ophthalmoscopy.

It allows you to assess the condition of blood vessels, the optic nerve disc (the place where the nerve exits the eye), the macula (the part of the retina that is responsible for central vision).

When ophthalmoscopy is determined:

  • In the initial stages of retinopathy, point hemorrhages are more often found in the fundus in the central part of the retina. Also there are areas of opacification of the fundus in the region of the optic nerve and macula.
  • In the later stages, hemorrhages become more extensive. Destructive processes on the retina, proliferation of pathological vessels are determined.

Also, a study of visual fields, an ultrasound examination of the structures of the eyeball, measurement of intraocular pressure.

Other eye diseases with diabetes

Decreased vision may result not only from retinopathy, but also from other parts of the eyeball.

For example, diabetic cataract. In this case, there is a bilateral rapid damage to the lenses. The lens is a lens, an important refractive structure of the eyeball. With cataracts, it becomes cloudy, which leads to a progressive decrease in vision.

Diabetic iritis and iridocyclitis. This is a lesion of the iris. The iris is a structure that contains many vessels, which also suffer from hyperglycemia.

Diabetic glaucoma is a disease characterized by an increase in intraocular pressure. In diabetes, it is caused by a violation of the outflow of aqueous humor due to proliferation of pathological vessels in the corner of the anterior chamber of the eye.

The anterior chamber is the space located behind the cornea. It is filled with a special fluid that constantly circulates and flows into the circulatory system through the corner of the chamber. Newly formed vessels block it, intraocular pressure rises.

Treatment of eye diseases in diabetes

At the present stage, there is no drug therapy for diabetic retinal damage.

Vision progressively worsens, especially at the proliferative stage, when vascular proliferation occurs. This can prevent laser coagulation. Using a laser beam, these vessels turn into cords that do not have blood flow. As a result, their further proliferation, hemorrhages is prevented.

In the treatment of diabetic iritis and iridocyclitis, instillation of hormonal solutions, substances dilating the pupil (atropine 1% solution) is used.

With an attack of glaucoma, special drugs are used that reduce intraocular pressure, diuretics.

Prevention of vision loss in diabetes

The main thing that is necessary to minimize the rate of visual impairment:

  1. Monitoring blood glucose, blood pressure. Regular clinical and laboratory examination by an endocrinologist, mandatory compliance with all points of treatment for diabetes. These include drug therapy, diet, and proper lifestyle management.
  2. Regular examination by an ophthalmologist. It needs to be held 2 times a year and with the appearance of signs of visual impairment. This is important for the early diagnosis of pathological changes, the beginning of timely treatment.

Watch the video: Treatment for diabetes vision loss (April 2020).