Characteristics Of Systemic And Ocular Factors In Participants With And Without Diabetes
Among the 6,786 enrolled participants , 734 had diabetes. The mean age ± standard deviation was slightly higher in patients with diabetes than in participants without diabetes . Individuals with diabetes were more likely to have a history of smoking higher body mass index and waist circumference higher levels of HbA1c, non-fasting serum glucose, triglycerides, and IOP and lower high-density lipoprotein cholesterol levels . Figure shows the IOP distribution according to the diabetic status. The mean IOP±SD was 14.3±2.8mmHg for participants with diabetes and 13.9±2.8mmHg for those without diabetes . The demographic breakdown of the IOP data from the participants in this study is presented in Supplementary Table . The mean IOP±SD was 13.7±2.8mmHg in men and 14.1±2.8mmHg in women, and the IOP values were inversely correlated with age in both sexes.
Table 1 Demographic, systemic, and ocular characteristics of the participants according to their diabetic statusa.
How Can Diabetes Affect Your Eyes
Diabetes occurs when your body does not properly process food as energy. When you have diabetes, your body either does not respond to or does not produce insulin, which is a hormone that delivers glucose to the cells in your body. Having too much glucose in the bloodstream, outside the cells where it belongs, can lead to damage of the blood vessels and nerves that run throughout your body, including to the eyes.
Know Your Blood Sugar Levels
Consistently high blood sugar levels make you more at risk of diabetes complications, including serious eye problems.
Knowing what your target levels are and regularly checking your blood sugars can help you keep on top of them. This means checking your blood sugar levels at home and getting a doctor to check your HbA1c levels regularly too.
Your healthcare team should help you set your targets. The closer you get, the lower your risk of developing eye problems.
If youre finding it difficult to keep your blood sugar levels to your target range, speak to your healthcare team for advice. Or you can call our helpline for more information and support.
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Does High Eye Pressure Always Require Treatment
Many people with high IOP do not need treatment. Regular monitoring ensures that your eyes are healthy and vision issues are addressed.
A 2021 study in JAMA Ophthalmology revealed that high eye pressure does not necessarily require treatment. Among study participants, those who delayed treatment did not experience significantly different outcomes than those who did not.
Another long-term study examining almost 3,300 subjects with elevated IOP, all between the ages of 40 and 80, looked at treating high eye pressure before glaucoma versus waiting. Researchers found that, over decades, there was not much difference between the patients who received treatment immediately and those who did not. The study concluded that monitoring eye pressure meant intervention came sooner, and more people kept their sight.
Ultimately, the best treatment approach and timeline will depend on a variety of personal factors. Discuss these with your doctor to best determine how to proceed.
Who Is More Likely To Develop Diabetic Eye Disease
Anyone with diabetes can develop diabetic eye disease. Your risk is greater with
- high blood glucose that is not treated
- high blood pressure that is not treated
High blood cholesterol and smoking may also raise your risk for diabetic eye disease.
Some groups are affected more than others. African Americans, American Indians and Alaska Natives, Hispanics/Latinos, Pacific Islanders, and older adults are at greater risk of losing vision or going blind from diabetes.
If you have diabetes and become pregnant, you can develop eye problems very quickly during your pregnancy. If you already have some diabetic retinopathy, it can get worse during pregnancy. Changes that help your body support a growing baby may put stress on the blood vessels in your eyes. Your health care team will suggest regular eye exams during pregnancy to catch and treat problems early and protect your vision.
Diabetes that occurs only during pregnancy, called gestational diabetes, does not usually cause eye problems. Researchers aren’t sure why this is the case.
Your chances of developing diabetic eye disease increase the longer you have diabetes.
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What Is Diabetic Retinopathy And How Does It Lead To Glaucoma
Diabetic retinopathy refers generally to the damage that occurs to the blood vessels going to and from the eye. As is true with other blood vessels in the body, diabetes that is unmanaged can take a toll on the blood vessels in the eye, and cause vision problems.
The retina is the tissue in the eye that is sensitive to light, and is found on the lining in the back of the eye. Diabetic retinopathy is the most common eye disease for people with diabetes. Leaky blood vessels and decreased blood supply to the retina hinders oxygen in the retina. Then the retina will start to make a new network of blood vessels to try and get oxygen needed to the tissues. When the circulation problem leads to increased intraocular pressure from poor drainage of the aqueous humor , as sometimes happens, there you have it! Voila!!!- Glaucoma. People with diabetes are affected by retinopathy, and it amounts to 7.7 million people with diabetes in the United States aged 40 and over.
Folks Most At Risk Of Developing Glaucoma Include:
A very common symptom of glaucoma, one that often goes unrecognized at first, is a loss of peripheral vision . Blurred vision, seeing halos, eye pain and headaches are also symptoms although they do vary from person to person.
Its always wise to seek out medical counsel when youre experiencing any new health issue. Talk to your eye doctor before starting any new treatments.
How Is Glaucoma Diagnosed And Treated
Because glaucoma often doesnt have symptoms in the early stages, its important to get regular eye exams. This is especially important if you have any risk factors, including diabetes.
According to the Centers for Disease Control and Prevention , people with diabetes should get a dilated eye exam every year . Having your eyes dilated can help your eye doctor to more easily check for optic nerve damage or other issues.
During your eye exam, your doctor will also measure the pressure in your eyes. Depending on your risk, you might need other tests, such as checking for areas of vision loss, measuring the thickness of your cornea, and looking at the angle at which your eye drains fluid.
If you receive a glaucoma diagnosis, prescription eye drops are usually the first treatment option.
If the eye drops dont help reduce the pressure buildup in your eye, your doctor may suggest medication or surgery.
Surgery options for glaucoma include:
- laser therapy to open clogged channels in your eye
- the insertion of drainage tubes or stents to help drain the fluid in your eye
- removal of the damaged parts of your eye drainage system
How Can I Reduce The Risks
If your diabetes is well controlled, youre less likely to have problems, or they may be less serious. However, some people with diabetes do have serious sight loss because of their retinopathy. You can reduce your risk of developing retinopathy, or help to stop it from getting worse, by:
- Keeping your blood glucose or blood sugar level within normal levels.
- Tightly controlling your blood pressure.
- Controlling your cholesterol levels.
- Keeping fit and maintaining a healthy weight.
- Giving up smoking. Nerve damage, kidney and cardiovascular disease are more likely in smokers with diabetes. Smoking increases your blood pressure and raises your blood sugar level, which makes it harder to control your diabetes.
- Having regular retinal screening. The most effective thing you can do to prevent sight loss due to diabetic retinopathy is to go to your retinal screening appointments. Early detection and treatment can stop you from losing sight.
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Q: Is There A Way To Prevent Diabetes
This depends on the type of diabetes.
Type 1 diabetes is a rare form of diabetes, affecting only 5%-10% of diabetics. Symptoms develop fairly early in life due to a DNA or genetic cause, and there is no known method of prevention.
Type 2 diabetes is the most common form of diabetes, affecting between 90% and 95% of diabetics. It develops over many years and can be prevented or slowed with the right medications, diet, weight maintenance and exercise.
High Blood Pressure May Lead To More Diabetic Eye Injections
A review of patient data finds a potential link to costly diabetic eye treatments. It also underscores the need for collaborative care.
When patients with diabetic retinopathy would see Michigan Medicine ophthalmologist Anjali Shah, M.D., the conversation was often the same.
And it could be frustrating.
I would tell them what I was taught to tell them: You have to get your blood sugar under control, says Shah, also an assistant professor of ophthalmology at the University of Michigan.
A lot of them would reply, But my A1c levels are great.
That management wasnt enough to reduce or eliminate the need for anti-vascular endothelial growth factor injections in many patients. The medication is delivered into the eye via syringe to combat diabetic retinopathy abnormal blood vessel growth and swelling in the retina that can contribute to vision loss.
I thought, Theres got to be more to the story, Shah says.
Her new research identifies another potential direct link: a patients blood pressure.
Published in Ophthalmology Retina, the retrospective cohort study examined 2,916 patients treated at U-Ms Kellogg Eye Center from June 1, 2016, through 2017.
But its just the start to answering a larger question. We now need to do a lot more investigating as to what exactly that correlation is, Shah says.
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What Is Ocular Hypertension
Ocular hypertension means the pressure in your eyes is higher than normal. Left untreated, high eye pressure can cause glaucoma and permanent vision loss. The medical term for the pressure inside the eye is intraocular pressure, or IOP.
According to the Ocular Hypertension Treatment Study, 3 to 6 million people in the United States are at increased risk of getting glaucoma because of elevated IOP, or ocular hypertension.
All About Glaucoma In People With Diabetes
Glaucoma is all about the pressure in your eyes and its very common in people with diabetes. The leading cause of irreversible blindness worldwide, it affects approximately 80 million people across the globe.
People with diabetes are twice as likely to develop glaucoma compared to the non-diabetic population, but there are many steps you can take to reduce your risk and protect your vision.
Scheduling an eye exam with an optometrist every year is the best way to catch glaucoma in its earliest stages, before it damages your vision.
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Four Facts You Should Know About Diabetes And Eye Health
1. At first, the eye damage from diabetes may not be noticeable
Often, Rosenthal explains, there arent clear early warning signs that you have diabetic eye disease, that its developing, or even progressing.
And the longer you have diabetes, the greater the risk you have of it affecting your eyes.
Early changes can include bleeding within the retina, which may not affect your vision at first. At any stage, you can develop swelling in the macula, which often leads to blurred central vision, known as macular edema, said Rosenthal. The macula is where you have your sweet spot of vision. It’s what helps you recognize faces, read and see objects up close.
As your diabetes advances to the later stages, the blood flow to the retina can decrease, depriving your retina of oxygen and nutrition, recruiting new blood vessels, called neovascularization, one of the hallmarks of a condition called diabetic retinopathy.
While those new blood vessels sound like a really great solution to not getting enough nutrients and oxygen, they’re not good blood vessels, said Rosenthal. And, if left untreated, they can lead to vision loss.”
2. If left untreated, diabetic retinopathy could cause irreversible vision loss
Diabetic retinopathy has two stages:
Macular edema can happen at either of these stages.
3. Luckily, there are treatment options available for diabetic retinopathy
According to Rosenthal, the gold standard for PDR is a laser treatment.
Diabetes Treatment And Blurriness
For people who take medication to increase insulin in the body, changing the timing of food or a change in activity levels can result in low blood sugar levels.
Blurriness from low blood sugar does not result from changes in the eye. Instead, it is due to the way hypoglycemia affects the brain.
Vision that changes in this way will return to normal after glucose levels return to normal.
Can You Help Improve Our Information Factsheet On Eye Conditions Associated With Diabetes
Do you live in the UK and have you been diagnosed with an eye condition associated with Diabetes? If so, we would like your views on our information factsheet about eye conditions associated with Diabetes. Your views will help us make our factsheet as useful as possible for other people diagnosed with this condition.
We would like to hear from you if you are happy to:
Read our factsheet on eye conditions associated with Diabetes
Answer a few questions over the phone or via email about how helpful the current content is, based on your experience of the condition, and how the information in our factsheet could be improved.
To find out more please contact the RNIB eye health information service on 020 7391 3299 or email .
Diabetes And High Blood Pressure The Link
Many diabetics end up suffering from high blood pressure. This happens because diabetes can damage the arteries, which may lead to arteriosclerosis and high blood pressure. By the same token, high blood pressure increases the risk of diabetes complications becoming a reality. Among common complications, youll find kidney disease as well as eye disease.
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Laser Surgery For Glaucoma
There is a particular type of laser surgery that can be performed on a patient with glaucoma to reduce intraocular pressure. This laser procedure has been around for over 20 years. Once it is confirmed that the eye drops can no longer get the pressure in the eye down enough, or when there are too many side effects from the medication, laser treatment may be an option for such patients. It may also be used when intraocular pressure is severe as a first line treatment.
Who is a candidate for laser surgery for glaucoma?
The procedure works for open angle glaucoma with high intraocular pressure. It is only for open angle glaucoma because there cannot be any blockage in the drainage system in the eye for the procedure to be performed. Your eye doctor will need to evaluate your situation to determine if you are a candidate for this laser surgery.
How does Selective Laser Trabeculoplasty work?
The laser is applied to tissues in the eye that are part of the drainage system of the eye. This allows for better drainage of the fluid to release the pressure. This doesnt happen overnight or directly after the laser procedure. It can take up to 3 months for the full results of the laser treatment to realize.
The laser is referred to as a cold laser. This is because not much heat is used, and there is less subsequent scar tissue and pain associated with the procedure.
How effective is laser treatment for glaucoma?
Two Types Of Glaucoma And One Rare Type Of Glaucoma
Primary Open-angle or wide-angle glaucoma
The first type of glaucoma is called open-angle glaucoma or wide-angle glaucoma, and it is the most common type of glaucoma. It occurs in a full 90 percent of glaucoma cases.
This condition can occur when the mesh-like channel gets blocked, and the fluid, or aqueous humor, is unable to flow through the eye efficiently.
This kind of glaucoma is seen more in Asian countries than in the Western world. Other names for it include acute or chronic angle-closure or narrow-angle glaucoma. The space between your iris and your cornea gets too small in this kind of glaucoma. This causes a buildup of intraocular pressure. People with this kind of glaucoma are more likely to have cataracts, and are more likely to be farsighted.
Neovascular glaucoma occurs rarely, but is often associated with diabetes. This is due to diabetic retinopathy. What happens is the eye forms collateral circulation, or new blood vessels around the retina, in order to move fluid through that is blocked. When the new blood vessels grow into the iris of the eye , this shuts off the flow of aqueous humor through the eye, thereby raising the intraocular pressure.
This type of glaucoma is notoriously difficult to treat. Laser surgery is one option that is available to patients. There has been some limited success using drainage implants in this type of glaucoma.
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