DIABETES, if not treated properly and well in time, it increases the risk of developing visual as well as general complications. It damages the tiny blood vessels ( through leaking hemorrhages) and the nerves of the retina. It is a most photo-sensitive and vulnerable layer at the back of the eye, which receives and transmits the images to the brain via the optic, to complete the visual process. The central area of the retina is known as Macula, which is responsible for the finer vision used in reading, writing and discrimination of minor details of the objects we perceive and these changes are collectively known as diabetic retinopathy. Hence, the diabetics have to take special eye care in controlling the blood sugar. The family of the patient should be fully be aware of the complications of diabetes and help the patient for intake of proper diabetic diet along with prescribed medication promptly in time and follow the prescribed balanced diet and not to eat everything blindly and eat moderately.
Usual complication are sudden change in your vision like cloudiness, constant redness, double vision, flashing of lights, rings around lights and floaters in the visual fields. In fact, people with diabetes are likely to develop cataracts (Sufaid Motia) in the eyes which may further be complicated with Glaucoma (Kala Motia), if diabetes remains uncontrolled for a longer period. Basically, the diabetes is a disease of small blood vessels, hence diabetics are more prone to suffer from high blood pressure (hypertension) which may further damage the sensitive layer of retina and the optic nerve, in any age group.
Additionally, all diabetics must undertake moderate exercise regularly and sleep according to the age (adults minimum 7-8 hours daily), preferably with short naps in the afternoon, If he is engaged in some office-work or a business, avoid fatigue this will not disturb his blood sugar as well as blood pressure. Observe prompt regularity in the treatment and the patient will certainly live a healthy and normal life like non-diabetics. Minor carelessness may disturb the level of blood sugar, therefore one must control it from the next food intakes. Similarly, diabetics must be careful in using sweets, candies, drinks and desserts, on the contrary encourage yourself to take vegetables, cereals and lean meat. If a person suffers from type 1 diabetes he she should schedule an eye exam with his doctor with regularity, if he suffers from type 2 diabetes, he should schedule his future visits regardless of any age. Most of the visual complication from Diabetes takes about 5 to 10 Years to develop, but it doesn’t mean your vision is safe during this period. Hence it is necessary to get eye examined regularly before the appearance of complications. It develops earlier at a younger age and progresses faster in adults. Therefore, maintaining a strict control of blood sugar is the key to healthful life. Moreover, it will delay the development of cataract and other complications. If Diabetes remained uncontrolled for some time, it can result in paralysis of the eye muscles responsible for development squint and double vision (diplopia), which alerts the patient against permanent visual disability. However, a busy life is not an excuse to observe shortcuts with the visual health.
In summary, cataract surgery and treatment is the only choice to save the vision, being replaced with the clear artificial lens (intraocular lens – IOL) in its place). Pregnant women with gestational diabetes are at a higher risk of complications, therefore, they should get their eye examined at the earliest with regularity during pregnancy and should use the correct eyesight glasses. Since the diabetes affects the body’s immune system, patients are more susceptible to eye infections easily. Therefore, wash your hands and eyes repeatedly and never touch the eyes unnecessarily. Deprivation of sleep results in poor control of diabetes, fatigue, poor performance on the job, memory problems and mood disorders, likely to cause obesity, fulminating diabetes and dry eyes in the long run. Moreover, working on any digital device for too long hours makes the diabetic eyes tired and blurriness of vision, as people tend to blink much less while staring at the computer screen. Remember! It is, therefore, important to take short and frequent breaks from computers screen.
The American Academy of Ophthalmology recommends to follow the rule of 20-20-20, rest the eyes after every 20 minutes, use the device only for 20 minutes. Hence, monitoring of HbA1C blood test (normally 6.4), will gives you an indication of your control of diabetes during the last 3 months. For those who are interested in reading, it is advisable to use paper book reading in place of e-books and leave reading after every two chapters. Avoid using computer in brightly lit areas, because the glare of light will create strain and tiredness of eyes. Moreover, adjust the brightness and contrast of your computer screen according to your comfort. Always, sit in erect posture while using a computer or sitting on a chair for office work. In summary, a healthy lifestyle is important for diabetics and to keep the vision in the healthy state. Exercising, taking proper anti-diabetic diet and avoid smoking are the best principles for avoiding the risk of visual complications of diabetic and age-related macular degeneration, cataracts, and glaucoma.
—The author is a retired Prof of Eye from Rawalpindi Medical University and recipient of Presidential scientific award in Eye Surgery.
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