What is diabetes mellitus?
The term diabetes mellitus refers to a group of medical disorders of varying causes which are usually accompanied by long standing elevations of blood glucose levels, over and above what is generally acceptable as normal. Blood glucose elevation in this situation being a direct consequence of inadequate production of insulin by the body part called the pancreas. Insulin can best be described as a body chemical medically referred to as “hormone”. It is usually released by the pancreas in response to meal or glucose containing drink.

Diabetes and the Eye
Eye problems which can affect people with diabetes more commonly include cataract (clouding of the lens of the eye), glaucoma (increase of fluid pressure inside the eye leading to optic nerve damage and loss of vision), diabetic retinopathy (the most common diabetic eye disease) and some less dangerous others.  These eye complications are commonly seen in those with a longer duration of diabetes, those with poorly controlled or uncontrolled diabetes, and those with other organ problems. These eye problems are often unknown to the sufferer at the early stages when their treatments are better assured, unless they undergo regular eye examinations by an eye doctor. Eye examinations should be done every 6 months or yearly. Treatments depend on the advice of the eye care specialist in conjunction with other diabetic care specialists. Cataracts are usually curable with operation; glaucoma is better treated early with drugs, laser and or operation, while diabetic retinopathy requires laser therapy.

What are the risk factors for diabetic retinopathy?
The longer a person has diabetes, the greater the chance of developing diabetic retinopathy. Almost 80% of people, who have diabetes for 15 years or more, have some damage done on the blood vessels in their retina.

What can be done to prevent diabetic retinopathy?
There is no treatment that can prevent diabetic retinopathy altogether. Persons with any form of diabetes may develop diabetic retinopathy. It has however been proven that a good control of diabetes can delay and slow down the rate of progress of diabetic retinopathy and its complications. Besides, good control of blood glucose, one must exercise regularly, keep the blood pressure under control, avoid smoking and avoid excessive weight.

How do I know if I have diabetic retinopathy?
You might not know that you are having diabetic retinopathy, as there are no symptoms in the early stages of the disease. Therefore it is essential to have periodic evaluation of your eye by an eye doctor to detect the condition early. Early diagnosis and timely treatment is very essential in preventing the complications of this disease and thus maintaining vision.

How frequently should I get my eye examined?
Because a person with diabetes can have retinopathy and not know it, a regular check-up with an eye care professional is essential. If  one has diabetes, it is advised to   get a  bi-annual or yearly examination with the eye doctor. The  pupils may be dilated with eye drops, so that the eye doctor may have a good look at the back of the  eye. Once there is  diabetic retinopathy, then the eye doctor will advise if  there will be need for some investigations, treatment or just follow up. In these cases, the frequency of follow up visits is decided on the basis of the severity of the disease.

Treatment for diabetic retinopathy
Specific treatment will be determined by the  doctor(s) based on:  age, overall health condition, and medical history, extent of the disease involvement, individual tolerance for specific medications, procedures or therapies, expectations for the course of the disease, personal opinion or preference. Diabetic retinopathy is often treated with laser surgery to shrink the abnormal blood vessels or to seal the leaking ones.

What are the other possible eye conditions in diabetes?
Glaucoma
People with diabetes are 40% more likely to suffer from glaucoma than people without diabetes. The longer someone has had diabetes, the more common glaucoma is. Risk also increases with age.

Glaucoma occurs when pressure builds up in the eye. In most cases, the pressure causes drainage of the aqueous humor to slow down so that it builds up in the front chamber of the eye. The pressure pinches the blood vessels that carry blood to the retina and optic nerve. Vision is gradually lost because the retina and nerves are damaged. There are several treatments for glaucoma. Some use drugs to reduce pressure in the eye, while others involve surgery.

Cataracts
Many people without diabetes get cataracts, but people with diabetes are 60% more likely to develop this eye condition. People with diabetes also tend to develop cataracts at a younger age and have them progress faster. With cataracts, the clear eye lens becomes cloudy, blocking light. To help deal with mild cataracts, one may need to wear sunglasses. For cataracts that interfere greatly with vision, doctors usually remove the lens of the eye. Sometimes, the patient gets a new transplanted lens. In people with diabetes, retinopathy can get worse after removal of the lens and glaucoma may start to develop.