Diabetes is something that affects many aging adults. In fact, the American Diabetes Association estimates that nearly 25 percent of Americans over the age of 60 have diabetes – with type 2 being the most common. If not managed carefully, diabetes can contribute to everything from heart and kidney disease to nerve damage. What many may not know, however, is that the health of the eyes can also take a significant hit from diabetes. Diabetic eye disease, to be specific, is often cited as the leading cause of blindness in adults from the age of 20 to 74.

Rather than being just one isolated condition, diabetic eye disease actual represents an entire group of eye diseases that can affect those with diabetes. This includes diabetic retinopathy, diabetic macular edema, cataracts, and glaucoma. Before diving into each of these, let’s explore the way in which diabetes affects the eyes.

How does diabetes affect the eyes?

When blood sugar, or glucose, levels become too high, fluid levels in the eye change and can cause the lens to swell. For those who have diabetes and regularly manage blood sugar levels, vision can be blurred until levels are back to normal. If, however, levels remain high over time, a variety of problems can occur – usually involving the blood vessels in the back of the eyes which can become damaged.

Below are the eye diseases that can result from these unstable glucose levels.

Diabetic eye diseases

• Diabetic retinopathy: Similar to the description above, this disease is caused by damage to tiny blood vessels in the retina, due to chronic high blood sugar. In the early stages of diabetic retinopathy (nonproliferative), blood vessels can bulge or leak into the retina. In later stages, the blood vessels will actually close off – forcing new, fragile vessels to grow onto the retina. Because these vessels are weak, they’re more likely to break off and cause bleeding. The accompanying scar tissue can lead to retinal detachment, which can lead to permanent blindness. The bleeding then causes floating spots to appear in one’s vision.

• Diabetic Macular Edema (DME): The macula – the part of your retina that is essential for the vision involved with activities such as reading, writing, driving, and even recognizing faces – can become swollen from diabetes. This can then lead to the deterioration of one’s sharp vision. In fact, DME is often cited as the most common cause of total vision loss for people with diabetes. It’s also closely related to diabetic retinopathy, with about 50 percent of people with diabetic retinopathy developing DME. Blurred vision is the primary symptom of DME.

• Cataracts: The lens of the eye allows us to focus in on what we’re seeing. And as we age, the lens can gradually become clouded or fogged, indicating a cataract. These are quite common among older adults because of natural age-related factors, but for those with diabetes, cataracts can occur earlier and develop much more rapidly. Similar to DME, cataracts cause vision to become blurry or glared.

• Glaucoma: Although technically considered a group of eye diseases, glaucoma represents damage made to the optic nerve (the primary connection between the eyes and the brain), caused by a gradual increase of normal fluid pressure in the eyes. Similar to cataracts, the risk of developing glaucoma increases the older we become – but having diabetes makes the risk of glaucoma that much greater. Glaucoma symptoms can depend on the type, but generally include hazy vision, severe eye pain, or the appearance of bright lights or colors.

Detection & treatment

If your aging loved one has diabetes and is beginning to experience vision problems, advise that he or she schedules a checkup. All of the aforementioned diabetic eye diseases can be detected by eye exams that check everything from tonometry (the pressure inside the eyes), visual acuity, and pupil dilation. These tests allow doctors to check changes in the lens, nerve tissue damage, and any alterations to the eyes blood vessels. If any of these diseases are detected, doctors will advise accordingly and may suggest treatment.

Treatment has become more sophisticated over the years, especially with the advent of Anti-VEGF Injection Therapy – used to treat DME specifically – and the National Eye Institute continues to bolster research efforts in refining detection/treatment approaches. Of course, our understanding of diabetes itself is also a vital factor. While the hope is that we will find a cure for diabetes, a goal that the Diabetes Research Institute is actively working toward, it may be a long way off. In the interim, there are ways for seniors to reduce their overall risk of diabetic eye disease, as provided by the American Diabetes Association.

Risk reduction

• For those with type 1 diabetes:

• Have a dilated eye exam by an ophthalmologist or optometrist within 3-5 years of diagnosis

• Have an eye exam conducted annually, or more frequently, if possible

• For those with type 2 diabetes:

• Have a dilated eye exam by an ophthalmologist or optometrist soon after diagnosis

• Have an eye exam conducted annually, or more frequently, if possible

• General risk reduction tips for both parties:

• Closely monitor blood sugar levels

• Take diabetes medication as prescribed by a physician

• Maintain a healthy weight

• Monitor diet carefully, paying close attention to intake of fats and complex carbohydrates

• Incorporate an exercise regime into your daily routine, with at least 30 minutes of moderate activity (with physician approval)

Comfort Keepers can help

At Comfort Keepers, our caregivers can provide assistance with daily living and promote proper nutrition, conducive to diabetes management. Additionally, if his or her eyesight is poor, we can provide safe, dependable transportation to places in and around town – whether it’s the grocery store, senior center, or doctor’s office for a scheduled visit.

Comfort Keepers is a leader in providing in-home care consisting of such services as companionship, transportation, housekeeping, meal preparation, bathing, mobility assistance, nursing services, and a host of additional items all meant to keep seniors living independently worry free in the comfort of their homes. Comfort Keepers have been serving New Hampshire residents since 2005. Let us help you stay independent. Please call 603-536-6060 or visit our website at www.comfortkeepers.com/plymouthnh for more information.

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