What is diabetes and how can it affect my eyes?
Diabetes is a disease in which the sugar level in our blood stream is too high. When we have diabetes, our pancreas either does not make enough insulin to lower blood sugar levels (typically type I diabetes), or there is a diminished response to insulin called “insulin resistance” (typically type II diabetes).
If we don’t control our diabetes, our blood sugar levels can remain elevated for long periods of time. This can cause damage to several organs including the heart, kidney, and eyes.
Diabetes can cause several eye conditions such as cataracts (a clouding of the eye’s lens), glaucoma (optic nerve damage from eye pressure changes), and retinopathy (damage to the retina). Damage to the retina is the most common eye condition related to diabetes, in which the elevated sugar levels destroy the blood vessels in our eyes and cause them to leak.
All of these conditions can decrease our vision or cause complete blindness. In fact, diabetes is the leading cause of blindness in the United States in people between age 20 and 74.
If my diabetes is affecting my eyes, what treatment options do I have?
With diabetic retinopathy, the damaged blood vessels can leak blood, proteins, and fluid into our eye which causes the retina to swell. The swollen retina is traditionally treated with a painless laser that seals off the leaky vessels, after which our vision should improve while the swelling decreases. A newer treatment option is the use of medications that are inserted into our eye.
When diabetic retinopathy becomes more severe, oxygen flow to our eye is reduced. This “starves” the retina for oxygen. The retina, however, attempts to counteract the decreased oxygen flow by producing new blood vessels to deliver more oxygen. While this makes sense, the problem is that these new vessels are very fragile and easily break off into the eye. This can lead to internal bleeding, called a vitreous hemorrhage.
It is possible that a vitreous hemorrhage clears on its own, allowing us to perform a different laser treatment that brings oxygen to the eye and causes the abnormal vessels to regress. If the hemorrhage does not clear on its own, surgery may be required to remove the blood.
If diabetic retinopathy remains untreated, the leaky blood vessels can create scar tissue in our eye. This scar tissue can pull the retina from the back of our eye, often resulting in a retinal detachment and severe vision loss.
What are some steps I can take to control my diabetes or prevent it from worsening?
As previously mentioned, diabetes is marked by elevated blood sugar levels and either a lack of insulin from the pancreas, or a decreased response to insulin. There are several causes of high blood sugar and insulin resistance. However, one of the primary causes is a typical American diet that is not only high in processed carbohydrate but also deficient in protein and healthy fats.
While there are prescription drugs available to help control blood sugar levels and increase insulin sensitivity, several significant studies have suggested that nutritional intervention can be just as effective as prescription drugs, and in some cases even more effective. We therefore believe strongly in a treatment approach that includes empowering our patients with sustainable nutrition habits. This is done through one-on-one counseling, as well as monthly seminars open to the public.
There are cases where medication may be necessary. Our hope, however, is to reduce the dependence on prescription drugs while improving overall health through proper nutrition. With this approach, a number of our patients have decreased the need for drugs while also improving other biomarkers of good health.
The food we eat has the power to cause disease. But our food also has the power to heal and prevent disease. Proper nutrition can bring improvements in not just our eyes but our overall health as well!
Dr. Ana Lucia Flores, MD
Memphis Eye Clinic
6029 Walnut Grove Road
Medical Plaza 3, Suite 101
Memphis, TN 38120