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There are many complications of uncontrolled type 2 diabetes (T2D) and other risk factors like hypertension. These complications include stroke, blindness, heart disease, kidney failure and amputations. Earlier, we discussed stroke or cerebro-vascular accident (CVA) due to T2D and high blood pressure in our ongoing Beyond Medicine: Lifestyle Demons series. Here I will discuss, in a little more detail, the eye complications of T2D and other risk factors.

High blood sugar levels affect the eyes in the short term as well as in the long term. The short-term problems can manifest as blurred or poor vision. Vision may vary during the day depending on the blood sugar level. Poor vision occurs when the focusing tissues in the eye swell up due to raised blood sugar level, which retains water. Poor or blurred vision may last for a few days or weeks and usually settles down when the blood sugar level is controlled. This harm is not permanent and vision can return to normal once T2D is controlled.

The more serious eye complications are usually not reversible. The damage occurs in the blood vessels, nerves, lens and the focal point of the eye, called the macula. The four major long-term complications of T2D are called:

1. Diabetic Retinopathy – where there is damage to the back inner lining of the eye. This lining is called the retina, which receives the signal when we see something and sends the message to the brain to decipher the image. There are very small blood vessels supplying blood to the retina. When these tiny blood vessels get damaged due to uncontrolled T2D, small portions of the retina get deprived of the blood and nutrients, and start dying. This is called retinopathy. Since the body has a great ability to heal, other blood vessels try to send new branches to help with the area that is dying. These new blood vessels are weak and prone to bursting or bleeding. When bleeding occurs, there is more harm in the eye and pressure in the eyeball may increase. This damage is mostly irreversible. Laser treatments halt the bleeding from new weak blood vessels to prevent harm to other areas of the retina.
2. Diabetic Macula Edema – affects the ‘sharp focus’ area of the retina. Macula is the spot or area on the retina where we focus when we read or want to see something clearly like when we thread a needle. High blood sugar levels cause damage to the blood vessels supplying the macula, which begins to swell up. This leads to loss of sharp or clear focal vision, partial vision loss or blindness. This damage is mostly not reversible, however, may be halted with good T2D and other risk factor control.
3. Glaucoma – is a group of eye diseases that cause damage to the optic nerve. The optic nerve transmits messages from all parts of the retina to the brain for interpretation. Due to damage in the eye, the pressure in the eyeball increases. This is one of the reasons why the optic nerve gets damaged. Once the optic nerve gets damaged, your brain does not get the messages from the retina to interpret what you are seeing. Usually peripheral vision gets affected first. Irreversible blindness occurs as a result.
4. Cataracts – occur when the lens in the eye becomes opaque or cloudy. The lenses shorten or shrink the images we see so that it can be projected on to the retina. Usually the lenses are very clear but they tend to become cloudy as we age. In T2D, this process is accelerated and diabetic people may get cataract at an earlier age. Cataracts cannot be reversed but eye specialists can replace the lenses through cataract surgery.

The sad news is that when the T2D is not controlled, these permanent types of damage occur earlier in life, leading to blindness. Unfortunately, there are no major signs or symptoms to warn you of the damages occurring to your eyes, so having regular eye checkup is important, especially if the blood sugar control is not good. In addition, Hypertension, smoking and high blood cholesterol levels cause similar damage to blood vessels and also lead to these complications occurring earlier in life. Other lifestyle risk factors such as stress, alcohol, substance abuse and inadequate rest add to the risk even more.

However, the good news is that all these can be prevented or delayed to a large extent by good control of T2D and other risk factors. By following a healthy diet, mainly whole foods, plant-based; controlling T2D and high blood pressure; quitting or avoiding smoking; managing stress; keeping blood cholesterol level normal; exercising and resting well; controlling your weight; and avoiding alcohol abuse and use of recreational drugs, we can lead a healthy life. This reduces our health bill, increases our self-esteem, productivity, and independence. It is never too late to start controlling T2D and other risk factors to delay the onset of eye damage as well as harm to other organs. 

Share with me what your lifestyle demons are and how you are coping, via email: Margaret@alchemusprime.com.