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Diabetes and
Eye Care
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What is Diabetes?
Diabetes is a condition in which there is too much sugar
(glucose) in the blood. Although sugar is needed to provide
energy for the body, when in excess, it causes problem.

Persons with diabetes have excess sugar because they lack
or have deficient supply of insulin.

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Diabetes
Mild Disease
Serious consequences
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Leading cause of new
cases of blindness
25 times more prone to
eye problems
6 times higher risk for
Paralysis (stroke)

5 times more prone to
Kidney failure
20 times more prone to
lower limb amputation
Nerve damage causes
loss of sensation
2-3 times higher risk for
heart attack
Diabetes Mellitus
A Serious Disease
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Why eye care is important when you have Diabetes
Diabetes is the third most important cause of new
blindness in adults
Serious eye problems often develop without warning symptoms
Blurring of vision is often the only symptom when blood sugar is
high
Consistent high blood sugar causes severe loss of vision
Diabetes and Your Eyes
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Cornea
Iris and pupil
Lens
Vitreous
Retina
Optic Nerve
Sclera
Aqueous humor
(anterior chamber)
Choroid
The Eye
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Retina - the inner lining of the eye ball is sensitive to light and continues as
the optic nerve

The light, enters the eye through the cornea and pupil - the central hole in
the iris (curtain of the eye); gets focused by the lens and falls on the retina,
which changes it into nerve signals

The signals are transmitted through the optic nerve to the brain enabling
us to see

How do we see ?
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Without proper functioning of the retina, it is not possible to see

Retina has a rich supply of thin blood vessels

Macula is the dense area in the centre of the retina without blood
capillaries and concentration of light sensitive cells. It is the centre of
sharp and colour vision where the focused light falls. Damage to the
macula causes loss of vision
How do we see ?
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The eye is supplied with oxygen and other necessary nutrients through
a network of capillaries (very small blood vessels). Unfortunately this
blood supply can be damaged as a result of diabetes.

When enough capillaries are damaged, the blood supply to an area of
the retina is impaired

This interruption of the circulation causes formation of new, smaller
blood vessels

These new blood vessels are fragile and can easily break. When this
happens blood leaks in to the eye spaces and results in to visual loss.
Newly formed blood vessels
Diabetes and Eye Problems
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The cornea

The iris; pupil and anterior
chamber

The lens

The vitreous

The retina

The eye muscles
Corneal erosion ulcer in the
cornea due to dryness

Acute glaucoma

Swelling and Cataract (lens
becomes opaque) causing blurred
vision and blindness

Bleeding in vitreous

Swelling, new blood vessels;
bleeding; detachment

Double vision
Parts of the Eye
How they are affected by Diabetes
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Blurred vision
Double vision
Cloudy vision
Floating spots in the visual field
Curtain like shadows in the eye
Red, irritated eyes
Painful pressure in the eye
Visual Disturbances in
Diabetes
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Blurred Vision - high blood sugar changes the shape and flexibility of the
lens distorting the ability to focus and causes blurred vision. Frequent
changes in eye glasses can occur both when diabetes is out of control
and when it is brought under control.

Double Vision - means two objects are seen where only one exists. It
occurs when the nerves controlling eye muscle are damaged due to high
blood sugar.

Symptoms of Eye Disease
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Cloudy vision- occurs because of developing cataract or swelling of the
retina, it occurs over a period of months of uncontrolled diabetes.

Floating spots - the vitreous of the eye contains small transparent threads,
which lose their transparency with age and may be seen as dark spots or
lines. This occurs earlier in persons with diabetes.
Symptoms of Eye Disease
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Curtain like shadows in the eye - retinal detachment or major bleeding in
the retina may cause curtain like shadows in the front of the eye. This
occurs suddenly and causes blindness.

Red irritated eyes may be due to some infection in the eye.

Sudden pain in the eye may be due to glaucoma, which is due to increased
pressure in the eye.
Symptoms of Eye Disease
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You may also have serious eye problems without any symptoms


Insist on examining your eyes when you are diagnosed or as soon as
possible


See your eye specialist regularly for examination as advised by your doctor

Symptoms of Eye Disease
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Children >10 years and Within 3-5 years of diagnosis and
adults < 30 years thereafter once a year


Adults > 30 years At the time of diagnosis and
thereafter once a year

When to get your eyes
Tested ?
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Women with diabetes in child bearing age prior to or after becoming
pregnant and then in the 1st trimester; after pregnancy as advised
above.

Those already diagnosed with abnormal findings need to be tested more
frequently as advised by their doctor.
When to get your eyes
Tested ?
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Visual acuity (sharpness of vision) test: The eye chart test measures how
well we can see at various distances.
Ophthalmoscopy: Examination of the eye with a fundoscope an
instrument through which the doctor looks into the eye. Sometimes the
doctor may put eye drops to widen the pupil- central hole in the iris the
curtain of the eye) so that he can look at the retina better for signs of
diabetic retinopathy.

Common Test done to
Check the Eyes
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Tonometry: A test that determines the fluid pressure in the eye to check for
glaucoma.
Common Test done to
Check the Eyes
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Retinal swelling, such as macular edema
New blood vessel formation or changes in the blood vessels
Leaking blood vessels or retinal bleeds
Pale, fatty deposits on the retina -sign of leaking blood vessels in the past
Damaged nerve tissue
Detachment of the retina
What can be found through
Ophthalmoscopy ?
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Macula
Optic Disc
Retinal Blood Vessels
Normal Eye on Fundoscopy ?
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Bleeding Microaneurysm
Changes in Retina due to
Diabetes ?
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Newly formed blood vessels
Changes in Retina due to
Diabetes ?
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These changes cause no uncomfortable symptoms at first, but if allowed to
continue over the years can result in serious loss of vision

Strict control of diabetes is most important to prevent these changes

Regular eye examinations are essential to detect and treat these changes
at an early stage
How to Prevent Eye Problems
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Good diabetes control is important to prevent further
progression

Laser Surgery - Doctors pass laser rays to burn the leaking
capillaries and also the non essential parts of the retina to
reduce need for new blood vessels to form and reduce
swelling in the macula

Vitrectomy Vitreo- retinal surgery is done to remove clots
from the vitreous over the retina; remove fibrous tissue and
reattach the retina which has been torn apart to restore
vision to the eye
What is the Treatment for
Retinopathy
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Consult your diabetes care team or eye doctor if you find any changes in
your vision or any problems with your eye

Insist on your eye being examined as required

Take good care of your diabetes, achieve good blood sugar control. Take
Insulin if advised

It will save your eye sight and vision

Save Your Eye Sight
Take Action
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