Wednesday, 17 Oct 2018

Diabetes: Visual diseases that trigger this disease

In Ecuador, diabetes is affecting the population with increasing rates. According to the Ensanut survey, the prevalence of diabetes in the population aged 10 to 59 years is 1.7%. This proportion goes up after 30 years of age, and at 50, one in ten Ecuadorians already have diabetes. Also, according to data from the National Institute of Statistics and Census (INEC), diabetes is the second leading cause of death in the country after ischemic heart disease.

Expert ophthalmologists from the Santa Lucía Clinic highlight that, for the most part, people suffering from diabetes attend general consultations on a regular basis; but, they do not know the damages that can suffer in their vision, derived from this disease. Emphasizing that the key is to detect eye problems in time to prevent vision deterioration and what is more serious to reach blindness. Hence, the importance of these patients going to ophthalmological consultations at the same time that allows them to have a comprehensive check-up.

The specialists point out that people with diabetes are exposed to diabetic retinopathy, being more prone to develop cataracts, vitreous hemorrhage, diabetic macular edema and neovascular glaucoma.

Being the cause of 5% of blindness worldwide, is the most common diabetic eye disease, occurs when there are changes in blood vessels in the retina. Sometimes, these vessels can swell and leak fluids, or even clog completely. In other cases, new abnormal blood vessels grow on the surface of the retina.

The retina is a thin layer of light-sensitive tissue that covers the back of the eye. The rays of light focus on the retina, where they are transmitted to the brain and interpreted as images. The macula is a very small area in the center of the retina and is responsible for detailed vision, allowing the person to read, sew or recognize a face.

Generally, diabetic retinopathy affects both eyes. People who suffer from this pathology often do not realize the changes in their vision during the early stages of the disease. But as it progresses, diabetic retinopathy usually causes a loss of vision that in many cases can not be reversed, hence the importance of prevention.

The ophthalmologists at the Santa Lucía Clinic explain that successively the following phenomena occur:

  • Formation of microaneurysms (dilatations of small vessels that break easily).
  • Increased permeability of the capillaries of the retina. The consequence is the outflow of liquids from inside the vessels and the formation of deposits in the retina called exudates.
  • Obstruction of the capillaries and arterioles of the retina. The obstruction of the vessels, produces lack of oxygen to the cells responsible for the reception of light stimuli, cones and rods.
  • Proliferation of new vessels and fibrous tissue. The body tries to compensate for oxygen deficiency by forming new blood vessels, but these new vessels are fragile, break easily and lead to new complications.
  • Contraction of fibrous tissue, intraocular hemorrhages and retinal detachment due to traction. This is the last phase of the disease that can lead to a very important loss of visual ability. In addition, new vessels grow in other parts of the eye, such as the anterior chamber (rubeosis iridis) and block the circulation of aqueous humor, which leads to one last complication, neovascular glaucoma.

On the recommendations in visual health for diabetic people

  • Periodic visual checks. People with diabetes should have an eye exam by an ophthalmologist at least once every six months. This review must be very complete and include the dilatation of the pupils to be able to examine the retina carefully and to also make a digital photograph of it.
  • Strict and periodic control of sugar levels. It is necessary that the patient avoid hyperglycemia, since it increases the chances of having eye problems. For this, ophthalmologists must be in permanent contact with the patient’s GP.
  • Control blood pressure. It should be avoided to be less than 130/80, which are acceptable levels for people with diabetes. For this, it is necessary to take the tension at least 2 times a year and, always under medical supervision. In certain cases, the doctor may consider the need to take medication.
  • Do moderate exercises. The physical exercise, always adapted to the state and possibilities of each person, is fundamental. However, movements that require a lot of effort, such as lifting weights or strong contact, should be avoided, as they can be counterproductive for patients with certain eye problems.

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