Health Tips

Diabetes is a slow and silent ‘killer’. As time goes by, uncontrolled diabetes can lead to many health complications in various organs, and the eyes are one of the body systems that are commonly affected. Diabetes can damage your eyesight, resulting in what is known as the diabetic retinopathy. About 60% of type 2 diabetes mellitus patients have some degree of retinopathy after 20 years of being diagnosed with diabetes.

In conjunction with World Sight Day 2021, we bring you an interesting topic on how diabetes can affect your eyesight.

How does high blood sugar level affect your eyesight?

The progression of diabetic retinopathy is complicated, but in general, persistently high blood sugar levels damage the blood vessels in your eyes. During the early stage of diabetes, long-term high blood sugar level leads to changes and blockage in the blood capillaries of the eyes, which affect the retinal blood flow. As a result, the tissues in the eye do not get adequate oxygen, thus leading to tissue injury that may eventually affect eyesight.

At the later stage of diabetes, the cells in the eyes started to produce their own blood capillaries in response to long-term lack of oxygen, a process known as neovascularization. Such a process is made possible by a substance produced by the eye cells known as vascular endothelial growth factor (VEGF). VEGF promotes growth of new blood vessels and may increase vascular permeability, which is not as good as it sounds — swelling (macular oedema) may soon follow and these blood vessels are often abnormal, which can further worsen the eyesight. All in all, the organs in our body, including the eyes, do not function well when the blood is drenched in too much sugar. 

This is why if you have diabetes, it’s important to ensure your blood sugar level is well controlled, i.e. always be at the target blood sugar level doctor sets for you. Studies have shown that a well-controlled diabetes can significantly reduce the chance of developing diabetic retinopathy.

Treatment of diabetic retinopathy

The following treatments are beneficial for patients with diabetic retinopathy:

• An adequate glucose-lowering therapy that control the diabetes

• Blood pressure treatment — High blood pressure can also damage eyesight, therefore it’s also important that you follow through your blood pressure treatment diligently. 

• Your doctor may prescribe you a medication called fenofibrate (Brand name: Lipanthyl Penta). While fenofibrate is a cholesterol-lowering medication, it has also been shown to be beneficial for diabetic retinopathy.

• Laser therapy 

• anti-VEGF treatment (e.g. bevacizumab, ranibizumab and aflibercept)

Discuss with your doctor and an ophthalmologist on the best treatment strategy for diabetic retinopathy.

Get your eyes check-up every year

The importance of eye screening is severely underestimated by many diabetic patients. In fact, 36% of type 2 diabetic patients never had their eyes examined. A regular eye check-up ensures that treatment and prevention can be initiated before it’s too late.

If you’re a diabetes patient, ask your doctor how often you should do an eye check up. Typically, diabetes patients who do not have any retinopathy should still get their eye check up every 1 to 2 years. For those who have retinopathy, they may need to attend follow-up more frequently.

A word from DOC2US

If you have any questions related to diabetic retinopathy, you can consult our professional doctors and healthcare professionals on DOC2US. DOC2US is a mobile application that allows you to talk to a doctor or any healthcare professionals via text chat at any time and from anywhere. For better communication, you can even send our online doctor images or voice messages related to your medical inquiry.

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Cover image credit: Photo by Arteum.ro on Unsplash

Written by

Ms Joyce Toh