Diabetes support site how does diabetes affect your eyesight presentation

  • Published on
    17-Jan-2017

  • View
    279

  • Download
    0

Embed Size (px)

Transcript

  • How Does DiabetesAffect Your

    Eyesight?

    Diabetes Support Site Website

    http://diabetessupportsite.com/

    http://diabetessupportsite.com/how-does-diabetes-affect-your-eyesight

  • How Does Diabetes Affect Your Eyesight?

    Acommoncomplicationofdiabetesisdiabeticeye

    disease.Diabeticeyediseasereferstoagroupofsightthreateningeyeproblemsthatpeoplewithdiabetesmaydevelop.

    Ifyouhavediabetes,regularvisitstoyoureyedoctorforregularexamsareimportanttoavoideye

    problems.Highbloodsugar(glucose)increasestheriskofeyeproblemsfromdiabetes.Infact,diabetesistheleadingcauseofblindnessinadultsages20to74.

    Highbloodsugarindiabetes

    causesthelensoftheeyeto

    swell,whichchangesyour

    abilitytosee.Tocorrectthis

    kindofeyeproblem,you

    needtogetyourbloodsugar

    backintothetargetrange

    (70130milligramsper

    deciliterormg/dLbefore

    meals,andlessthan180

    mg/dLonetotwohoursafter

    ameal).Itmaytakeaslong

    asthreemonthsafteryour

    bloodsugariswellcontrolled

    foryourvisiontofullyget

    backtonormal.

    Blurredvisioncanalsobea

    symptomofmoreseriouseye

    problemwithdiabetes.The

    threemajoreyeproblemsthat

    peoplewithdiabetesmay

    developandshouldbeaware

    ofarecataracts,glaucoma,

    andretinopathy.

  • What is the relationship between Diabetes and Glaucoma?

    Therelationshipbetweendiabetesandopenangle

    glaucoma(themostcommontypeof

    glaucoma),hasintriguedresearchersforyears.

    Peoplewithdiabetesaretwiceaslikelytodevelopglaucomaasarenon

    diabetics,althoughsomecurrentresearchis

    beginningtocallthisintoquestion.Similarly,thelikelihoodofsomeone

    withopenangleglaucomadevelopingdiabetesishigherthanthatofa

    personwithouttheeyedisease.

    Neovascularglaucoma,

    araretypeof

    glaucoma,isalways

    associatedwithother

    abnormalities,diabetes

    beingthemost

    common.

    Insomecasesof

    diabeticretinopathy,

    bloodvesselsonthe

    retinaaredamaged.

    Theretina

    manufacturesnew,

    abnormalblood

    vessels.

    Neovascularglaucoma

    canoccurifthesenew

    bloodvesselsgrowon

    theiris(thecolored

    partoftheeye),closing

    offthefluidflowinthe

    eyeandraisingtheeye

    pressure.

    Neovascularglaucoma

    isadifficultdiseaseto

    treat.Oneoptionis

    lasersurgerytoreduce

    abnormalblood

    vesselsontheirisand

    ontheretinalsurface.

    Recentstudieshave

    alsoshownsome

    successwiththeuseof

    drainageimplants.

  • Glaucoma and DiabetesGlaucomaiscausedbyexcessfluid

    pressingonthenerveatthebackof

    theeye

    Glaucomamayoccuramongst

    peoplewithandwithoutdiabetes,

    andcanbeacomplicationof

    diabetesifretinopathydevelops.

    Glaucomaiscausedbyanexcess

    amountoffluidpressingonthe

    nerveatthebackoftheeye.

    Howdoesglaucomastart?

    Theeyeproducesasmallamount

    offluidlikewaterinitsmiddle

    chamber,whichflowsaroundthe

    lensoftheeyeintothefront

    chamber.

    Thefluidleavestheeyeusinga

    drainagenetworkandthenenters

    thebloodstream.

    Commonly,glaucomacausesthe

    drainagesystemtobecome

    blocked,andfluidbecomestrapped

    intheeye.Thiscausespressureto

    buildupintheeyeandpasstothe

    nerveattherearoftheeye.

    Thisnervemaybecomedamaged

    byglaucoma.

  • What are the Symptoms of Glaucoma?

    Glaucomahasvery

    fewsymptomsinits

    earlystage,so

    peoplemaybe

    unawarethat

    somethingiswrong

    withthem.

    Assomeonewith

    diabetes,an

    optometristor

    anothereye

    specialistshould

    testyoufor

    glaucomaatleast

    onceeachyear.

  • Howisglaucomadiagnosed?

    Glaucomamaybediagnosed

    byanoptometristby

    measuringyoureyepressure,

    checkingtheeyeattheoptic

    nerve,andtestingthefieldof

    yourvision.

    Acommontestthesedaysis

    anoncontacttonometrytest

    (NCTtest)inwhichabriefpuff

    ofairwillbedirectedintothe

    frontofyoureye.Themachine

    yousitinfrontofmeasures

    theresistanceofyoureyeto

    thepuffofairwithoutneeding

    tomakecontactwithyoureye.

    Thepuffofairisnoticeable

    butisnotpainful.

    Expertswillquicklybeableto

    determineifyouhave

    glaucoma.

    Howisglaucomatreated?

    Glaucomawillusuallybetreatedwitheyedropstorelievepressureintheeye.Treatmentsinclude:

    Betablockers(suchasbetaxololhydrochloride,levobunololhydrochlorideortimolol)

    Prostaglandinanalogues(suchaslatanoprost,bimatoprost,tafluprostortravoprost)

    Carbonicanhydraseinhibitors(suchasbrinzolamideordorzolamide)

    Yourhealthcareprofessionalwillbeabletoadviseyoufurtheronthemostsuitabledropsforyourcondition.

    Alternativetreatmentsincludelasertreatment(laseriridotomy)andtrabeculectomysurgery.

  • What is the worst case scenario, will I go blind?

    Indevelopedstagesof

    glaucoma,poorvision

    startstospread,which

    canextendtoinclude

    thewholeofthesight.

    Ifthepressureof

    glaucomacanbe

    successfullyeased,

    however,thecondition

    shouldnotdeteriorate

    further.Shouldyour

    visionbecome

    significantlyimpaired,

    thereareanumberof

    aidswhichcanhelp

    peoplewithdiabetes

    whohavevisual

    impairments.

  • Cataracts and DiabetesCataractsarecloudy

    opacificationsofthe

    lensoftheeye

    Cataractsareoneof

    thesightrelated

    complicationsof

    diabetesthatcan

    causemistingor

    blurringofvision.

    Attendingregulareye

    checksaspartofyour

    annualdiabeticreview

    willhelpyourhealth

    teamtoidentifyany

    signsofcataractsatan

    earlystageandadvise

    ontreatment.

    Whatarethesymptomsof

    cataracts?

    Themainsignsofcataractsare:

    Cloudyormistyvision

    Blurredvision

    Spotsinyourvision

    Beingdazzledbybrightlights

    Seeingacircleoflightaroundlights

    Ayellowingofyourvision

    Earlystagecataractsymptomsmay

    barelyinfluencethevision,anda

    cataractdiagnosismaycomeasa

    genuinesurprise.

    Challengingvisualsituationssuch

    asdrivingatnightandbright

    sunlightmaycauseyoursightto

    becomehazy.Attendingregular

    eyechecksandscreeningswill

    makeiteasierforyourhealthteam

    todiagnosecataractsatanearly

    stage.

    Whatcausescataracts?

    Thelensoftheeyeismadeupoffluidsthat

    containprotein.

    Overtimethisfluidmaybegintocloudover,

    causingcataracts.Ageisoneofthefactorsandotherfactorsinclude:

    Havingdiabetes

    Smoking

    Afamilyhistoryofcataracts

    Longperiodsoftakingcorticosteroids

  • Does diabetes increase the risk of cataracts?Diabetesisoneofthekeyfactorsthatresultinthe

    developmentofcataracts.

    Althoughthereasonswhyarestillnotfully

    understood,peoplewithdiabetesmellitus

    statisticallyfacea60%greaterriskofdevelopingcataracts.Aswithmost

    complicationsofdiabetes,maintaininggoodcontrolofyourbloodsugarlevelswillhelptoreduceyour

    risk.

    Inaddition,researchhasshownthatpeoplewith

    type2diabeteswholowertheirHbA1clevelbyjust1%canreducetheirriskofcataractsby19%.

  • How are Cataracts Treated?

    Cataractstreatmenthasadvanced

    considerablyinrecentyears.

    Surgeryisoftenprescribed,with

    thelensremovedandreplacedwith

    anartificialone.Cataractsurgeryis

    widelyrecommendedandis

    commonlyperformed.

    Yourophthalmologistwilldetermine

    whetheryouneedcataractsurgery.

    Cataractsurgeryisgenerallysafe,

    sothepointatwhichanoperation

    isundertakendependspartlyon

    theindividual.

    Cataractoperationsaretypically

    daycases,withthelocal

    anaestheticoftensitedasthemost

    uncomfortablepart.

    Forpeoplewithdiabetes,thereisa

    slightlygreaterriskofdeveloping

    moreseriousproblemssuchas

    maculaoedema,diabetic

    retinopathycomplications,and

    infectionsasaresultofthesurgery.

  • Diabetic MaculopathyDiabeticmaculopathymay

    resultfromretinopathy

    Diabeticmaculopathyisa

    conditionthatcanresultfrom

    retinopathy.Maculopathyis

    damagetothemacula,the

    partoftheeyewhichprovides

    uswithourcentralvision.

    Acommonfromofdamageis

    fromdiabeticmacular

    oedema(DMO)inwhichfluid

    buildsuponthemacula.

    Diabeticmaculopathyisoften

    treatedbylasersurgery.

    Anumberofothertreatments

    arepossiblebuttherehas

    recentlybeenalotof

    discussionaboutwhich

    treatmentsareappropriate.

    Themaculaisthepartofthe

    eyethathelpstoprovideus

    withourcentralvision.

    Diabeticmaculopathyiswhen

    themaculasustainssome

    formofdamage.Onesuch

    causeofmaculardamageis

    fromdiabeticmacular

    oedemawherebyblood

    vesselsneartothemacula

    leakfluidorproteinontothe

    macula.

    Iftheleakagescausethe

    retinatohardenandexudates

    (depositsoffatfromthe

    blood)becomesignificantly

    largeandclosetothefovea,

    thentheconditionistermed

    asClinicallySignificant

    MacularOedema(CSMO).

  • Symptomsofdiabeticmaculopathy

    Thesymptomsofdiabeticmaculopathyareablurringofonescentralvision.

    Thismaybenoticedby:

    Troublewithreading

    Recognisingfacesinthecentreofyourvision

    Howisdiabeticmaculopathy/

    diabeticmacularoedematreated?

    Mildmacularoedemamayresolve

    itselfwithouttreatmentbutmost

    peoplewillneedthefirstlineof

    diabeticmaculopathytreatment

    whichislaserphotocoagulation

    treatment.

    Othertreatmentsincludehaving

    injectionsofwhatarecalledanti

    VEGFdrugs(antivascular

    endothelialgrowthfactor),suchas

    LucentisorAvastin.

    InDecember2012,Lucentiswas

    approvedforuseintreating

    diabeticmacularoedemain

    Scotland.

    Anothertreatment,whichisrare

    becauseofthesideeffectsthatcan

    exist,istohaveinjectionsof

    intravitrealsteroids.

  • Diabetic RetinopathyRetinopathyisa

    diseaseoftheretina.

    Theretinaisthenerve

    layerthatlinestheback

    ofyoureye.Itisthe

    partofyoureyethat

    takespicturesand

    sendstheimagesto

    yourbrain.

    Manypeoplewith

    diabetesget

    retinopathy.Thiskindof

    retinopathyiscalled

    diabeticretinopathy

    (retinaldiseasecaused

    bydiabetes).

  • Diabetic Retinopathy CauseDiabeticretinopathycanleadtopoorvisionandevenblindness.Mostofthetime,itgetsworse

    overmanyyears.Atfirst,thebloodvesselsinthe

    eyegetweak.

    Thiscanleadtobloodandotherliquidleakingintotheretinafromthebloodvessels.Thisiscallednonproliferativeretinopathy.Andthisis

    themostcommonretinopathy.Ifthefluidleaksintothecenterofyoureye,youmayhave

    blurryvision.

    Mostpeoplewithnonproliferative

    retinopathyhavenosymptoms.

    Ifbloodsugarlevelsstayhigh,

    diabeticretinopathywillkeepgetting

    worse.Newbloodvesselsgrowon

    theretina.

    Thismaysoundgood,butthese

    newbloodvesselsareweak.They

    canbreakopenveryeasily,even

    whileyouaresleeping.

    Iftheybreakopen,bloodcanleak

    intothemiddlepartofyoureyein

    frontoftheretinaandchangeyour

    vision.

    Thisbleedingcanalsocausescar

    tissuetoform,whichcanpullonthe

    retinaandcausetheretinatomove

    awayfromthewalloftheeye

    (retinaldetachment).

    Thisiscalledproliferative

    retinopathy.Sometimespeople

    donthavesymptomsuntilitistoo

    latetotreatthem.Thisiswhy

    havingeyeexamsregularlyisso

    important.(Getyoureyescheckedat

    leastonceayearforDiabetic

    Retinopathy)

    Retinopathycanalsocauseswelling

    ofthemaculaoftheeye.Thisis

    calledmacularedema.

    Themaculaisthemiddleofthe

    retina,whichletsyouseedetails.

    Whenitswells,itcanmakeyour

    visionmuchworse.Itcaneven

    causelegalblindness.

    Ifyouarenotabletokeepyour

    bloodsugarlevelsinatargetrange,

    itcancausedamagetoyourblood

    vessels.

    Diabeticretinopathyhappenswhen

    highbloodsugardamagesthetiny

    bloodvesselsoftheretina.

    Whenyouhavediabeticretinopathy,

    highbloodpressurecanmakeit

    worse

    Highbloodpressurecancause

    moredamagetotheweakened

    vesselsinyoureye,leadingtomore

    leakingoffluidorbloodandclouding

    moreofyourvision.

  • Diabetic Retinopathy SymptomsMostofthetime,therearenosymptomsofdiabeticretinopathyuntilitstartstochangeyourvision.Whenthishappens,diabeticretinopathyisalready

    severe.Havingyoureyescheckedregularlycanfinddiabeticretinopathyearlyenoughtotreatitandhelp

    preventvisionloss.

    Ifyounoticeproblemswithyourvision,callan

    eyedoctor(ophthalmologist)rightaway.Changesinvisioncanbeasignofseveredamagetoyoureye.Thesechangescan

    includefloaters,painintheeye,blurryvision,or

    newvisionloss.

    Aneyeexambyaneyespecialist

    (ophthalmologistoroptometrist)is

    theonlywaytodetectdiabetic

    retinopathy.

    Havingadilatedeyeexam

    regularlycanhelpfindretinopathy

    beforeitchangesyourvision.On

    yourown,youmaynotnotice

    symptomsuntilthedisease

    becomessevere.

    Symptomsofdiabeticretinopathy

    anditscomplicationsmayinclude:

    Blurred,double,ordistortedvision

    ordifficultyreading.

    Floatersorspotsinyourvision.

    Partialortotallossofvisionora

    shadoworveilacrossyourfieldof

    vision.

    Pain,pressure,orconstant

    rednessoftheeye.

  • Diabetic Retinopathy What Increases Your RiskYourriskfordiabeticretinopathy

    dependslargelyontwothings:how

    longyouhavehaddiabetesand

    whetherornotyouhavekeptgood

    controlofyourbloodsugar.

    Youcancontrolsomeriskfactors,

    whicharethingsthatmayincrease

    yourriskfordiabeticretinopathy

    anditscomplications.

    Riskfactorsthatyoucancontrol

    include:

    Pregnancy

    Womenwhohavediabetesareat

    increasedriskofdeveloping

    retinopathyduringpregnancy.

    Inwomenwhoalreadyhave

    retinopathywhentheybecome

    pregnant,theconditioncanbecome

    muchworseduringpregnancy.

    Ifyougetpregnant,youwillneedto

    haveaneyeexamsometimeduring

    thefirst3months.Youllalsoneed

    closefollowupduringyour

    pregnancyandfor1yearafteryou

    haveyourbaby.

    Consistentlyhighbloodsugar

    Highbloodsugarlevelsincrease

    yourriskofretinopathy.

    (Hyperglycaemia)Keepingyour

    bloodsugarlevelsinatargetrange

    canreduceyourriskfordiabetic

    retinopathyandcanslowthe

    progressionofthediseaseifithas

    alreadystarted.

    Highbloodpressure

    Ingeneral,peoplewithdiabetes

    whoalsohavehighbloodpressure

    aremorelikelytodevelop

    complicationsthataffecttheblood

    vesselsinthebody,includingthose

    intheeyes.

    Delayeddiagnosisandtreatment

    Gettingadilatedeyeexamwillnot

    preventretinopathy.Butitmay

    reduceyourriskofseverevision

    lossfromcomplicationsof

    retinopathy.Bydetectingitearly,

    youcangettreatmentthatcan

    preventvisionlossanddelaythe

    progressionofthedisease.

  • SmokingAlthoughsmokinghasnotbeenprovedto

    increasetheriskof

    retinopathy,smoking

    makesmanyofthe

    otherhealthproblems

    facedbypeoplewith

    diabetesworse,

    includingdiseaseof

    thesmallblood

    vessels.Stopping

    smokinghasmany

    healthbenefits,itwill

    reduceyourchancesof

    gettingseriousdiabetic

    complicationsaswell

    asthefinancialgain

    youwillhavemore

    moneyinyourpocket

    attheendofthe

    month.

  • Diabetic Retinopathy Exams and Tests

    Diabeticretinopathycanbedetectedduringa

    dilatedeyeexambyanophthalmologistor

    optometrist.

    Anexambyyourprimarydoctor,duringwhichyoureyesarenotdilated,isnotanadequatesubstituteforafullexamdonebyanophthalmologist.Eyeexamsforpeoplewithdiabetescaninclude:

    Visualacuitytesting

    Visualacuitytestingmeasurestheeyesabilitytofocusandtoseedetailsatnearandfardistances.Itcanhelpdetectvisionlossandotherproblems.

    Ophthalmoscopyandslitlamp

    exam

    Thesetestsallowyourdoctor

    toseethebackoftheeyeand

    otherstructureswithintheeye.

    Theymaybeusedtodetect

    cloudingofthelens(cataract),

    changesintheretina,and

    otherproblems.

    Gonioscopy

    Gonioscopyisusedtofindout

    whethertheareawherefluid

    drainsoutofyoureye(called

    thedrainageangle)isopenor

    closed.

    Thistestisdoneifyourdoctor

    thinksyoumayhave

    glaucoma,agroupofeye

    diseasesthatcancause

    blindnessbydamagingthe

    opticnerve.

    Tonometry

    Thistestmeasuresthe

    pressureinsidetheeye,which

    iscalledintraocularpressure

    (IOP).

    Itisusedtohelpdetect

    glaucoma.Diabetescan

    increaseyourriskof

    glaucoma.

    Yourdoctormayalsodoatest

    calledanopticalcoherence

    tomography(OCT)tocheck

    forfluidinyourretina.

    Sometimesafluorescein

    angiogramisdonetocheck

    forandlocateleakingblood

    vesselsintheretina,

    especiallyifyouhave

    symptoms,suchasblurredor

    distortedvision,thatsuggest

    damagetoorswellingofthe

    retina.

  • Fundus PhotographyCantrackchangesintheeyeovertimeinpeople

    whohavediabeticretinopathyandespeciallyinthosewhohavebeen

    treatedforit.

    Fundusphotographyproducesaccurate

    picturesofthebackoftheeye(thefundus).

    Aneyedoctorcancomparephotographs

    takenatdifferenttimestowatchtheprogressionofthediseaseandfindouthowwelltreatmentis

    working.

    Butthephotosdonottaketheplaceofafulleye

    exam.

  • Early DetectionEarlydetectionandtreatmentofdiabeticretinopathycanhelp

    preventvisionloss.Forpeopleinwhomdiabeticretinopathyhasnotbeendiagnosed,theDiabetesAssociationrecommendsthatscreeningbedonebasedonthefollowing

    guidelines:

    Peoplewithtype1diabeteswhoareage10andoldershouldhaveadilatedeyeexamwithin5yearsafterdiabetesis

    diagnosedandtheneveryyear.

    Peoplew...