Ocular Associations Of Diabetes Other Than Diabetic Retinopathy
Diabetic retinopathy is the most well-known ocular complication of diabetes and the leading cause of blindness among people 20–64 years of age in the U.S. (1). Up to 4 million Americans with diabetes, 40 years of age and older, have retinopathy, and nearly 1 million have sight-threatening retinopathy (2). In major clinical trials, tight control of blood glucose and blood pressure has been demonstrated to reduce the risk of retinopathy and associated blindness (3). A range of ocular diseases is also associated with diabetes, which may lead to vision loss. However, some of these ocular conditions may not be familiar to noneye clinicians (4–6). In this review, we aim to highlight the frequencies, clinical presentations, natural histories, and management of these ocular conditions. Physicians who manage patients with diabetes may benefit from knowledge of these associated conditions and are thus able to ensure adequate and timely referral and treatment. Routine eye screening for retinopathy of individuals with diabetes offers the opportunity to detect these other ocular diseases early, many of which are sight threatening. Physician education remains an important public health strategy in the prevention of vision loss in patients with diabetes. Go to: OCULAR CONDITIONS DIRECTLY ASSOCATED WITH DIABETES 1. Cataracts and cataract surgery Cataract is a major cause of vision impairment in people with diabetes. Numerous studies have documented an association between diabetes and cataracts. This association is supported by an abundance of data from clinical epidemiological studies and basic science studies (7–22). Both cross-sectional and prospective data from three population-based studies, the Beaver Dam Eye Study, the Blue Mountains Eye Study, and the Visual Impairment Pro Continue reading >>
- Carmel Valley resident joins more than 180 diabetes advocates for the American Diabetes Associations 2017 Call to Congress Advocacy Day
- Conjoint Associations of Gestational Diabetes and Hypertension With Diabetes, Hypertension, and Cardiovascular Disease in Parents: A Retrospective Cohort Study
- Type 2 Diabetes and Comorbid Symptoms of Depression and Anxiety: Longitudinal Associations With Mortality Risk
Diabetic Retinopathy
Are you or someone you know at risk for diabetes? You are at risk if you: do not exercise regularly have a family history of diabetes delivered a baby weighing over 9 pounds are African-American, Hispanic or Native American If you have diabetes, you probably know that your body can't use or store sugar properly. When your blood sugar gets too high, it can damage the blood vessels in your eyes. This damage may lead to diabetic retinopathy. In later stages, the disease may lead to new blood vessel growth over the retina. The new blood vessels can cause scar tissue to develop, which can pull the retina away from the back of the eye. This is known as retinal detachment, and can lead to blindness if untreated. In addition, abnormal blood vessels can grow on the iris, which can lead to glaucoma. Signs of Diabetic Retinopathy Everyone who has diabetes is at risk for developing diabetic retinopathy, but not everyone develops it. In its early stages, you may not notice any change in your vision, but it can lead to the later, sight-threatening form of the disease. Floaters can be a sign of diabetic retinopathy. Sometimes difficulty reading or doing close work can indicate that fluid is collecting in the macula, the most light-sensitive part of the retina. This fluid build-up is called macular edema. Another sign is double vision, which occurs when the nerves controlling the eye muscles are affected. If you experience any of these signs, see your eyecare practitioner immediately. Your eyecare practitioner may diagnose retinopathy using a special test called fluorescein angiography. In this test, dye is injected into the body and then gradually appears within the retina due to blood flow. Your eyecare practitioner will photograph the retina with the illuminated dye. Evaluating thes Continue reading >>
The Glaucoma And Diabetes Eye Institute
Glaucoma The Glaucoma Service at Harper’s Point Eye Associates offers comprehensive consultations and long-term care for all forms of glaucoma, including medical, laser, and surgical treatment. We utilize computerized optic disc nerve fiber layer and visual field analysis available using state-of-the art perimetry. Our state of the art electronic medical records system allows our doctors to immediately access your test data from any point in our office. Dynamic Contour Tonometry, which is considered to be the most precise method of eye pressure measurement, is the standard in our practice. Such tests can lead to early treatment before obvious vision problems materialize. The Glaucoma and Diabetes Eye Institute at Harper’s Point Eye Associates is recognized as a regional center for glaucoma research and management where many area eye doctors refer their patients for glaucoma care. Glaucoma Defined A group of diseases characterized by increased pressure inside the eye. If left untreated, it causes blindness through permanent damage to the optic nerve. Sometimes glaucoma is called a “thief in the night” because there are often no symptoms until damage has been done. Diagnosis involves measurement of eye pressure, visual field testing, optic nerve imaging and direct observation of the optic nerve. The treatment for early glaucoma is usually eye drops, which lower eye pressure. More serious types of glaucoma may require surgery. Dr. Kirstein has and continues to conduct glaucoma research. He is the glaucoma research coordinator for Ziemer Ophthalmology, AG, Switzerland. A scene as it might be viewed by a person with Glaucoma: Diabetes Management at the Glaucoma and Eye Institute The diabetic eye disease service at Harper’s Point Eye Associates offers comprehensive Continue reading >>
Does Diabetes Lead To Glaucoma?
Among the many ways that diabetes can ravage the body, eye problems are high on the list. Those with untreated diabetes are at higher risks for blindness and eye problems such as glaucoma, where the risk factor is 40% higher as compared to the general population How Glaucoma Changes Normal Eye Functioning In an eye that functions normally, light passes through the curved area of the eye known as the cornea, which both protects the eye and focuses light. The light then travels through the anterior chamber of the eye, which is filled with aqueous humor, a protective fluid, then through the pupil (a hole in the iris, the colored part of the eye), and then through a lens for additional focusing. Finally, light traverses through another fluid-filled chamber in the center of the eye (the vitreous) to strike the back of the eye or the retina, which records image, converts them to electrical signals, and sends them to the brain for decoding. Glaucoma results when pressure builds up in the eye and causes the aqueous humor to drain slowly and build up in the anterior chamber. When the pressure on blood vessels to the retina and the optic nerve increase, the result is damage and loss of vision. Diabetes And Primary Open Angle Glaucoma (POAG) The most common type of glaucoma is known as primary open angle glaucoma (POAG), which often presents no symptoms until the disease is advanced and there is vision loss. Someone suffering from the early stages of this problem might experience a pain in the eyes, headaches, halos around lights, blurred vision, watering eyes, and reduced vision. POAG is a risk for those with Type II Diabetes, which often develops later in life. In contrast to Type I diabetes patients, where there is a complete loss of the cells in the pancreas that make insulin, Continue reading >>
Diabetes And Your Eyesight
Diabetes is a complex disease resulting from the inability of the body to produce insulin, a hormone that takes sugar out of the blood and into cells where it can be used for energy. Without enough insulin, there is too much sugar in your blood. It’s like having a car full of gas but no key; you have the fuel you need, but can’t start using it. Diabetes affects more than 29 million Americans. The most common form of diabetes is adult-onset diabetes. Adult-onset diabetes typically strikes those who are over 40, overweight and have a sedentary lifestyle. Other risk factors include those with a family history of diabetes and those belonging to certain ethnic groups. Persons of African, Native American, Japanese, Latino or Polynesian descent are more at risk. Diabetic Eye Disease A common complication of diabetes is diabetic eye disease. Diabetic eye disease refers to a group of sight-threatening eye problems that people with diabetes may develop. Glaucoma is one of these diseases. Diabetic eye disease also includes diabetic retinopathy and cataracts. Diabetic retinopathy, a disease which damages the tiny blood vessels in the retina (the light-sensitive tissue that lines the back of the eye) is the most common diabetic eye disease. Diabetic retinopathy affects nearly 7.7 million Americans age 40 and older. A cataract is a clouding of the eye’s lens that results in blurring of normal vision. People with diabetes are nearly twice as likely to develop cataracts as other adults. Cataracts also tend to develop at an earlier age. Diabetes and Glaucoma The relationship between diabetes and open-angle glaucoma (the most common type of glaucoma), has intrigued researchers for years. People with diabetes are twice as likely to develop glaucoma as are non-diabetics, although som Continue reading >>
Does Diabetes Cause Glaucoma?
Diabetes affects more than 29 million Americans today. The most common type of diabetes is type II diabetes, or adult-onset diabetes, which typically affects adults who are over 40, overweight and have an inactive lifestyle. These three precursors can increase the risk of developing other diseases such as hypertension, high cholesterol, and heart disease. A significant percentage of diabetics also develop glaucoma, a seemingly unrelated disease. There is no doubt that a connection exists between diabetes and glaucoma, but does diabetes cause glaucoma? This is a difficult question to which doctors and researchers are still seeking answers. While we may not be able to prove that diabetes causes glaucoma, there are some interesting statistics that link these diseases: Diabetics are twice as likely to develop glaucoma as non-diabetics Someone with open-angle glaucoma (the most common type of glaucoma) is more likely to develop diabetes than someone who does not have open-angle glaucoma In some diabetics, new blood vessels grow on the iris and block the flow of eye fluid which raises inner eye pressure. This is known as neovascular glaucoma. These statistics certainly support the assertion that diabetes and glaucoma are strongly connected. Other eye diseases have a similar link to diabetes, such as cataracts and diabetic retinopathy. These conditions, along with glaucoma, are collectively referred to as diabetic eye disease. This is a general term for a group of vision problems that diabetics may develop (Source: Glaucoma Research Foundation). It may be too early to conclude that diabetes causes glaucoma, but it is clear that these diseases are not independent of one another. Therefore, preventing one of these diseases may be a key factor in preventing the development of sev Continue reading >>
Diabetes And Your Eyes
Do you or a loved one have diabetes? If so, it’s important to get your eye doctor involved in treatments and preventative care right away. Most with diabetes will only experience minor issues with their eyesight; some diabetic eye diseases can cause blindness, so it’s important to educate yourself on possible conditions. Both type 1 and type 2 diabetes cause an abnormal increase in blood sugar levels. This imbalance can cause strain on the body—including the eyes. A number of eye conditions fall under the category of “diabetic eye disease.” These include: Diabetic retinopathy–This condition is the most serious complication of diabetes and is a leading cause of blindness in the U.S. It is a general term for all disorders of the retina caused by diabetes and involves leaking or blockage of the network of blood vessels supplying the retina. Forty percent of people with type 1 diabetes and 20 percent with type 2 diabetes will develop some sort of diabetic retinopathy. Diabetic maculopathy/macular edema–Light entering your eye is focused onto one tiny area of your central retina the size of a pinhead called the macula and is vital to seeing fine detail. Diabetic maculopathy, a form of retinopathy, means your macula is affected by diabetes. If this happens, it may be difficult to read print or recognize faces. If the macula swells with fluid, it is called a macula edema and can mean severe vision loss. Glaucoma–The increased blood sugar levels caused by diabetes can lead to increased pressure in the eye and damaged nerves. This condition is called glaucoma and people with diabetes are 40 percent more likely to develop this disorder. Cataracts–Diabetes can play a role in speeding up the formation of cataracts. High blood sugar can cause excess sugar to accumu Continue reading >>
Glaucoma
Glaucoma is a group of eye disorders that lead to progressive damage to the optic nerve. People with glaucoma can lose nerve tissue, resulting in vision loss. The optic nerve is a bundle of about 1 million individual nerve fibers that transmits the visual signals from the eye to the brain. In the most common form of glaucoma, primary open-angle glaucoma, the fluid pressure inside the eye increases. This increase in pressure may cause progressive damage to the optic nerve and loss of nerve fibers. Vision loss may result. Advanced glaucoma may even cause blindness. Not everyone with high eye pressure will develop glaucoma, and some people with normal eye pressure will develop glaucoma. When the pressure inside a person's eye is too high for a particular optic nerve, whatever that pressure measurement may be, glaucoma will develop. Glaucoma is the second-leading cause of blindness in the U.S. It most often occurs in people over age 40, although an infant (congenital) form of glaucoma exists. People with a family history of glaucoma, African Americans over the age of 40 and Hispanics over the age of 60 have an increased risk of developing glaucoma. Other risk factors include thinner corneas, chronic eye inflammation and taking medications that increase the pressure in the eyes. The most common form of glaucoma, primary open-angle glaucoma, develops slowly and usually without any symptoms. Many people are not aware they have the condition until they have significant vision loss. Initially, glaucoma affects peripheral or side vision, but it can advance to central vision loss. If left untreated, glaucoma can lead to significant vision loss in both eyes, and may even lead to blindness. A less common type of glaucoma, acute angle-closure glaucoma, usually occurs abruptly due to Continue reading >>
What Is Glaucoma?
Glaucoma is a disease of the eye in which fluid pressure within the eye rises; if left untreated, the patient may lose vision and even become blind. Glaucoma is relatively common, especially in older adults and can cause damage to the optic nerve if left untreated. In this article, we will cover the causes, symptoms, and treatment of glaucoma. We will also explain the different types and possible surgical procedures. Glaucoma has been called the silent thief of sight. The main types of glaucoma are open-angle and closed-angle. Age and thyroid problems increase the risk of glaucoma. Symptoms can include severe eye pain. Treatment includes surgery and medications. What is glaucoma? In short, glaucoma is a build up of pressure within the eye that causes damage to the optic nerve. There is a small space in the front of the eye called the anterior chamber. Clear liquid flows in and out of the anterior chamber, this fluid nourishes and bathes nearby tissues. If a patient has glaucoma, the fluid drains too slowly out of the eye. This leads to fluid build-up, and pressure inside the eye rises. Unless this pressure is brought down and controlled, the optic nerve and other parts of the eye may become damaged, leading to loss of vision. The disease usually affects both eyes, although one may be more severely affected than the other. Treatments for glaucoma Treatments involve either improving the flow of fluid from the eye, reducing its production, or both: Eyedrops for glaucoma In the majority of cases, initial treatment for glaucoma includes eye drops. Compliance is vital for best results and to prevent undesirable side effects - this means following the doctor's instructions carefully. Examples of eyedrops include: Side effects of eyedrops can include stinging, redness, eyelash Continue reading >>
Glaucoma
A disease of the eye that can lead to vision loss due to damage to the retina and optic nerve. The risk of developing glaucoma increases with age. People with diabetes are twice as likely to develop glaucoma as others. The eye is neither hollow nor solid. Rather, it is composed of two segments filled with fluids called the aqueous and vitreous humors. The aqueous humor is constantly being replenished as the excess is drained away. If the drainage is too slow or if it is blocked, pressure will gradually build up in the eye. Ophthalmologists and optometrists can measure this pressure, called intraocular pressure, with a procedure called tonometry. In glaucoma, the pressure is elevated. The increased pressure constricts the blood vessels of the eye, which can damage the retina or optic nerve and result in blind spots or loss of peripheral vision. With early diagnosis and treatment, vision can almost always be spared, but the damage caused by glaucoma is not reversible. -- Keep an eye on your vision! Learn about preventive steps and treatments for diabetic retinopathy from retinal specialist Dr. Charles Wykoff. >> There are several types of glaucoma, including open-angle, closed-angle, and neovascular. Open-angle glaucoma, the most common, is a gradual process in which damage may not be evident until later stages. It generally has no noticeable symptoms in the early stages. Closed-angle glaucoma tends to affect only one eye and may be characterized by a sudden increase in pressure in the eye, causing pain, nausea, and visual effects such as halos around lights. Neovascular glaucoma can but does not always cause sudden, severe loss of vision. It may accompany or be related to diabetic retinopathy. Treatment depends on the type of glaucoma and the severity of the problem and Continue reading >>
The Connection Between Sugar And Glaucoma
Is there are connection between sugar and glaucoma? The relationship between glaucoma and sugar diseases such as diabetes is confusing and controversial. The first thing to realize is that there is type 1 and type 2 diabetes as well as many different types of glaucoma. In the first type of diabetes, the beta cells in the pancreas no longer make diabetes. In the second type of diabetes, insulin-making cells are not destroyed. Patients with this type make more insulin than non-diabetics. However, the high blood sugar is not lowered by the increase in insulin due to insulin resistance. In type 1 diabetes, insulin replacement therapy is the treatment. On the other hand, lifestyle measures are taken to deal with type 2 as well as medications. Various Glaucoma Types Since there are various types of glaucoma as well, there needs to be a determination of the type of diabetes there is as well as the type of glaucoma in order to determine the relationship. One thing that is certain is that a long period of uncontrolled diabetes of both types will lead to poor blood supply to the retina and leaking blood vessels. The retina starves for oxygen. A Word About Open-Angle Glaucoma and Diabetes For years, researchers have been intrigued by the most common glaucoma type called open-angle glaucoma and diabetes. Compared to people with no diabetes, those with the disease have twice the likelihood of developing glaucoma in comparison. In the same way, there is a higher chance of someone with open-angle glaucoma compared to someone who does not have the disease. Diabetic Eye Disease For diabetics, diabetic eye disease is a common complication. This term refers to eye problems that a group of people with diabetics develops. One of them is glaucoma. Diabetic eye disease also includes cataracts Continue reading >>
Glaucoma And Diabetes
People with diabetes are at risk for several types of glaucoma. This article provides helpful information on prevention strategies and treatment options. Primary Open-Angle Glaucoma Type 2 diabetes is a risk factor for primary open-angle glaucoma. This has been demonstrated by large epidemiologic studies including the Los Angeles Latino Eye Study and the Blue Mountains eye study in Australia. If you have type 2 diabetes, you should have been referred to an ophthalmologist at the time of diagnosis to look for signs of diabetic retinopathy, a disease in which high blood sugar damages the retina’s blood vessels. A diabetic patient should also have a yearly dilated exam so that any signs of glaucoma can also be identified. In diabetic patients who have primary open-angle glaucoma, the glaucoma is treated the same way as for non-diabetic patients with open-angle glaucoma by lowering the eye pressure with medications, laser, and surgery if needed. Neovascular Glaucoma Neovascular glaucoma is another type of glaucoma for which diabetic patients are at higher risk. In this type of glaucoma, patients usually have a severe form of diabetic retinopathy, in which new vessels exhibit abnormal growth. These new vessels grow on the iris and over the drainage angle, causing scar formation and a form of angle-closure glaucoma. The treatment plan includes treating the diabetic retinopathy, typically by a laser applied to the retina and/or injections of medications. Both treatments are intended to stop these abnormal new vessels from growing. However, even if these vessels “regress,” the drainage angle may be so compromised that the eye pressure is uncontrolled even with eye drops. Patients will sometimes require surgery to manage the neovascular glaucoma. Most ophthalmologists will Continue reading >>
Glaucoma
Glaucoma is an eye disease that can damage your optic nerve. The optic nerve supplies visual information to your brain from your eyes. Glaucoma is usually, but not always, the result of abnormally high pressure inside your eye. Over time, the increased pressure can erode your optic nerve tissue, which may lead to vision loss or even blindness. If it’s caught early, you may be able to prevent additional vision loss. The most common type of glaucoma is primary open-angle glaucoma. It has no signs or symptoms except gradual vision loss. For that reason, it’s important that you go to yearly comprehensive eye exams so your ophthalmologist, or eye specialist, can monitor any changes in your vision. Acute-angle closure glaucoma, which is also known as narrow-angle glaucoma, is a medical emergency. See your doctor immediately if you experience any of the following symptoms: severe eye pain nausea vomiting redness in your eye sudden vision disturbances seeing colored rings around lights sudden blurred vision The back of your eye continuously makes a clear fluid called aqueous humor. As this fluid is made, it fills the front part of your eye. Then, it leaves your eye through channels in your cornea and iris. If these channels are blocked or partially obstructed, the natural pressure in your eye, which is called the intraocular pressure (IOP), may increase. As your IOP increases, your optic nerve may become damaged. As damage to your nerve progresses, you may begin losing sight in your eye. What causes the pressure in your eye to increase isn’t always known. However, doctors believe one or more of these factors may play a role: dilating eye drops blocked or restricted drainage in your eye medications, such as corticosteroids poor or reduced blood flow to your optic nerve hig Continue reading >>
Secondary Glaucoma
Throughout this guide, we have mostly talked about the primary glaucomas, those that happen largely because of inherited traits and things we don’t fully understand. By and large, there’s really nothing else wrong in the eye (or the body) other than glaucoma in primary glaucoma. Secondary glaucoma happens because of something else. It can be a something in the eye or in the body that affects the eye. If we total up all those with glaucoma in the world, the secondary ones are still a fair number, maybe 10% of all glaucoma. They much more often affect one eye and not both eyes, unlike primary open angle or angle closure that affect both eyes. All secondary glaucomas share the feature that the eye pressure is above normal due to something that causes abnormal outflow of aqueous. Some people think we should classify some of the more common subgroups of open angle glaucoma as separate and secondary. This includes pigment dispersion syndrome and exfoliation syndrome (see How did you get glaucoma?)see section How did you get glaucoma?. In this guide, we considered these as primary. Probably the most common secondary glaucomas in the developed world are those that come from having new blood vessels grow in the meshwork and block outflow of aqueous: the neovascular glaucomas. We now know that this usually happens when the retina does not have enough blood supply. This leads to production of a chemical called vascular endothelial growth factor (VEGF) that floats around the inside of the eye, making new vessels to get blood flowing. The problem is that the new vessels grow in the wrong places, messing up vision, detaching the retina and causing glaucoma. Diabetic persons sometimes have this happen. It also happens in those persons who have a blockage in a main artery or vein i Continue reading >>
Diabetes Heightens Glaucoma Risk
While diabetes has long been associated with the potentially sight-stealing disease diabetic retinopathy, it appears that another serious eye disease — glaucoma — may also be a complication of the metabolic disorder. Regular screenings may help prevent irreversible nerve damage. A recent study in the journal Ophthalmology found that women with diabetes have about a 70 percent increased risk of developing the most common form of glaucoma — primary open-angle glaucoma — compared to women without diabetes. "The study supports the notion that type 2 diabetes is associated with an increased risk of glaucoma," study lead author Dr. Louis Pasquale, co-director of the glaucoma service at the Massachusetts Eye and Ear Infirmary and an assistant professor of ophthalmology at Harvard Medical School, said in a prepared statement. Primary open-angle glaucoma affects an estimated 2 million Americans, according to the U.S. National Eye Institute, and it is one of the leading causes of blindness. Yet the link between diabetes and glaucoma hasn’t been proven conclusively. "There are a number of things, like diabetes, that appear to be a risk factor in a lot of population studies, but the association between diabetes and glaucoma is somewhat controversial," explained Dr. Joel Schuman, chairman of the department of ophthalmology at the University of Pittsburgh School of Medicine and Medical Center, and the director of the UPMC Eye Center. Another study, also published in Ophthalmology, failed to find a link between diabetes and glaucoma in a trial that included almost 4,000 people from the Netherlands. But, Pasquale’s study was significantly larger, including more than 76,000 women enrolled in the 20-year-long Nurses’ Health Study. And, the available evidence is convincing e Continue reading >>
