Statistics:

• In Trinidad &Tobago, 1 in every 8 persons has diabetes

• 1 in every 3 diabetic patients   have some degree of retinopathy (bleeding in the eyes)

• Diabetes is the 5th leading cause of death worldwide.  70% of all these deaths occur from congestive heart failure.

Diabetes and THE EYE

Everything is transparent.  Progression of diabetes is easily seen and tracked in the eyes.

• Sudden changes in vision are caused by swelling in the lens of the eye with blood glucose fluctuations.  This particularly happens before diabetes diagnosis

• Diabetic Retinopathy (bleeding in the retina) is often seen at the time of diagnosis.  The eye is unique.  It is the only part of the body that allows a direct view of the blood vessels, nerves and tissues of the body.  It is thought that most people have the condition for 4-7 years before being officially diagnosed. Blood vessel walls get damaged allowing blood and other fluids to leak. The patient may notice black spots (floaters) and blurred vision in the early stages.  The body tries to heal itself by growing new vessels, but these are weak and fragile. The disease progression can lead more serious to bleeding in the vitreous and retinal detachment which causes significant vision loss. 

• Cataracts can occur earlier in diabetics due to fluctuating glucose levels.

• Wash your hands.  Don’t rub or touch the eyes as you increase the risk of infections.  Diabetics lose nerve sensitivity and therefore healing is slower in the event of an injury or infection.

To prepare for your eye exam:

1. Make a note of your last HbA1c.  It’s a good indicator of your diabetic control which directly affects the presence of retinopathy or its absence.

2. Bring a list of the medications you take.

3. Make a list of the questions you want to ask. 

4. Bring someone with you.  Your pupils will be dilated with eyedrops to examine the retina.  These can leave you blurry for up to an hour afterwards so you may want someone to accompany you getting home. 

What to expect at your eye exam

1. Your BGL will be checked.   Your reading should be <200mg/dL.  If it is higher than that, the spectacle prescription will be affected.  You may find vision varies from day to day, week to week if your BGL fluctuates widely.

2. The exam can take up to an hour including time to dilate the pupils.  

3. You will have retinal photos and possibly scans done.

Have an annual dilated eye exam.

Looking after your eyes when you have retinopathy:

For healthy eyes, there needs to be a cycle of care.  If the Ophthalmologist treats the eyes and the BGL remains uncontrolled, the retinopathy will continue.  Treatment is not a permanent fix - changes will continue according to the BGLs. 

In other words, diabetes management is everything!