Doctors warn how diabetic patients could lose eyesight

A 58-year-old truck driver who has lived with Type 2 diabetes for 20 years suddenly reported losing vision in his right eye. He managed his blood sugar levels moderately well at home for the past two years but never had his eyes checked.

It was the same case with another female resident. The 52-year-old, who has been diabetic for the past 18 years, also complained of gradual vision loss over the past year, which only worsened recently. She reported having difficulty reading and not seeing details. She also experienced occasional flashes of light and floaters in her vision.

The common denominator between the two patients is having Type 2 diabetes or high blood sugar, which can lead to not only developing heart or kidney disease but also blindness.

Dr Wissam Charafeddin, a specialist ophthalmologist at Barraquer Eye Hospital Dubai, who is treating the first patient, Ahmed, said: “Diabetes can lead to blindness in some patients. The main cause is diabetic retinopathy, a condition where high blood sugar levels damage the blood vessels in the retina.”

He explained to Khaleej Times, “Patients with diabetic retinopathy in early stages are usually asymptomatic, but over time, progressive damage can lead to vision loss if left untreated. Other eye conditions like cataracts (clouding of the lens) and glaucoma (increased pressure in the eye) are also more common in people with diabetes and can affect vision as well.”

Dr Charafeddin added that his patient had managed his blood sugar levels moderately at home for the past few years but had not visited an eye clinic for the last eight years.

“Ahmed came in after suddenly losing vision in his right eye, which drastically affected his daily life, and he couldn’t drive anymore. We discovered a moderate haemorrhage in his right eye and advanced diabetic retinopathy in the left eye. Ahmed was understandably devastated and worried about his ability to return to work, as it was his only source of income. We advised him to take a three-week sick leave and recommended an injection in his right eye and laser treatment in both eyes to prevent the disease’s progression,” Dr Charafeddin continued.

Fortunately for Ahmed, after the haemorrhage was cleared, his vision fully recovered without the need for surgery, and he could return to work.

“Ahmed’s experience underscores the importance of regular eye check-ups and effective diabetes management to prevent severe eye complications. Vision loss in one or both eyes can significantly impact a person’s ability to carry out daily tasks. Thankfully, Ahmed’s condition was not too advanced, allowing for a full recovery without surgery,” Dr Charafeddin underscored.

Heightened risk for eye complications
Meanwhile, Dr Abner Rivas Abejo, specialist Internal Medicine at International Modern Hospital, who is treating the second patient, explained how people with Type 1 and Type 2 diabetes are at a heightened risk for eye complications.

He said, “High blood sugars lead to both macrovascular and microvascular complications. Microvascular damage involves blood vessels in the eyes that can cause vision impairments and sometimes blindness. It also damages the peripheral nerves, leading to numbness or tingling sensations in the hands and feet.”

In a nutshell, Dr Abejo said, “Chronic uncontrolled high blood sugar can damage the blood vessels that supply blood to the retina in the eyes and this can lead to vision impairment and potential vision loss.”

Complications that affect the eyes vary depending on factors such as the duration of diabetes, glycemic (or sugar) control, and other risk factors. Generally, however, Dr Abejo noted:

Around 25 to 30 per cent of patients with Type 1 diabetes develop some degree of retinopathy within five years of diagnosis. After 20 years, nearly all individuals with type 1 diabetes have some degree of retinopathy.
The prevalence is lower initially for patients with Type 2 diabetes but increases with the duration of diabetes. Approximately 60 per cent of people with Type 2 diabetes have some form of retinopathy after 20 years.
What diabetic patients must do?
Both Dr Charafeddin and Dr Abejo recommend regular screening and good management of blood glucose, blood pressure, and cholesterol levels to reduce the risk and progression of diabetic retinopathy significantly.

They added that regular eye checks are essential for patients with diabetes to detect and manage complications early, preserve vision, and optimise overall health outcomes.

“Many diabetes-related eye conditions, such as diabetic retinopathy, often have no symptoms in their early stages,” noted Dr Charafeddin, reiterating: “Regular eye exams are essential because they enable doctors to detect and address problems before they progress to more severe complications, including blindness.

“Yearly check-ups are crucial for monitoring any changes in eye health and ensuring timely interventions to protect vision. Consistent eye care and effective blood sugar control are vital for maintaining healthy eyesight in individuals with diabetes,” Dr Charafeddin concluded.