Protect Your Eyes & Micro Vessels

Chapter 32 · Vihang Rahul Vasa

In the immediate near future, get both your eyes thoroughly checked by an ophthalmologist. Here is something most people don’t know: diabetes affects the micro vessels first: the tiny blood vessels in your eyes, kidneys, and nerves. Early detection means early prevention.

Also remember: diabetes has a strong memory effect. The damage from prolonged high plasma glucose (blood sugar) lingers even after you bring levels under control. That is why starting now, today, matters so much.

What Retinopathy Is: and Why It Frightens Doctors

The retina is the thin layer at the back of the eye that actually sees. It is fed by some of the smallest blood vessels in the body. Years of high plasma glucose (blood sugar) weaken these vessels: they leak, they bleed, and the retina swells. Later, the eye tries to grow new vessels to make up for the damage, but these new ones are fragile, and they bleed and scar even more. This is retinopathy due to diabetes, and it is one of the leading causes of blindness in working adults.

The dangerous part: it has no symptoms until it is far advanced. Your eyesight can feel perfectly normal while the retina is already damaged. By the time you notice blurring, floating spots, or a dark patch, the damage may already be well advanced, which is why the eye check matters before any symptom appears, and why any new change in vision deserves a prompt visit to the eye doctor rather than a wait.

Can it be reversed? Mostly, no. Damage already done to the retina does not usually come back. What treatment can do, if caught early, is stop it from getting worse and protect the sight you still have. That is why early detection is everything.

How to make sure it does not happen to you: keep your plasma glucose (blood sugar), blood pressure, and cholesterol under control; do not smoke; and get a dilated eye examination once a year, or as often as your ophthalmologist advises. Report any change in vision to your doctor immediately: do not wait for it to pass.

One more thing most people get wrong. Going to an optician is not the same as going to an ophthalmologist. An optician tests your eyesight and makes your spectacles. An ophthalmologist is a medical doctor of the eye: the one who examines the retina with your pupils dilated, diagnoses damage caused by diabetes, and treats it. Retinal photographs are sometimes taken by trained optometrists or technicians, but the diagnosis and the treatment are the ophthalmologist’s. For diabetes, you need the ophthalmologist.

Nerves: The Damage You Cannot See

The same small blood vessels that feed the eyes also feed the nerves, and years of high plasma glucose (blood sugar) can damage them too. Most people know the first kind of nerve damage: numbness, tingling, or burning in the feet and hands (see Chapter 38). Fewer know the second kind, which medical research describes well: damage to the nerves that run the body’s automatic work. It can show up as a stomach that empties slowly (bloating, feeling full quickly, nausea after meals), a bladder that does not empty properly, dizziness on standing up, a heart rate that does not change with effort, sweating too much or too little, and sexual difficulties (Chapter 56). And one effect matters more than all the others: it can take away the warning signs of a low plasma glucose (blood sugar): the shaking and sweating that tell you to act (Chapter 25). If any of these sound familiar, do not treat them as separate problems. Tell your doctor that you live with diabetes and describe them together; there are tests for nerve damage, and the earlier it is found, the more can be done to slow it.

(References for this chapter, the American Diabetes Association position statements on diabetic retinopathy and on diabetic neuropathy, are listed in Appendix B.)

Illustration: Chapter 32 illustrated summary. Diabetes can damage vision through tiny retinal blood vessels; changes can be silent.

Chapter 32 Diabetes can damage vision through tiny retinal blood vessels; changes can be silent. The figure distinguishes an ophthalmologist examination from an optician's spectacles. It also notes nerve symptoms and that warning signs of lows may fade.

Chapter at a glance: an AI-generated illustration to be read with the chapter, not instead of it. The people shown are not real.