Q1. How does diabetes affect the eyes?

The longer the duration of diabetes, the more likely the development of diabetic eye complications. After 20 years of diabetes, nearly all patients with type 1 diabetes and >60% of patients with type 2 diabetes have some degree of eye complications.

Complications of diabetes include diabetic retinopathy (damage to the blood vessels in the retina), cataracts (clouding of the eye's lens) and glaucoma (increase in fluid pressure inside the eye that leads to optic nerve damage and loss of vision). People without diabetes can get some of these eye problems e.g. cataracts too. But people with diabetes get them more often and at a younger age.

Laser treatment using a light beam to seal the leaking blood vessels can be done. It may stop blood and fluid from leaking into the vitreous and slow the loss of sight. If a lot of blood has leaked into the vitreous, a surgery called vitrectomy can remove the blood and fluids from the vitreous. Then clean fluid is put back into the eye.

Keeping blood glucose and blood pressure as close to normal as possible and having an eye examination once a year. Identifying eye problems early and getting prompt treatment will help prevent development of serious eye problems. Diabetic patients should also not smoke.

There are no special diets or supplements, but healthy eating helps to reduce blood sugar level. It is a critical part of managing diabetes, because controlling blood sugar can prevent blinding diabetes eye complications. Healthy diabetic eating includes sugar limitation, spacing out of meals, careful carbohydrates intake, eating lots of whole-grain foods, fruits and vegetables, eating less fat and limiting alcohol consumption.

Diabetes alone does not automatically exclude one from lasik or other refractive surgery, but there are two important considerations. Diabetic patients have a higher probability of requiring enhancement surgery because corneal ablation is somewhat less predictable than in patients without diabetes. If one has diabetic retinopathy, he or she should have a retina examination prior to refractive surgery.