Diabetes and the eye

Diabetes mellitus is one of the pandemics of the 21st century. Today, about 463 million adults worldwide suffer from diabetes, in Germany about 10 percent of adults. Diabetes is the most common metabolic disease in children and adolescents. The frequency trend is increasing for all age groups.

A serious complication of diabetes is diabetic retinopathy (diabetic eye disease). It usually affects both eyes. Common symptoms of this are: Blurred vision, fluctuations in vision or eyeglass readings, decrease in color vision, "haze" in the visual field, visual field loss up to blindness.

The cause of diabetic retinopathy lies in a permanent Elevated blood glucose levelwhich results in vascular impairment, causing a chronic disturbance of blood flow to the retina. In the early stages, small haemorrhages and vascular bulges (microaneurisms) develop. As the disease progresses, the number of haemorrhages increases and swelling of the site of sharpest vision may develop (macular oedema), leading to a significant reduction in vision and requiring prompt ophthalmological treatment. If diabetic retinopathy continues to progress uncontrollably, bleeding inside the eye is possible (vitreous haemorrhage), as well as retinal detachment or eye pressure increase with chronic optic nerve damage (glaucoma) that can lead to blindness.

Risk factors for developing diabetic retinopathy include: Duration of disease (the longer you have diabetes, the higher the risk), inadequate blood sugar control, high blood pressure, high cholesterol (hypercholesterolemia), pregnancy, smoking, and hereditary factors.

A health-conscious lifestyle plays a decisive role in the prevention of diabetes. This includes, for example, a Mediterranean diet, avoiding obesity, lack of exercise and smoking, adequate sleepconscious handling of stress. To prevent the progression of diagnosed diabetes, regular blood glucose, blood pressure and blood lipid checks, as well as annual ophthalmological checks, are also necessary. In order to prevent a permanent reduction in vision in the case of a diagnosed diabetic retinopathy, close retinal checks by an ophthalmologist also play an important role (e.g. every 3-6 months). In the presence of diabetic complications, timely retinal examinations should be performed. Ophthalmological therapy (e.g. retinal laser treatment, introduction of medication into the vitreous cavity, pressure-reducing therapy, retinal surgery, etc.).

The active role of the patient as well as good cooperation between internists and ophthalmologists is crucial in preventing the development of diabetes.



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