Diabetes and Cataracts: Understanding the Connection
Diabetes, also known as diabetes mellitus, is a chronic condition characterised by consistently high blood glucose levels (hyperglycaemia). It typically develops when the pancreas fails to produce enough insulin or when the body does not respond to insulin effects. Over time, diabetes can lead to serious damage to various body systems, particularly the eyes.
One of the most common eye conditions associated with diabetes is cataracts, a clouding of the natural lens of the eye. This article will clarify the link between diabetes and cataracts, outlining the underlying causes, risk factors, and treatment strategies to help individuals maintain their vision.
The Link Between Diabetes and Cataracts
While anyone can develop cataracts, individuals with diabetes are more susceptible. Poorly controlled diabetes can damage blood vessels in the eyes, leading to swelling of the aqueous humour, the fluid between the cornea and the lens.
Several factors further contribute to the increased risk of cataract development in diabetic individuals, including:
- High Blood Sugar Levels: High blood sugar levels can cause chemical changes in the eye's lens. Excessive glucose may cause proteins in the lens to clump together, leading to clouding and reduced clarity of vision.
- Oxidative Stress: Diabetes typically increases oxidative stress, an imbalance of harmful free radicals and antioxidants in the eye. This can damage lens proteins and the surrounding structures, thereby expediting the cloudiness and dysfunction of the lens.
- Sorbitol Buildup: Excessive glucose in the eye may be converted into a substance called sorbitol. When sorbitol accumulates in the lens, it can disrupt the normal fluid balance, causing lens swelling and distortion of lens fibres
- Advanced Glycation End Products (AGEs): High levels of blood sugar can contribute to the formation of AGEs, which are compounds formed by the reaction of glucose molecules with proteins. These compounds can accumulate in the lens and tissues, causing structural changes that contribute to cataract formation.
- Chronic Diabetes: Having diabetes for a prolonged period may increase the risk of cataracts due to the cumulative effects of persistently high levels of blood sugar.
An individual with diabetes may be up to five times more likely to develop cataracts earlier (sometimes before age 45) compared to non-diabetics. Type 1 diabetics commonly develop posterior subcapsular or snowflake cataracts.
Symptoms of Cataracts in People with Diabetes
Diabetic individuals may experience a range of symptoms that can indicate the presence of cataracts. These notable symptoms include:
- Cloudy or blurred vision
- Floaters or spots in vision
- Increased sensitivity to light and glare
- Fading or yellowing of colours
- Having trouble seeing at night
- Bright rings or halos around the lights
- Frequent changes to eyeglass prescription
- Double vision in one eye (monocular diplopia)
If you are experiencing changes in your vision and suspect that you may have diabetic cataracts, schedule a consultation with our specialist for cataract screening.
Diagnosis and Eye Screening for Diabetic Patients
Regular eye examinations are essential for diabetic cataract patients to determine the severity of the condition and plan the appropriate course of action for treatment.
Several tests are involved in the screening process, including:
- Visual Acuity Test: This test measures how well a patient can see at various distances using an eye chart. A decrease in visual acuity may suggest the presence of cataracts.
- Slit-Lamp Examination: Using a specialised microscope, the doctor closely examines the structures of the eye and detects opacities in the lens, which might indicate cataracts.
- Dilated Eye Exam: Eye drops are used to dilate (widen) the pupils and get a detailed view of the retina and optic nerve for signs of damage that often accompany cataract development.
Treatment for Cataracts in Diabetic Patients
If cataracts begin to interfere with daily activities, your doctor will likely recommend cataract surgery.
Performed by a skilled cataract surgeon, this replaces the clouded natural lens with a clear artificial intraocular lens (IOL) to restore vision. Thanks to recent advancements, including laser-assisted techniques, cataract surgery offers a safe and highly effective treatment option for many individuals, including those with diabetes.
Diabetic patients must maintain stable blood sugar levels before, during, and after cataract surgery. It is crucial for them to also inform their doctors about all current diabetes medications and undergo necessary preoperative tests to identify any diabetes-related issues that could affect the surgery.
Recovery Timeline for a Diabetic Patient
While every patient’s healing journey is unique, knowing the recovery timeline for cataract surgery can help set realistic expectations regarding vision improvement. Here is a general overview:
- First 24–48 Hours: The initial stage of recovery involves regaining consciousness after anaesthesia and adjusting to vision changes. Patients should monitor for unusual symptoms such as excessive pain, redness, discharge, or sudden vision changes.
- First Few Weeks: During this period, patients must attend multiple follow-up appointments to assess their healing progress and identify post-surgery complications. They may apply prescribed eye drops to manage inflammation and prevent infection.
- One to Three Months: Most patients achieve stable vision within this period, but they should watch out for any delayed complications, such as macular oedema.
Risks of Cataract Surgery in Diabetic Patients
While generally safe and effective, diabetic patients are more susceptible to certain complications from cataract surgery due to the systemic nature of their condition. These risks may include:
- Delayed Healing: Diabetes can slow down the body's healing processes, leading to prolonged recovery times and complications.
- Infection: Diabetic individuals tend to have weakened immune systems, which can increase the risk of postoperative infections.
- Diabetic Macular Oedema: A swelling in the central part of the retina can be exacerbated or triggered by cataract surgery, affecting visual outcomes.
- Fluctuating Vision: Vision may not stabilise immediately and can fluctuate during the recovery period.
- Inflammation: Diabetic patients may experience increased inflammation post-surgery.
At ERS Cataract Centre, we offer specialised eye care, from preoperative cataract assessments to postoperative care, with expertise in managing diabetic patients. Our goal is to help you maintain a clear vision and enhance your overall quality of life. Contact our cataract clinic today at +65 6738 2000 (Camden) or +65 6734 8309 / +65 6734 8319 (Novena) to schedule your appointment and take the first step towards better eye health.