Alternative Names
diabetes; sugar diabetes

Definition
A disorder caused by decreased production of insulin or by decreased ability to use insulin. Insulin is a hormone produced by the pancreas that is necessary for cells to be able to use blood sugar.

Causes, incidence, and risk factors

The cause of diabetes mellitus is unknown, but heredity and diet are believed to play a role in its development. Diabetes results when the pancreas produces insufficient amounts of insulin to meet the body's needs. It can also result when the pancreas produces insulin, but the cells are unable to efficiently use it (insulin resistance). Insulin is necessary for blood sugar (glucose) to go from the blood to the inside of the cells, and unless the sugar gets into the cells, the body cannot use it. The excess sugar remains in the blood and is then removed by the kidneys. Symptoms of excessive thirst, frequent urination, and hunger develop. The (metabolism) of carbohydrates, fats, and proteins is altered.

Diabetes occurs in several forms. The most common types are: Type I, or insulin-dependent diabetes mellitus (IDDM); Type II, or non-insulin-dependent diabetes mellitus (NIDDM); and Gestational Diabetes Mellitus.

Insulin-dependent diabetes mellitus (IDDM or Type I) usually occurs in people before the age of 30 requires insulin injections to live. Risk factors for IDDM include autoimmune disease, viral infections, and a family history of diabetes.

Noninsulin-dependent diabetes mellitus (NIDDM or Type II) usually occurs in severely overweight (obese) adults and rarely requires insulin treatment. Treatment includes diet for diabetics and exercise. Risk factors for Type II are obesity, physiological or emotional stress, pregnancy, certain medications, age over 40, and family history.

Gestational diabetes starts or is first recognized during pregnancy. It usually becomes apparent during the 24th to 28th weeks of pregnancy. In many cases, the blood-glucose level returns to normal after delivery. Risk factors for gestational diabetes are maternal age over 25 years, family history of diabetes, obesity, birth weight over 9 pounds in a previous infant, unexplained death in a previous infant or newborn, congenital malformation in a previous child, and recurrent infections.

Diabetes mellitus affects up to 5% of the population in the Canada, almost 1.4 million people.

Vision abnormalities - Diabetes and The Eye

Definition
Blurred vision is the loss of visual acuity or sharpness resulting in unclear visual details. Vision loss is the inability to perceive visual stimuli. Blind spots are apparent dark "holes" in the visual field in which nothing can be seen. An enlarging blind spot is growth in the size of a blind spot that is readily apparent to the individual.

Alternative Names
decreased vision; diminished eyesight; blindness, temporary; impaired vision; eyesight diminished

Call your Optometrist if

• any sudden visual changes occur
• there is partial or complete blindness in one or both eyes
• there is trouble seeing objects to either side (decreased peripheral vision) or if halos are seen around lights.
• blind spots suddenly appear

Common Causes

• aging, (the most common cause of decreased vision)
• cataracts (also common in the elderly)
• glaucoma
• complications of diabetes (the most common cause of blindness in the North America)
• intermittent or fixed double vision (usually temporary)
• retinal hemorrhages, which can cause more permanent blindness
• diabetic retinopathy
• eye infection, inflammation, or injury
• infections of the cornea that cause scarring, distortion or perforation
• nfections of the retina with viruses, fungi or parasites--seen with increasing frequency in AIDS
• floaters (tiny particles) drifting across the eye usually are harmless and require no treatment
• fatigue and prolonged exposure to the outdoors (temporary and reversible blurring of vision)
• drugs (blurring, spots, and halos)
• anticholinergics
• antihistamines
• clomiphene
• chloroquine
• cycloplegic
• digitalis derivatives (temporary)
• ethambutol
• guanethidineo indomethacin
• methanol toxicity (permanent)
• phenothiazines
• phenylbutazone
• quinine sulfate
• reserpine
• thiazide diuretics

• migraine headaches (spots of light, halos, or zigzag patterns are common preliminary symptoms)
• congenital disorders
• heritable disorders

What to expect at your Optometrists office.

The medical history will be obtained and an examination performed.

Medical history questions documenting the vision abnormalities in detail may include:

• time pattern
• When did this begin?
• Did it occur suddenly or gradually?
• Does it occur only occasionally? How often?
• How long does it last?
• When does it occur? Evening? Morning?
• quality
• Is the vision blurred or is there double vision?
• Are there blind spots?
• Are there areas that look black and missing?
• Is side vision missing?
• Are halos (circles of light) seen around shiny objects or lights?
• Are flashing lights or zigzag lines seen?
• Is extreme sensitivity to light present?
• Do stationary things seem to be moving?
• Are colors missing?
• Is it difficult to differentiate colors?
• Is there pain?
• Is there drainage from the eye(s)?
• Are the eyes crossed?
• Does one of the eyes "drift"? Do both?
• location
• Is the problem in one eye or both eyes?
• aggravating factors
• Have you had any of the following in the last few weeks to months?
• injury
• infection
• increased stress
• anxiety
• depression
• fatigue
• headache
• exposure to pollens, wind, sunlight, or chemicals
• use of soaps, lotions, or cosmetics
• relieving factors
• Is your vision better after you rest?
• Is it better with corrective lenses
• other
• What other symptoms are also present?
• redness
• swelling
• bruising
• headache
• pain
• itching
• a sense that something is in the eye
• increased tearing
• decreased tearing

• additional important information
• What medications are being taken?
• Is there a family history of diabetes?
• Have you had a previous head injury?
• Do you have any allergies?
• Has there been a loss of eyelashes?

The examination will include an eye examination. The Optometrist will check vision, eye movements, pupils, back of the eye, and eye pressure when indicated.

Diagnostic tests that may be performed include:

• slit-lamp examination
• refraction test
• tonometry

Intervention:
Surgery will be recommended for some conditions (such as cataracts or muscle problems). Diabetics must control their blood-sugar level. Other treatments depend on the cause.
 

Home Care
Safety measures may be necessary to help a person with vision abnormalities. For example, it may be helpful to increase the amount of light in a room.

• Considerations
  Loss of visual acuity, changes in vision, blurriness or decreased light perception should always be evaluated as soon as possible by a medical professional. Changes may represent primary eye disease, aging, eye trauma, or a generalized (systemic) illness. Whatever the cause, visual changes should never be ignored. Decreased vision is a significant threat to the quality of life. Professional help is always indicated, but which professional to see is often a question.
  
   If you have any concerns about your vision or your eyes health, please contact us immediately. You can phone, email or use the question form linked here.              
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