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Navid Hakimian
Ask The Experts

Navid Hakimian, MD
Ophthalmologist, Retina Specialist
Lincoln Medical Center

Q. Are eye problems common among diabetics?

A. Yes. In uncontrolled diabetes, the high blood sugar damages the blood vessels in your eyes and throughout your body. Diabetes is a blinding disease if it's not well controlled. In New York City, diabetes is one of the more common causes of blindness. On a national basis, 12,000 to 24,000 people every year become blind because of diabetic eye disease. Screening and proper care could prevent up to 90 percent of diabetes-related blindness.

Q. What are the most common eye diseases that people with diabetes develop?

A. People with diabetes are 40 percent more likely to develop glaucoma and 60 percent more likely to develop cataracts than people without diabetes. Also, people who have had diabetes for a long time or whose diabetes has not been under control for some time are susceptible to retinopathy, which is damage to the blood vessels in the retina, the membrane that lines the inside wall of the eyeball. I am a retina specialist at the eye clinic here at Lincoln Medical & Mental Health Center, and 60 to 70 percent of our patients have diabetes. They come to us because they have a serious condition or as a preventive measure.

Q. As a diabetic, how do I avoid eye disease?

A.There are several things you can do to avoid diabetic eye disease:

  • Eat a healthy diet (high protein, high fiber, low fat)
  • Watch your portion size (use the plate method to help you)
  • Exercise daily for 30 minutes
  • Take your medicines as prescribed by your physician
  • Monitor your glucose levels regularly

Q. What could happen to my eyes if I don't take care of my diabetes?

A. High blood sugar in uncontrolled diabetes can damage the blood vessels in your eyes. The blood vessels begin to shut down and leak. You start losing vision. This is a bad disease and if it's not controlled, every part of the body starts to get into trouble - the eyes, kidneys, heart and brain. But, most people with controlled diabetes have no eye disorders or have minor ones.

Q. What does it mean if I have blurry vision?

A. If you have diabetes, blurry vision should make you ask, "Is my glucose too high, too low or do I have a more serious eye disease?" There are many conditions that can cause blurry vision and loss of sight - diabetes, cataracts, glaucoma, and macular degeneration, to mention a few. If you have diabetes, but no specific eye conditions you should see your eye doctor every year. If you develop one or more eye conditions, you should be seen at least three to four times a year.

Q. Is there a difference between the impact of Type 1 and Type 2 diabetes on vision?

A. Yes. Patients with Type 1 diabetes have usually had the disease since they were as young as 5 or 6 years old and because they've had it longer they are more likely to develop related health issues, including vision problems. If you have Type 1 diabetes, screening for eye disease should begin five years after diagnosis.

Patients with Type 2 diabetes usually didn't get the disease until they were much older -- in their 40s or 50s. These patients are usually overweight and have excess fat tissue in the body. Fat tissue is resistant to insulin, as opposed to muscle tissue. If you have Type 2 diabetes, screening for eye disease should begin immediately when a diagnosis is made.

Q. Will laser vision correction surgery work on me if I'm diabetic?

A. Yes it should. Laser vision correction surgery is not related to laser surgery for retinopathy or any other diabetes-related treatment. Laser correction reshapes the front of the eye on the exterior, not the part affected by diabetes. The main eye surgery we do for diabetic patients is laser treatment to seal leaky vessels in the eye. If that is not possible then we do a vitrectomy, which is a surgery to remove blood and scar tissue caused by the diabetes.

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