Diabetic Eye Disease in Elderly Residents
In the general population, about 9.4% of people have a diabetes diagnosis. Among seniors, that percentage jumps to 25%.
Along with the concerns for diabetes itself, a closely related issue is diabetic eye disease. There are four conditions that fall under this category, which may be seen in elderly residents. Assisted Living Education discusses diabetic eye disease and the complications associated with it.
Diabetic Eye Disease
Diabetic retinopathy, diabetic macular edema (DME), cataract, and glaucoma are the big four of the eye conditions that fall under diabetic eye disease. Individuals who have diabetes are at risk of developing these conditions, and the risk only increases with age. Fortunately, early detection, treatment, and careful management of diabetes can prevent or delay the onset of vision loss caused by diabetic eye disease.
The Big Four – Types of Diabetic Eye Disease
Diabetic retinopathy is caused by maintained high blood glucose levels over time which can eventually damage the retina’s blood vessels. These vessels may swell, leak, or bleed and subsequently become blocked, leading to a distortion in vision. The individual may start to see spots floating across their vision. As the condition worsens, irregular blood vessels begin forming on the surface of the retina as a work-around for the blood vessels that are no longer able to transport blood due to swelling and distortion. Left untreated, the irregular blood vessels will continue to proliferate and grow into the vitreous fluid in the center of the eye and leak or bleed. Scar tissue is frequently present at this advanced stage, which poses another risk: retinal detachment. A retinal detachment is an emergency situation; this left untreated can lead to an irreversible loss in vision.
Diabetic macular edema (DME)
DME goes hand-in-hand with diabetic retinopathy; it is the accumulation of fluid in the macula (the center of the retina crucial to our central field of vision) due to diabetic retinopathy. This can occur at any stage of diabetic retinopathy.
As the macula is crucial to our central vision, it is the most sensitive area of the retina. The accumulation of fluid causes swelling and results in blurry vision. Of the individuals who already have diabetic retinopathy, about half of them will experience DME.
Many are familiar with this term and may understand its basic meaning; that there is a cloudiness in the lens of the eye. The lens of the eye is clear and composed of mostly water and proteins. In a normal or healthy eye, the proteins do not much get in the way of the light, allowing it to pass through the lens. If an individual has a cataract, this means there is a build-up of those proteins in the lens, making it difficult for light to pass. Cataracts are typically removed with surgery.
In individuals with diabetes, they are two to five times more likely to develop cataracts than individuals without diabetes. Additionally, they are more likely to develop at a younger age for those with diabetes.
Glaucoma is actually a broad term for a group of diseases that can cause damage to the optic nerve, which sits at the back of the eye and connects to the brain. Increased pressure in the eye is the most prevalent cause of glaucoma. There is a potential for fluid to build up in the eye if it is not able to drain quickly enough. If severe enough, the pressure can cause damage to the optic nerve. Individuals with glaucoma who experience vision loss begin to lose their peripheral vision first. Eventually, they will be left with just their central vision before entire vision loss is present.
Currently, there is no cure for glaucoma, but there are treatments which can slow its progression. Medication, laser treatment, and surgery have been proven to slow the process.
Unfortunately for individuals with diabetes, their risk of developing glaucoma is two times more than a person without diabetes.
Preventing or Delaying Diabetic Eye Disease
As with any medical or health condition, it is important to catch it early and intervene as soon as possible. Individuals with diabetes should also receive a comprehensive eye exam, which includes dilation of the eyes, at least once a year. The comprehensive dilated eye exam allows the doctor to look for changes in the lens or blood vessels to detect possible vulnerabilities, as well as nerve tissue damage, or swelling of the macula. Despite seeming asymptomatic, the early stages of eye disease may be present in an individual, which is why it is important to be seen by a professional.
Any changes in vision, such as blurriness or floating spots warrants an eye exam, especially in elderly residents. Those already diagnosed with diabetic retinopathy should receive eye exams more frequently, depending on the stage of the condition.
Diet is also key in delaying the onset of diabetic eye disease. Keeping blood sugar levels under control and within a normal range, as well as blood pressure and cholesterol can help reduce the risk of diabetic eye disease.
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