Diabetes mellitus, commonly known as diabetes, is a chronic disease in which the body's mechanism for regulating blood sugar is impaired. In this condition, the pancreas either cannot produce enough insulin or the body cannot use insulin effectively. As a result, blood sugar levels rise, which over time causes damage to various organs, particularly the eyes, kidneys, nerves, and heart.
Diabetes is mainly divided into two types: Type 1 and Type 2. Type 1 diabetes usually appears in childhood and is characterized by the pancreas not producing insulin. Type 2 diabetes, on the other hand, generally develops in adulthood and is associated with insulin resistance.
In both types, if left untreated or poorly managed, eye health can be seriously affected. The most common and most dangerous eye complication is diabetic retinopathy.
Diabetic retinopathy is a vascular disease that develops as a result of diabetes and affects the retina, the light-sensitive layer at the back of the eye. High blood sugar gradually damages the structure of the retinal vessels, leading to bleeding, leakage, and even the formation of new abnormal blood vessels. This condition is a serious health problem that can progress to vision loss.
According to Op. Dr. Diclehan, diabetic retinopathy is the leading cause of vision loss among adults aged 20–65 worldwide. With early diagnosis and regular eye examinations, the effects of this disease can be significantly reduced.
In the initial stage that develops due to diabetes, microaneurysms (small bulges), blood leaks, and vascular occlusions begin to appear in the retinal vessels. Vision is usually not affected at this stage. However, the retina continues to be damaged over time.
At this stage, people often experience no symptoms. But during regular eye examinations, doctors can detect early changes in the retina. For this reason, Op. Dr. Diclehan emphasizes that every individual diagnosed with diabetes should undergo a detailed retinal examination at least once a year.
This stage is when the damage in the retina reaches severe levels and new abnormal blood vessels begin to form in the eye. These new vessels are fragile and can easily bleed, causing blood to leak onto the retina surface or into the fluid filling the eye. This can lead to sudden vision loss.
In addition, these vessels can form scar tissue inside the eye, leading to retinal detachment. Retinal detachment is when the retinal layer separates from its position, and if not treated urgently, it can cause permanent blindness.
Diabetic retinopathy usually progresses silently. In the early stages, there may be no symptoms. However, as the disease advances, the following symptoms may occur
Blurred vision
Floating objects in front of the eye (floaters)
Impaired night vision
Difficulty distinguishing colors
Sudden vision loss
A feeling of darkness in the eye
Op. Dr. Diclehan states that if any of these symptoms are present, an eye doctor should be consulted without delay.
Diabetes is a systemic disease that damages vascular structures throughout the body. The retina in the eye is filled with delicate and sensitive vessels. Therefore, high blood sugar levels affect the retinal vessels, leading to leakage, blockages, and abnormal vessel formation.
In addition, diabetes increases intraocular pressure, paving the way for glaucoma. Cataracts also tend to appear at an earlier age in diabetic individuals. Therefore, not only diabetic retinopathy but also other eye diseases pose a high risk.
Retinal examination is performed after dilating the pupil with eye drops. This allows the doctor to directly examine the retinal vessels. During this examination, vascular abnormalities, hemorrhages, and other changes can be clearly observed.
Fluorescein Angiography
Leaks and blockages in the retinal vessels can be visualized with a special dye (fluorescein). During this procedure, dye is injected intravenously and detailed photographs of the retinal vessels are taken using special cameras.
The thickness and structure of the retinal layers can be imaged layer by layer with this non-invasive method. It is especially effective in detecting conditions such as macular edema (fluid accumulation in the center of the retina).
Op. Dr. Diclehan states that these imaging methods performed in the early stages allow treatment to begin before permanent damage occurs.
In advanced diabetic retinopathy cases, abnormal vessels are cauterized with laser beams applied to the retina. This method reduces bleeding and can halt the progression of vision loss. It is widely used, especially in patients who have reached the proliferative stage.
Special drugs (anti-VEGF) injected into the eye can suppress the formation of new vessels. These drugs prevent abnormal vessel growth and reduce macular edema. Usually, multiple doses are required.
In severe cases such as intraocular bleeding or retinal detachment, a surgical method called vitrectomy is performed. In this procedure, the vitreous, the gel-like fluid inside the eye, is cleaned and replaced with special fluids or gas. At the same time, bleeding and scar tissues are removed.
Op. Dr. Diclehan emphasizes that vitrectomy surgeries should be performed by experienced eye surgeons and that timing is critical for treatment success.
Risk Factors for Diabetic Retinopathy
Long duration of diabetes
High blood sugar levels
High blood pressure (hypertension)
High cholesterol
Kidney disease
Pregnancy, especially in women with Type 1 diabetes
If one or more of these risk factors are present, the likelihood of developing diabetic retinopathy increases significantly.
Diabetic retinopathy is a preventable disease. The key is to keep diabetes under good control and not to neglect regular eye examinations. Preventive measures include:
Regular monitoring of blood sugar, blood pressure, and cholesterol levels
Annual eye fundus examination
Healthy diet and exercise
Avoiding smoking and alcohol consumption
Monitoring diabetes symptoms
Op. Dr. Diclehan states that with interventions especially in the early stages of the disease, vision loss can be largely prevented.
Vision loss directly affects a person’s daily life. Especially diabetic retinopathy, which develops due to diabetes, can dramatically reduce quality of life if left untreated. Starting treatment with early diagnosis is extremely important for maintaining an individual’s independent life.
In addition, psychological and social problems such as depression, social isolation, and loss of work capacity are also common in individuals with visual impairment. Therefore, the condition must be addressed in both its physical and psychological dimensions.
Diabetes is not just a metabolic disease, it is a systemic problem that affects the whole body. One of the most dangerous complications of this disease on the eyes, diabetic retinopathy, can largely be prevented or controlled with regular follow-ups and proper treatment.
Op. Dr. Diclehan emphasizes that all individuals diagnosed with diabetes must have a detailed retinal examination at least once a year and that no symptom should be taken lightly.
Remember, your eyes not only allow you to see, they also enable you to live life to the fullest. Take action for your eye health, do not delay.
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