Diabetes can damage the very small blood vessels in the back of the eye. The medical name for this damage is diabetic retinopathy. This disease can lead to vision loss and even blindness.
Diabetes can cause a variety of eye diseases, such as corneal ulcers, glaucoma, vitreous hemorrhage, optic neuropathy, and most commonly retinopathy. The prevalence of diabetic retinopathy varies with the course of diabetes. The incidence of retinopathy in diabetic patients ranges from 21 to 36% and has the greatest impact on vision. When diabetes is complicated by eye disease, patients are more aware that diabetes can cause retinopathy. In fact, as the duration of diabetes lengthens, the effects on the eyes become more and more pronounced. In addition to the commonly referred to diabetic retinopathy, there are several eye diseases as follows.
1, myopia: manifested as the occurrence of myopia in people who are not myopic or the constant change of eye prescription in people who are already myopic. While replacing glasses, the possibility of diabetes should be thought of.
2, droopy eyelid: suddenly appear one side of the eyelid drooping (upper eyelid drooping, can not open the eyes), older patients have a more rapid onset, mostly one side of the onset, accompanied by facial pain, at the same time eye movement is limited, appear to see things into double shadow, to find a doctor in time to make the correct diagnosis and treatment.
3, cataract: often manifested as a gradual decline in visual acuity.
4. Paralytic strabismus: It usually starts suddenly and manifests as seeing things in double shadows and limited eye movements. The appearance of the eye is outward or inward skewed. Patients will feel dizzy, walk unsteadily, and in severe cases, nausea and vomiting, and the cause should be promptly identified for active treatment. Once these conditions occur in middle-aged, elderly and diabetic patients, it is important to go to the hospital for examination in order to prevent diabetic eye disease.
Care and treatment
(a) Prevention is an important part of preventing diabetic eye disease.
Prevention is the most important part of preventing diabetic eye disease. Since the early stages of diabetic retinopathy can be asymptomatic or painful, there can be no change in vision until the disease progresses. Therefore, a comprehensive eye examination should be done from the beginning of diabetes. The examination items include visual acuity (near and far), pupil-to-light reflex, fundus examination after pupil dilation, intraocular pressure measurement, fundus photography, and fundus fluorescence angiography if necessary. Check the fundus at least once a year for early detection of lesions and treatment.
(ii) Control of blood glucose to achieve the desired goal.
Active and effective control of diabetes, to make both fasting and postprandial blood glucose close to normal levels, so that glycosylated hemoglobin is controlled below 7%, is the basic measure to prevent and treat diabetic retinopathy, and the merit of blood glucose control is related to the severity of retinopathy.
(C) Good psychological guidance for patients.
Because diabetes is a lifelong disease, if combined eye disease is also found, anxiety and fear will appear, which is not conducive to treatment. We should do a good job of psychological care for the different psychological problems of patients.
(iv) Promote a healthy lifestyle.
1, let patients know that smoking can make blood vessels spasm and cause poor blood circulation, drinking alcohol can make blood vessels dilate, which is more likely to cause fundus hemorrhage, and forceful defecation will aggravate the bleeding. Ask the patient to quit smoking, quit drinking, eat more fresh vegetables and fruits, keep the bowel movement smooth and prevent constipation.
2, daily life pay attention to eye care and eye cleaning, usually can use the massage method for eye care.
3.Patients with diabetic retinopathy, especially those with fundus hemorrhage, must be prohibited from overworking, watching TV and reading books for a long time, and should not do strenuous sports and diving and other activities.
(E) Laser treatment.
Laser treatment is an effective means for diabetic retinopathy. Fundus fluorescence imaging is required before treatment, and the purpose of the examination, precautions and cooperation matters should be explained to the patient. After treatment, pay attention to the observation of intraocular pressure and visual acuity. Any eye pain and vision loss should be reported to the doctor for treatment.
(F) Cataract surgery.
1. Do all routine examinations before surgery, understand in detail the changes of patients’ visual acuity, and do eye electrophysiological examination for patients suspected of having diabetic retinopathy to judge the recovery of visual acuity after surgery. Patients with retinal dysfunction should be explained to the patients before surgery to prepare their minds and prevent them from being disappointed by the poor recovery of vision after surgery.
2.Postoperatively, lie flat and relax the head; avoid excessive head movement, sudden sitting up and lowering the head, bending over and extracting heavy objects; avoid strenuous activities, coughing and sneezing to prevent secondary bleeding.
3.For patients with cardiovascular, renal and respiratory system diseases, give intraoperative and postoperative cardiac monitoring and nasal catheter oxygenation as a way to prevent heart-eye opposition and accidents.
4. Observe the pain in the fundus after surgery. Mild pain is a reaction to surgery; severe pain should be noted for infection, anterior chamber bleeding, high intraocular pressure or improper dressing. When changing medication every day, focus on observing whether the eyelid is red and swollen, the amount of conjunctival secretions, the wound alignment, whether the cornea is cloudy and edematous, whether there is exudation, bleeding and intraocular infection in the anterior chamber, intraocular pressure and pupil size.
5.Use painkillers if necessary to reduce irritation and keep blood sugar stable.
6.Prevent postoperative infection and reduce inflammatory reaction.
7.Keep the eye clean, do not let foreign bodies and unclean water enter the operated eye for two weeks after surgery, and do not go to places with more serious pollution and dust. You can wash your hair and take a shower, and gently dry the eye skin afterwards.
8, avoid bending low to make the eye congestion, pressure action, do not do heavy physical labor and violent avoidance and collision.