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By: Yasser Elshatory, M.D., Ph.D.

In normal form, components of the eye including the cornea, lens and retina, must be clear tissue. When the tissue becomes unclear, vision loss can occur and is the underlying cause of many different diseases of the eye. Patients with diabetes are at higher risk for these vision issues because of elevated blood sugar levels.

The link between sugar and vision

When blood sugar levels are high, sugar molecules get tacked on to other components of blood and blood vessel lining. This is so important in diabetes, that physicians monitor one’s diabetes control by measuring the percentage of a certain protein in the blood that has sugar attached to it (hemoglobin A1c). The higher the percentage, the higher the blood sugar levels have been.

Diabetic retinal disease is easily explained by drawing an analogy to what happens when sugar, fat, and protein react together when making crème brulee. The brittle sugar layer on top is created through a browning process that makes the topping crisp. This is what happens to small vessels in the retina that are bathed in elevated blood sugar levels for many years. These tiny vessels become brittle and break. The leakage of blood, fluid and cholesterol from these fragile vessels can lead to blurry vision.

Managing diabetes and vision

Diabetic patients who closely manage their sugar levels may be able to prevent the progression to diabetic retinopathy. Karen from Rock Island has been diabetic for over 20 years. By getting her eyes examined annually at ESA and checking her sugar levels regularly, she’s avoided diabetic retinopathy. ”I manage my portions and sugar intake and make smart choices when we go out to eat. I’m frustrated by not being able to eat many sweets, but it helps me keep my diabetes in check. I also walk and think that’s really helped.”


Fortunately, many of the vision changes that occur in diabetes patients can be reversed. As treatment options continue to expand and improve, the extent to which vision loss is permanent or is irreversible from diabetes is decreasing.

Bio: Dr. Elshatory of Eye Surgeons Associates, is a board certified and fellowship trained retina specialist. His specialty interests include the medical and surgical treatment of age-related macular degeneration, diabetic retinopathy, retinal vascular disease, complex retinal detachment, uveitis, complex cataracts, and ocular trauma. Dr. Elshatory practices in Bettendorf, Iowa and Rock Island, Illinois.

The material contained in this article is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health care provider.

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