Insights into Diabetic Eye Problems in Singapore

Eye problems due to diabetes have steadily become a significant public health concern in Singapore, with rising diabetes prevalence creating a ripple effect on the ocular health of our population. It’s crucial to understand how diabetes affects the eyes and the subsequent eye problems that can result from the disease. But more importantly, remember that early detection and appropriate treatment can prevent severe vision loss or eyesight impairment related to diabetes. 

The Ministry of Health (MOH) estimates show that nearly 500 million people globally have diabetes and, consequently, diabetic eye issues. And as it turns out, Singapore has one of the highest rates of diabetes among developed nations, according to the Singapore Eye Research Institute (SERI). To drive home the point, the MOH said, “If nothing is done, by 2050, it is estimated that about 1 million Singaporeans will be living with diabetes.”

A chronic condition that affects the body’s ability to process sugar, diabetes is affecting the eyes by inflicting a significant toll on the eyes, which leads to various ocular conditions collectively termed diabetic eye diseases. High blood sugar levels caused by diabetes can damage blood vessels in the eyes — they may leak fluid or bleed, creating vision distortion. And if not detected and managed appropriately, this can lead to severe vision loss over time.

Book a consultation with Dr Jimmy Lim today to learn more about diabetic eye diseases

Understanding Diabetes

The main reasons why one-third of the Singapore population is grappling with diabetes are a less-than-ideal lifestyle (i.e., unhealthy diet and lack of exercise) and an ageing population. But as Dr Jimmy Lim, JL Eye Specialists Medical Director and Senior Consultant, told The Straits Times Singapore, healthcare policies and healthcare could be mitigating factors. 

Diabetes is a complex metabolic disease characterised by high blood sugar levels over time. There are two main types of diabetes: Type 1 and Type 2, and they have different causes. 

TYPE 1 DIABETES: also known as juvenile diabetes, the disease usually develops during childhood, although it can occur at any age. In Type 1 diabetes, the body’s immune system destroys the cells in the pancreas that produce insulin, a hormone that regulates blood sugar. The general cause is believed to be a combination of genetic predisposition and environmental factors, including some viral infections.

TYPE 2 DIABETES: the most common type of diabetes, accounting for at least 90% of all cases. It usually develops in adults but is increasingly seen in children and adolescents and in people who are overweight or obese. In Type 2 diabetes, the body either doesn’t produce enough insulin or doesn’t use the insulin it does produce effectively (insulin resistance).

Major Risk Factors:

1. overweight/obesity
2. physical inactivity
3. poor diet
4. age (risk increases with age)
5. family history of diabetes
6. polycystic ovary syndrome (PCOS)
7. metabolic syndrome
8. high blood pressure
9. abnormal cholesterol and triglyceride levels

Common Eye Problems Due To Diabetes

Diabetes can lead to several eye-related complications. It is why it’s essential for people with diabetes to regularly monitor their blood sugar levels, maintain a healthy lifestyle, and get regular eye exams to detect these conditions early and receive appropriate treatment.

Some common eye problems caused by diabetes are:

1. Diabetic Retinopathy: affects the blood vessels in the light-sensitive tissue at the back of the eye (retina). High blood sugar levels can cause the blood vessels in the retina to leak fluid or bleed, distorting vision.
2. Diabetic Macular Edema (DME): a complication of diabetic retinopathy with swelling in an area of the retina (macula). It’s the most common cause of vision loss among people with diabetic retinopathy.
3. Cataracts: People with diabetes are 2 to 5 times more likely to develop cataracts at a younger age. A cataract is a clouding of the eye’s clear lens and can cause blurred vision.
4. Glaucoma: Diabetic patients have a higher risk of developing glaucoma, where increased pressure in the eye can lead to optic nerve damage and vision loss.
5. Nonproliferative Diabetic Retinopathy (NPDR): the early stage of diabetic eye disease, where high blood sugar levels cause the blood vessels in the retina to weaken and bulge.
6. Proliferative Diabetic Retinopathy (PDR): the more advanced stage of diabetic retinopathy, in which damaged blood vessels close off, causing new, abnormal blood vessels to grow, potentially leading to serious vision problems.

Read: Cataract: Know Why It’s Clouding Your Vision

Awareness and Prevention

While it’s true that diabetes affects blood sugar levels and can lead to serious eye problems, take heart as these complications can be largely preventable through the proactive management of one’s health and lifestyle. 

Here are some strategies to help prevent or delay the development of eye problems due to diabetes:

1. Regular Self-Monitoring: Keep your blood sugar levels under control and make it a habit to check regularly
2. Regular Check-ups: Regular eye examinations are critical in identifying issues early when they’re most treatable. An annual dilated eye exam is recommended for people with diabetes
3. Manage Blood Pressure and Cholesterol: Keep them in check by eating a healthy diet, exercising regularly, and taking prescribed medications
4. Quit Smoking: Smoking increases your risk of diabetes complications, including eye diseases. If you’re a smoker, ask your doctor for help to quit
5. Exercise Regularly: Regular physical activity can help you control your blood glucose, blood pressure, and cholesterol levels
6. Healthy Diet: A diet rich in fruits, vegetables, lean proteins, and whole grains can help manage your blood sugar levels and overall health
7. Control Alcohol Intake: Excessive alcohol consumption can lead to increased blood sugar levels and can also raise blood pressure

Read: Here’s what you need to know about Glaucoma

What you can do NOW

If you are at risk for diabetes, then a comprehensive eye examination is imperative. A dilated eye exam is recommended as it allows the doctor to view the back of the eye better and check for signs of damage or other issues that can occur with diabetes.

This comprehensive eye examination typically includes a visual acuity test that measures vision sharpness; and a tonometry test to measure the pressure inside the eye, which helps detect glaucoma. Eye drops are used to dilate the pupils and allow the doctor to examine the retina and optic nerve more clearly for any signs of damage or disease. 

Additionally, optical coherence tomography (OCT), a non-invasive imaging test that uses light waves to take cross-section pictures of the retina, can be performed to assess the thickness of the retina and the optic nerve, which can be affected by diabetes.

At JL Eye Specialists, we advocate for comprehensive eye care, beginning with education and regular screening. We encourage you to proactively take charge of your eye health, starting with a consultation with our medical director, Dr Jimmy Lim.