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June 26, 2001

Complications

Question from Lubbock, Texas, USA:

My 70 year old mother, diagnosed with diabetes several weeks ago, is on medication but has not begun testing her glucose because she could not get into the diabetes clinic until this week., and she is experiencing blurred vision. She went to the ophthalmologist today, who could not find anything, and she has an appointment with a retinal specialist. I am pretty sure the blurry vision is being caused by the diabetes, but it came on so quickly. Is this reversible or will she lose her eyesight? The ophthalmologist said he could not give her anything to improve her eyesight. I am very concerned.

Answer:

With the information you provided it is difficult to know exactly what is going on. It is good to know that she has seen an ophthalmologist and will see a retinal specialist. The management of her visual problem is taking the right path, by seeing these professionals, and hopefully in time you will be given adequate explanations concerning your mother’s condition.

Vision changes can occur when medication for diabetes is started. Sometimes the vision improves or sometimes it “worsens”, but these changes can be compensated for by a change in or the prescribing of eyeglasses. When a vision change occurs and the medication is suspected, one needs to check the blood sugar. If the blood sugar is within normal limits, the vision change is the individuals “true” vision and glasses need to be updated or prescribed. Diabetes medication should not be stopped because the vision became blurry.

Elevated glucose can accelerate the development of cataracts, which occur naturally with age. This may be a factor in your mother’s apparent vision change, but most likely would have been seen at her first recent eye appointment. In most cases, once cataracts are removed the vision is improved.

Diabetes can causes vascular changes in the retina and optic nerve and these changes can cause abrupt vision changes which, depending upon the diagnosis, may be able to be treated. Treatment may improve the vision somewhat but more typically helps to prevent further vision loss.

Vision changes can also occur form a mild stroke that may only affect the vision and otherwise not be so apparent. This would come on suddenly, and there may be some recovery of vision. This possibility will mostly likely be considered during her work-up.

The exact prognosis will depend on the diagnosis. I have only given you some ideas. Diabetes is a blinding disease and may have a genetic connection in your mother’s instance, so family members have a family risk factor for the same. Prevention is the best treatment for diabetes so appropriate physicals and eye examinations is your way of avoiding complications related to diabetes or avoiding diabetes all together.

Lastly, once your mother’s ocular health is “stable” she should be examined by a low vision specialist to see if an enhancement in her remaining vision can be achieved by optical or video means. If so this may allow her to continue to do some activities she enjoys.

CAG