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Diabetes and the eye

Diabetes represents a metabolic problem, with the inability or reduced ability of a cell to use blood glucose, while the level of glycemia in blood is high due to a complete cessation or reduction of insulin secretion by the pancreas. This hormone is secreted in the pancreas and helps the cell to use glucose. With the lack of insulin, the blood level of glucose is high, while at the same time cells are unable to have it in. So, we have a situation with high glucose levels in the blood, and at the same time its deficiency in the cell, which is called, hyperglycemia.

Consequently, a mosaic of changes develops in the body: on the blood vessels generally, in the heart, kidneys, brain, nervous tissue and eye. Specific changes are easily observed while looking into the fundus of the eye through a dilated pupil. Frequently, it is actually an ophthalmologist who first suspects diabetes, before the clinical picture is clearly revealed.

Specific biochemical processes develop in the situation of an increased blood level of glucose, and its lack in the cells, with big changing in the quality and permeability of the walls of the blood vessels. A lack of adequate tissue nutrition (ischaemia) creates suitable conditions for forming non-functional, easy breakable new vascularisation. Mainly on the place of ischaemia, the so-called growth factors appear which represent a stimulus for the development of these new-formed blood vessels. All these reflect on the patient’s decline of vision, due to the posterior repeated bleeding and membrane formation with traction effects on the retina causing retinal detachment at the end which means blindness if not operated in time. Argon laser photocoagulation regularly done can delay this moment and postpone the operation. This is a demand prior to vitreoretinal surgery, but only vitreoretinal surgery can save and conserve functional vision.

Vitreoretinal surgery here in Sveti Vid is on a very high level like in the top vitreoretinal clinics in the world (see link retinal detachment).