Alamo Optometry Blog

September 7, 2014

Systemic Diseases

Filed under: Eye Diseases and Disorders — gkblog @ 5:36 pm

(As appeared in Alamo Today, July, 2014)

As many of you may or may not be aware, almost every systemic disease can have ocular effects.  Most patients are aware that common conditions such as diabetes and high blood pressure can have severe visual and ocular consequences.  However, any disease including lupus, colitis, leukemia, and high cholesterol can affect the eye.  The eye is no different from any other organ in the body; it needs blood and oxygen to survive.  If this is affected or reduced, vision and/or ocular health will definitely be compromised.  These changes can vary from a prescription change, cataract formation, or retinal disease, to name a few.  That is why it is very important to let us know of any systemic ailments and medications on the patient questionnaire, as these can have a profound effect on the eyes.  Many times patients don’t report having some conditions and medications to us because they feel it is not important or that “it has nothing to do with my eyes”.  You can safely assume that any medication you take or ailment you have can alter vision and ocular health.  For the purposes of this article I will just cover the two most prevalent diseases, diabetes and high blood pressure.

Diabetes affects about 10 percent of the population in the United States and is characterized by either a deficiency in insulin production (type 1) or insulin resistance (type 2).  The main ocular effect of diabetes is retinopathy, which is a disease of the retina. Diabetic retinopathy can lead to poor vision and even blindness.  At first the integrity of the blood vessels breaks down which can lead to blood leaking into the retina.  If blood sugar levels stay high or fluctuate, diabetic retinopathy will keep getting worse. Due to the poor retinal blood flow through these damaged blood vessels, new blood vessels grow on the retina because insufficient amounts of oxygen are reaching the cells within the retina. This may sound good, but these new blood vessels are weak. They can leak very easily, even while you are sleeping. If this happens, blood can leak into and around the macula, which will cause decreased vision.  Retinopathy can also cause swelling of the macula; macular edema reduces vision as this specialized area of the retina is compromised.  The only way to diagnose this is through a comprehensive dilated optometric examination.  Annual exams can help detect retinopathy and monitor retinopathy before it affects your vision.

High blood pressure, or hypertension, is another vascular disorder that forces your heart to work harder to pump blood through your arteries.  This can lead to hardening of the arteries and subsequent heart failure.  In addition to all of the other body organs it can affect, the eye can also be compromised.  The blood vessels of the retina over time can narrow and cause a decrease in blood to the retina.  Compromised blood flow can cause swelling of the optic nerve and macula, which over time can lead to decreased vision and possible stroke in the eye.  Since this is something that cannot be self-monitored, an annual dilated examination can help in the detection and monitoring of this potentially blinding disease.

To help combat these diseases, the absolute best thing you can do is to keep the disease under control.  The more your blood sugar and blood pressure are under control, the less likely eye consequences will be an issue.  That means visits to your doctor and taking your medications, life-style changes, etc. as prescribed.  Keep in mind that just because you “feel” fine and have your diseases under control, the fact is you still have the disease.  Along with your regular doctor visits, annual eye exams should be on your list to keep these diseases monitored and under control.

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