Important Tips for Diabetic Patients with Cataract

Diabetes is a common ailment in India. According to the National Diabetes and Diabetic Retinotherapy Survey report of 2019 from the Ministry of Health and Family Welfare, the percentage of people over 50 years of age suffering from diabetes in India is 11.8%. Hence, it is not unknown for ophthalmologists and eye surgeons in India to treat diabetic patients with cataracts.

How diabetes affects cataracts?

Patients suffering from diabetes mellitus are at a higher risk of developing cataracts, especially at a younger age. They are more likely to develop a particular type of cataracts- posterior subcapsular cataracts. The severity of the cataract is determined by checking the visual acuity (ability to make out the shapes and details of objects) and additional signs reported. In some cases, there can be severe vision impairment which might be due to changes in the retina. 

Diabetes in which there is an increase in blood sugar levels than normal can cause proliferative diabetic retinopathy. Due to the proliferation of new blood vessels on the surface of the retina caused due to increased glucose levels, the person is likely to suffer from hemorrhages in the retina, retinal detachment, and neovascular glaucoma. Furthermore, there can be instances of macular edema in which blood or fluid leaks from these blood vessels and obstructs the vision. 

Therefore, several research studies concluded that individuals with high blood sugar levels or high blood pressure should control these body parameters to lower the chances of diabetic retinopathy or macular edema. 

What is the treatment for diabetic patients with cataracts? 

After proper evaluation and physical examination of the eye, doctors recommend cataract surgery. Before the removal of cataracts, ophthalmologists treat diabetic retinopathy and ensure that the retina is as healthy as possible. To treat diabetic retinopathy, the doctor shrinks the leaky blood vessels with a laser. Next, a vitrectomy may be considered in which the blood-infused vitreous, clear gel of the eye, is cleared. 

Once the prior diabetic retinopathy is treated, the surgeon recommends the most advanced treatment for cataracts- surgery. Cataract surgery involves removing the cloudy natural lens and implanting an intraocular lens. The choice of the type of intraocular lens becomes limited to only monofocal, toric, or accommodating lenses.

It is essential to note here that at times undergoing cataract surgery by individuals suffering from diabetic retinotherapy can worsen the condition. Hence, it is imperative that once the surgery is completed, patients visit the ophthalmologist regularly for checking the progress without fail.  

Post-operative tips for diabetic patients after cataract surgery 

After the cataract surgery, diabetic patients need to take extra care in order to ensure that the risk of complications decreases. Here are a couple of tips that can help them ensure a complication-free recovery. 

  • Take the topical steroids and nonsteroidal anti-inflammatory drugs (NSAIDs) as per the prescription to lower the risk of inflammation as well as to prevent macular edema. 
  • While the dosage of topical steroids continues, go for regular follow-ups to check the macular thickness. 
  • It is essential for patients to keep their blood sugar levels controlled during the entire recovery period to fasten the healing process. 
  • If needed, visit vitreoretinal surgeons regularly for monitoring the eye with dilated funduscopic examinations. 

How to prevent diabetes from affecting the eyes? 

Now that it is established that diabetes is one of the significant causes of eye problems, there are certain measures to lower the risk of diabetes developing. However, these measures may not work in people who are suffering from diabetes due to genetic factors. Take the below-mentioned preventive measures. 

  • Control the blood glucose levels-
    As elevated blood sugar level is one of the primary contributors to increased risk of eye problems including cataracts, doctors advise keeping the blood sugar level normal always. They further explain that doing so decreases the damage to the blood vessels inside the eyes. Eventually, the risk of eye problems also decreases. It is advised to get blood sugar levels tested with an A1c test. Ideally, the test result should be around 7% or less. 
  • Keep blood pressure in control-
    Another body parameter that needs to be monitored on a timely basis for diabetic patients is blood pressure. Diabetic patients with elevated blood pressure tend to be more prone to damage the blood vessels inside the eye, resulting in eye problems. During every doctor visit, get the blood pressure checked properly. Some patients may need drugs in addition to a low-salt diet, maintaining a healthy diet, and exercising to keep their blood pressure normal. 
  • Look for signs-
    There are a couple of warning signs that diabetic patients should look out for. The sooner they can identify these signs, it is more likely for them that treatment will provide suitable results. 

-Blurry or cloudy vision
-Double vision
-Spots floating in front of the eyes
-Halos around lights at night
-Redness of the eyes
-Pain or pressure inside the eyes
-Unable to see signs properly
-Straight lines appear distorted
-Sudden changes in vision 

  • Go for eye exams on a yearly basis-
    People over 35 years of age should go for eye tests on a yearly basis so that the doctor can diagnose the problem early and treat it accordingly. Early detection can help in treating the problem appropriately. 
  • Stop smoking-
    Diabetic patients should quit smoking immediately as smoking increases the risk of damage to the blood vessels. The nicotine has a disastrous effect on the lungs and arteries which can eventually lead to cataracts. 
  • Focus on overall health- 
    In general, diabetic patients should pay attention to their overall health. For a healthy lifestyle, keep an eye on your regular meals and lifestyle practices. 

Conclusion 

Diabetic patients with mature stages of cataract are prone to developing severe complications post-surgery. These complications can pose obstacles in the path to recovery. However, treating diabetic retinopathy prior to the surgery and choosing to undergo cataract surgery with advanced techniques can reduce the risk of complications to minimal. Moreover, following proper post-operative instructions can help the person recover more quickly.

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