How can Diabetes impact your eyes and what can we do to prevent damage?

So, the effects of high blood glucose on small vessels cause, such as those that feed the retina are that you can get new vessels forming because of factors and as well as leakage from the arteries themselves. Now you can get retinopathy which which means that any part of the retina gets affected but the but the point of your eye where where your images get focus is called the macula and you can get something called maculopathy. Now if that if your macula gets affected, that can affect your what's called your visual your ability to see things. I was going to say visual acuity but visual acuity is caused by a number of different things so that's why we have short sightedness and long sightedness you don't have to have diabetic retinopathy to not be able to see a TV screen properly without glasses. So there are a couple of things there that one is you get swelling around the macula and that can be caused by poor blood glucose control, rapid correction of blood glucose which can also cause the formation of new blood vessels. Now these new blood vessels that form that I've mentioned earlier, they're quite fragile and they can bleed very easily. So what can happen is sometimes your vision goes completely blank and that's because you've had a bleed. Now that is obviously very frightening, but it does resolve and you can have various operations that sort those out. Now we try and avoid people getting progression of eye disease by regular reviews by ophthalmologists and they have various agents that they can use apart from improving blood glucose control you also use improved blood pressure control and things like ACE inhibitors and angiotensin receptor blockers or ARBs have been shown to be very effective in reducing progression of eye disease. Well they also use laser therapy to to treat the eye disease itself. You have to be careful with certain drugs that have been shown to increase the risks of maculopathy. These are drugs used for the treatment of diabetes. Primarily these are pioglitazone and also semaglutide. Now often the effects of the drug are hard to tease away from the actual effects of poor blood glucose control, but there does appear to be an independent effect and probably it's a wise thing to stop those drugs if you do have maculopathy.