Fluctuating visual acuity can be a first symptom of diabetes mellitus

Changes in visual acuity during the day, possible indication of diabetes
Many people suffer from fluctuations in their eyesight during the day, which should be checked urgently by a doctor if there are clearly noticeable impairments in vision. Because the cause can be an unnoticed diabetes disease. If the visual acuity changes within a day, this is a possible early warning sign for diabetes mellitus, according to the current announcement by the German Ophthalmological Society (DOG).

Significant fluctuations in vision during the day are simply attributed to eye fatigue by many sufferers. However, an undiscovered disease from diabetes can also be the trigger. "The number of diabetes diseases is increasing dramatically in Germany" and "an estimated two million people are affected without knowing about it," reports the DOG. If there are clearly noticeable changes in visual acuity during the day, a specialist examination should therefore be carried out urgently.

Often, those affected do not know about their diabetes
"We come to the eye clinic every week for patients who suffer from fluctuations in visual acuity during the day," reports DOG expert Prof. Dr. med. Gabriele Lang. The cause of this is mostly diabetes mellitus, according to the head of the conservative retinology and laser surgery section of the Ulm University Eye Clinic. Some of the patients did not know about their own metabolic disorder until the eye examination. "Typical descriptions of these patients are: I saw blurry this morning, now it's better again," said Prof. Lang. Also, for example, an optimally adjusted pair of glasses could no longer fit after two days later, and those affected “suddenly see worse again with the new glasses in the distance or nearby.” In many of these cases, the cause is fluctuations in blood sugar due to diabetes.

Fluctuations in blood sugar affect vision
A rising blood sugar level increases the osmotic pressure in the eye, which in turn leads to water retention in the eye lens and thus has an effect on visual acuity, reports Prof. The shape of the lens changes temporarily, which affects the ability to see sharply. "Anyone who notices such signs should definitely consult an ophthalmologist," emphasizes the DOG expert. The ophthalmologist can "recognize the consequences of the metabolic disorder with a simple examination of the fundus," adds Professor Dr. Horst Helbig, President of the DOG. Both early diagnosis and regular eye examinations are important in diabetes, because otherwise there is a risk of severe retinal damage.

Damage to the retina
In the specialist examination, the vessels of the retina, the retina, can be examined and diabetes-related changes can be determined by mirroring the fundus of the eye - even before the metabolic disorder manifests itself with other symptoms, reports the DOG. Depending on the severity of the disease, small red spots on the retina can be seen in the study. "These are bleeding or sagging of the vessels, so-called microaneurysms," explains Prof.. Other pathological changes include swelling, new vascularization of the retina or vitreous hemorrhage. If the question of a known diabetes disease is answered in the negative by those affected, we will refer the patient to the family doctor or an internist to have the patient examined for diabetes, said Prof. Lang.

Imminent blindness of those affected
If the metabolic disorder is not recognized and progresses unchecked, blood sugar will increasingly damage the small blood vessels that supply the retina with nutrients, explain the DOG experts. 80 percent of patients suffering from type 2 diabetes mellitus would have diabetic retinopathy after 20 years. In the industrialized nations, this is the most common cause of blindness in working age. "Regular eye exams are therefore very important for diabetes patients, especially since the disease is symptom-free for a long time," said Prof. (fp)

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