Ocular Associations of Diabetes Other Than Diabetic Retinopathy
- V. Swetha E. Jeganathan, MBBS12,
- Jie Jin Wang, PHD13 and
- Tien Yin Wong, MD, PHD134
- 1Centre for Eye Research Australia, University of Melbourne, Victoria, Australia
- 2Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- 3Centre for Vision Research, University of Sydney, New South Wales, Australia
- 4Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Corresponding author: Tien Yin Wong, twong{at}unimelb.edu.au
Diabetic retinopathy is the most well-known ocular complication of diabetes and the leading cause of blindness among people 20–64 years of age in the U.S. (1). Up to 4 million Americans with diabetes, 40 years of age and older, have retinopathy, and nearly 1 million have sight-threatening retinopathy (2). In major clinical trials, tight control of blood glucose and blood pressure has been demonstrated to reduce the risk of retinopathy and associated blindness (3).
A range of ocular diseases is also associated with diabetes, which may lead to vision loss. However, some of these ocular conditions may not be familiar to noneye clinicians (4–6). In this review, we aim to highlight the frequencies, clinical presentations, natural histories, and management of these ocular conditions. Physicians who manage patients with diabetes may benefit from knowledge of these associated conditions and are thus able to ensure adequate and timely referral and treatment. Routine eye screening for retinopathy of individuals with diabetes offers the opportunity to detect these other ocular diseases early, many of which are sight threatening. Physician education remains an important public health strategy in the prevention of vision loss in patients with diabetes.
OCULAR CONDITIONS DIRECTLY ASSOCATED WITH DIABETES
1. Cataracts and cataract surgery
Cataract is a major cause of vision impairment in people with diabetes. Numerous studies have documented an association between diabetes and cataracts. This association is supported by an abundance of data from clinical epidemiological studies and basic science studies (7–22). Both cross-sectional and prospective data from three population-based studies, the Beaver Dam Eye Study, the Blue Mountains Eye Study, and the Visual Impairment Project, have documented associations between diabetes and both prevalent and incident posterior subcapsular cataract and, less consistently, with prevalent and incident cortical cataracts but not nuclear cataract (8–12,14–19,23,25). The Blue …
