Glaucoma and diabetic retinopathy: what are the risks and how to avoid them?

Every day, more than 100 people in the UK start to lose their sight, ⁱ a worryingly high statistic - but the good news is more than 50 per cent of these cases could be prevented. ⁱⁱ

Glaucoma

Glaucoma is the name for a group of eye conditions where the optic nerve, which connects the retina in your eye to your brain, becomes damaged.

This condition usually occurs when the fluid that fills the front part of your eye can't drain away properly, increasing pressure inside the eye. The eye needs pressure to keep the eyeball in shape, but if it gets too high, it squeezes the optic nerve, which carries visual information from the eye to the brain. This can lead to irreversible sight loss if it's not detected and treated.

Who gets it?

Anyone can get glaucoma, but getting older increases your chances, with two per cent of people over the age of 40 diagnosed with the condition. ⁱⁱⁱ Glaucoma is also hereditary, and you're more likely to get it if you have an African, Caribbean or Asian background. It can also be a complication of diabetes. ^iv

Treatments

Unfortunately, the damage caused by glaucoma can't be reversed, but treatment can stop your sight from getting worse. By detecting it early, glaucoma can be treated with eye drops, which can bring down the pressure within the eye and reduce the fluid build-up.

If glaucoma is left untreated, surgery may be the next option. The most common is a trabeculectomy procedure which may be used as an alternative to laser treatment to improve the drainage of fluids from your eye. ^v

Reduce your risks

If you're at increased risk of developing glaucoma, there are some things that you can do to reduce it:

• Get your eyes tested regularly: If you're over 60 or aged over 40 with a family history of glaucoma, or in other high risk groups, you're entitled to a free NHS eye test. ^vi

• Eat a healthy, well-balanced diet: Include plenty of green leafy vegetables. A study, published by JAMA Ophthalmology, found that those who ate enough leafy greens had a lower risk of getting primary open angle glaucoma (POAG). ^vii

• Go easy on coffee: One study found that drinking more coffee may be associated with glaucoma progression. ^viii

Diabetic retinopathy

Diabetic retinopathy is a common complication of diabetes and can lead to blindness if left untreated. It occurs when high blood sugar levels damage the small blood vessels in the back of the eye (retina). The lining of these delicate blood vessels may thicken or develop leaks ix and when they're damaged your eyes may be unable to work properly.

Who gets it?

You're more at risk if you persistently have high blood sugar, blood pressure and cholesterol, are pregnant or from an Asian or Afro-Caribbean background. ^x

Treatment

A laser treatment called photocoagulation, regular screening and good blood pressure and glucose control can successfully save central vision. ^xi

Reduce your risks

If you're at risk of developing diabetic retinopathy, there are steps you can take to significantly reduce this:

• Go for a screening: If you have diabetes, you'll be invited for a screening once a year, where the back of your eyes will be checked. This is the most effective way to detect it early. ^xii

• Get physical: One study found that increased physical activity was associated with less severe levels of diabetic retinopathy. ^xiii

• Eat colourful fruit and veg: Include plenty of lutein-rich fruits and vegetables, such as sweetcorn, red and yellow peppers, carrots and leafy green vegetables. A study found that carotenoid pigments found in lutein were significantly lower in people with retinopathy than those without it. ^xiv

• Quit smoking: Smoking can be very damaging if you have diabetes and can increase the risk of complications. One study found that smoking reduces thickness of the retina. ^xv

• Control your blood pressure: High blood pressure is a major risk factor for diabetic retinopathy. ^xvi You can bring it down by getting more active, not drinking too much alcohol and cutting down on salt in your food. ^xvii

Supplements

Supplements to support your eye health include:

• Lutein supplements may be a useful top up to your diet; studies suggest we should be getting around 10mg daily.^xviii

• Omega 3 supplements improved dry eye symptoms in patients with glaucoma. ^xix

• Lycopene may be beneficial for those with diabetic retinopathy. A study, published in the European Journal of Ophthalmology, found that lycopene levels were significantly lower in people with retinopathy. ^xx

• Beta carotene is an important nutrient because the human body converts it into vitamin A, an essential vitamin for eye health and vision.

Nothing beats a healthy, balanced diet to provide all the nutrients we need. But when this isn’t possible supplements can help. This article isn’t intended to replace medical advice. Please consult your healthcare professional before trying supplements or herbal medicines.