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Diabetic Cataracts

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Introduction to diabetic cataracts:diabetovalens.com:"Sight is one of basic senses affected by diabetes in the long term . There are various reasons for the loss of sight in diabetics ,some being retinopathy , cataracts and glaucoma. Most important among them is called diabetic retinopathy caused because of growth of new blood vessels in the retina .the diabetic cataract comes next in the list and finally the rarer glaucoma. These diabetic cataracts seem to be indistinguishable from senile cataracts in the nondiabetic population, however their incidence seems to be increased and the age of onset decreased. The mechanisms leading to diabetic cataracts are thought to be multi-faceted. The polyol pathway, in the presence of raised glucose levels in diabetics, becomes particularly active in the lens of the eye, leading to increased concentrations of sorbitol and other polyols. This has two main effects: an increase in osmolality leading to an influx of water, and a reduction in glutathione levels in the lens (a chemical important in the proper structure and function of the lens). Glycosylation of the crystallins (proteins in the lens cells which give the lens its unique properties) also seems to be important in cataract formation"
http://my.diabetovalens.com/complications/eyes.asp

What is a cataract?:St. Lukes Eye:"A cataract is a clouding of the natural lens, the part of the eye responsible for focusing light and producing clear, sharp images. The lens is contained in a sealed bag or capsule. As old cells die they become trapped within the capsule. Over time, the cells accumulate causing the lens to cloud, making images look blurred or fuzzy. For most people, cataracts are a natural result of aging. In fact, they are the leading cause of visual loss among adults 55 and older. Eye injuries, certain medications, and diseases such as diabetes and alcoholism have also been known to cause cataracts"
http://www.stlukeseye.com/Conditions/Cataracts.asp

Symptoms of cataracts:healthnotes.com:"What are the symptoms of cataracts? Cataracts usually develop slowly without any pain or redness of the eye. The most common symptoms of a cataract are fuzzy or blurred vision, increasing need for light when reading or doing other close work, visual disturbances caused by bright lights (e.g., sunlight, car headlights), faded color perception, poor night vision, and frequent need to change eyeglass or contact lens prescriptions. A cataract will not spread from one eye to the other, although many people develop cataracts in both eyes. Conventional treatment options: In the beginning stages, the use of magnifying lenses, stronger eyeglasses, and brighter lighting may compensate for the vision problems caused by cataracts. Once vision is no longer adequate for daily activities, a doctor may recommend surgery to remove the clouded lens and replace it with a clear artificial lens. In many people, the lens capsule remaining in the eye after surgery eventually turns cloudy, causing additional loss of vision."
http://www.gnc.com/health_notes/Concern/Cataracts.htm#Condition-Symptoms

what causes cataracts?:Nidus Information Services, Inc.:"Although older age is the primary risk factor for cataracts, experts are still not certain about the exact biologic mechanisms that tie cataracts to aging. Oxygen-Free Radicals (Oxidants) and Glutathione The Role of Oxidants in Cataracts. Researchers have been focusing on particles called oxygen-free radicals as a major factor in the development of cataracts. They cause harm in the following way. Oxygen free radicals (also called oxidants) are unstable molecules produced by natural chemical processes in the body. Because oxidants are missing an electron, they tend to bind with other molecules in the body. Toxins, smoking, ultraviolet radiation, infections, and many other factors can create reactions that produce excessive amounts of these oxygen free radicals. In such cases, overproduction can set off a chemical chain reaction that damages any type of cell in the body, including nerve cells in the brain, and even interferes with their DNA. Cataract formation is one of many of their destructive changes."
http://www.ucdmc.ucdavis.edu/health/a-z/26Cataracts/doc26causes.html

The Stages of Cataract Development::Life extension:"The first stage of cataract development occurs when there is a separation of laminated lens (cartilage-like) protein fibers, appearing as water and/or debris in eye vacuoles (spaces) in the eye. The second or middle stage of the disease presents with an increase in the size of the vacuole (space) area within the eye. This is when people can noticeably see a halo around lights at night, or may have an increase in visual glare, increase in nearsightedness, and decrease in farsightedness. In the third, or maturing stage, there is a large increase in vacuole space located in the lens, taking in water and distending protein fibers. These factors in turn cause a decrease in water in the aqueous humor, increasing disintegration of the cortex and calcification of the lens capsule and the lens. The release of lens proteins into the aqueous and vitreous humor may cause inflammation leading to the development of glaucoma. The lens is drying out at this stage. In the last stage, the disintegration causes byproducts to escape the lens capsule, leaving a shrunken, dried, yellow or brown lens"
http://www.lef.org/protocols/prtcl-030.shtml

What Causes Cataracts?:allaboutvision.com:"No one knows for sure why the eye's lens changes as we age, forming cataracts. Researchers are gradually identifying factors that may cause cataracts and information that may help to prevent them. Many studies suggest that exposure to ultraviolet light is associated with cataracts, so eyecare practitioners recommend wearing sunglasses and a wide-brimmed hat to lessen your exposure. Other studies suggest people with diabetes are at risk for developing a cataract. The same goes for users of steroids, diuretics and major tranquilizers, but more studies are needed to distinguish the effect of the disease from the consequences of the drugs themselves"
http://www.allaboutvision.com/conditions/cataracts.htm

Nutritional Supplements to help Cataracts:healthreaction.com:"People with low blood levels of antioxidants and whose diet is lacking in antioxidant-rich fruits and vegetables have been reported to be at high risk of developing cataracts. The major antioxidants in the lens of the eye are vitamin C and glutathione (an antioxidant enzyme). Both nutrients are important for healthy vision. Vitamin C is required to activate vitamin E, which in turn activates glutathione. Vitamin B2 and vitamin B3 are needed to protect glutathione. Vitamin B2 deficiency has been linked to cataracts. Vitamin C levels in the eye decrease with age, but supplementing the diet with vitamin C prevents this decrease and has been linked to a lower risk of developing cataracts. Nutritionally oriented doctors often recommend supplementation of 500 to 1,000 mg of vitamin as part of a cataract prevention programme. Low blood levels of vitamin E have been linked to a higher risk of forming cataracts. Vitamin E supplements have been reported to protect against cataracts in people and animals, though the evidence remains inconsistent. Nutritionally oriented doctors typically recommend 400iu of vitamin E per day as part of a cataract prevention programme."
http://www.healthreaction.com/web/articles/cataracts.htm

Non-Age-Related Cataracts Are Treatable With Surgery:healthlink:"More than two-thirds of people over the age of 60 will have a vision problem due to cataracts, so we usually think of the disease as one related to aging. However, cataracts -- the clouding of the lens inside the eye -- can strike at any age. The clouding of the lens scatters the light rays and prevents a clear image from being formed. The exact mechanism that causes cataracts is not well known. It is thought that the composition of the lens changes with time and contributes to the development of cataracts. Non-age-related cataracts might be caused by trauma to the eye, use of certain medications such as corticosteroids, exposure to radiation or ultraviolet light, or metabolic disturbances, such as diabetes. In addition, some people are born with cataracts. Chronic use of steroids for such conditions as asthma, rheumatoid arthritis or following organ transplantation can cause cataracts. Prolonged use of topical steroid creams on the eyelids may lead to cataract formation. Both the strength and duration of the steroid medication influence the formation of the cataract. Individuals who receive radiation therapy for cancer treatment or have excessive exposure to ultraviolet light from the sun are also at risk. In addition, diabetics account for a large portion of patients with non-age-related cataracts. The cause of diabetic cataracts is thought to be due to metabolic changes in the lens which occur secondary to hyperglycemia"
http://healthlink.mcw.edu/article/956868358.html

Careful evaluation for diabetics with cataracts:Sean Henahan:"Which diabetic patient should be considered a potential candidate for cataract surgery and which should be excluded? The answers come from a careful preoperative evaluation and, if necessary, referral to a retina specialist for further studies. "When I see a diabetic patient, I feel that patient should have a more significant decrease in visual acuity and symptoms related to the cataract than a non-diabetic patient before going ahead with surgery. "That's because the prognosis is not as good. I have a thorough discussion of the increased risks of surgery to the retina, including the increased incidence of CME and possible increase in the retinopathy," according to James J. Salz MD, Clinical Professor of Ophthalmology at the University of Southern California, Los Angeles County Medical Centre. Many, but not all, patients with diabetes have related eye problems, particularly macular oedema and/or proliferative retinopathy. These pathologies are associated with worse postoperative visual outcomes. A thorough examination of the retina preoperatively can eliminate disasters later, he noted."
http://www.escrs.org/eurotimes/August2002/careful.asp

Evidence of a glycemic threshold for the development of cataracts in diabetic rats:Swets&Zeitlinger:"Results. Different dosages of streptozotocin injection resulted in a broad range of plasma glucose levels in the rats which were grouped into three groups on the basis of their plasma glucose levels: mildly diabetic (< 170 mg/dl plasma glucose), moderately diabetic (190-350 mg/dl) and severely diabetic (> 400 mg/dl). On the 75th, 90th and 150th day post-injection, only the moderately and severely diabetic rats developed cataracts whereas lenses of the mildly diabetic rats remained clear. As seen on 90th day, levels of glycated hemoglobin and Amadori products in lens WS fraction increased significantly in the moderately and severely diabetic groups whereas in the mildly diabetic rats these levels remained more or less same as in the control group. Levels of CML in WS fractions remained unchanged between control rats and different diabetic groups, while US fractions showed a decrease in CML in both the moderately and severely diabetic groups compared to the controls and the mildly diabetic group. Interestingly, AS fractions contained the highest level of CML; the moderately and severely diabetic groups showed about 2-fold higher levels than the controls and the mildly diabetic group."
http://www.szp.swets.nl/szp/journals/ce186423.htm



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Last updated by Andrew Lopez, RN on Wednesday, September 29, 2010


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