I HAD A PATIENT ASK ME IF HAVING IMPLANTS WOULD PREVENT HIGH BLOOD SUGAR FROM CHANGING REFRACTION RESULTS. HIS ophthalmologist TOLD HIM DIFFERENT RESULTS FROM REFRACTIONS AREN'T BECAUSE OF HIGH BLOOD SUGAR. BECAUSE IOLS ARE IMMUNE TO THOSE CHANGES. CAN A DOCTOR GIVE ME SOME INFO ON THIS TOPIC.
Having implants does not necessarily prevent someone's refractive error from changing in cases of elevated (or fluctuating) blood sugar. Certainly the crystaline lens, being removed, eliminates the most common source of refractive change in diabetes, but the most damaging possibility in a pseudo-aphakic diabetic is macular edema (or CME, cystoid macular edema). Fluid buildup in the fovea can cause a fleeting change in prescription. (The edema brings the retina a little closer to the front of the eye, making it more hyperopic) I say fleeting because the next stage can be permanent loss of vision. Any refractive change in a pseudo-aphakic diabetic should be treated with great suspicion and urgent care should be recommended. An evaluation should be performed by an OD or OMD to determine if this change is a simple refractive change of no consequence, or if there is retinal swelling.
Diabetic Macular Edema is a big possibility.
thanks for the reply's guys
im sorry to burst your bubble fjpod, but cme without serous detachment of the rpe would not change the refractive power of the eye b/c if there is only intraretinal csme, the photoreceptor layer remains intact.
on the other hand, central serous chorioretinopathy would make the eye more hyperopic b/c the rpe and photoreceptor layer get pushed anteriorly by the leaking fluid.
so to accurately answer the original question: would changes in blood sugar levels change the refractive power of the eye in a pseudophakic patient, the correct answer would be "no".
"blessed to give; grateful to receive"
So, the really correct answer would be no,... unless they also happen to have a serous detachment. So this means the realy really correct answer is a possible yes. OK, my bubble is still intact.Originally Posted by medicalretina
Fjpod:
Is there such a thing as a non-serious retinal detachmemnt?
I thought they were all very serious. I thought there were just repairable and non-repairable ones.
Chip
Does anyone want to explain the difference between serious and serous (other than the spelling) to Mr. Anderson? Or is he just doing it to get my goat? Perhaps medicalretina can enlighten us?
Not serious, but serous.
One of the three major types of RD:
Serous - exudative fluid in the subretinal space (btwn neurosensory retina and RPE)
Tractional - Mechanical pulling of the retina off the RPE
Rhegmatogenous - with a retinal tear ( the tear allows effusion of liquified vitreous into the sub-retinal space causing the retina to float up off the RPE)
Sorry bout that , obviously experience doesn't provide all the benefits of education. However even had I been smart enough to know the difference with the spelling we use on optiboards (shame it can't be like my E. Mail program and spell check everything before I can send), I could have been right.
Chip
feliz navidad to all of you!
gill
"blessed to give; grateful to receive"
Your spell checker wouldn't have worked. They are both real words.
Anyway...as medicalretina posted...it's that time of year. Merry Christmas everybody.
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