The eyes are said to be the window to the soul. They reflect what is going on in the rest of the body and sometimes the first signs of systemic diseases are in the eyes. Diabetes mellitus and hypertension are the major non communicable diseases globally. In Nigeria, about 2.7 million people are estimated to be living with diabetes and 20.8 million people living with hypertension. 

They both have eye complications that may lead to blindness if not properly taken care of. Diabetes is the leading cause of blindness among people aged 15-64 years and diabetic retinopathy accounts for 5% of blindness globally.

Diabetes and the eyes 

Diabetes mellitus (DM) is a condition of defective metabolism of glucose leading to chronic hyperglycaemia due to defects in insulin production or function. It leads to long term damage and dysfunction of many organs in the body – the eyes, kidneys, blood vessels, nerves and the heart. People with diabetes often develop complications in their eyes. 

Hypertension and the eyes 

Hypertension is persistent elevated blood pressure which puts a person at an increased risk of developing target organ damage in the vessels of the retina, brain, heart, kidneys and blood vessels.  The cut off is arbitrarily placed at a systolic blood pressure of 130mmHg and diastolic blood pressure of 90mmHg in a person not on anti-hypertensive medication. The ocular effects of hypertension may be the first presentation of hypertension in a patient.

Treatment 

The most important treatment in hypertensive and diabetic retinopathy is to control the risk factors. This involves strict glucose control and blood pressure control, life style changes like weight loss, avoiding alcohol and smoking, low fat diet and exercise. 

People with diabetes and hypertension should report any changes in their vision to their doctors and be drug compliant. Annual eye check-ups are recommended to pick these ocular complications because the retina may be severely damaged before any change of vision is noticed. Regular screening for diabetes and routine blood pressure monitoring are important because loss of vision may be the first complaint.

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