Eyes and Chronic Kidney Disease

Diabetes and high blood pressure aren’t only the leading causes of chronic kidney disease (CKD). They’re also the leading causes of eye disease and loss of vision. If your renal disease is a result of either condition your vision may be at risk.

Some of the most common eye problems that occur in CKD patients are retinopathy, cataracts and glaucoma.

Retinopathy

Retinopathy is a condition where the small blood vessels in the eyes become damaged as a result of hypertension or diabetes. When the damage is caused by diabetes, it is called diabetic retinopathy.

Diabetes elevates the blood glucose levels in the bloodstream which can damage the tiny blood vessels in the kidneys, fingers feet and eyes. High blood pressure places strain on the walls of the blood vessels, weakening them to the point where they can break or burst. Like CKD, both types of retinopathy occur over time and symptoms are often not felt until the damage is done. Sometimes damaged vessels can become scar tissue and turn into detached retina, a condition that causes severe loss of sight or blindness. It should be treated by a medical professional right away.

Cataracts

Cataracts occur when the lens of your eye becomes cloudy. The lens of the eye is normally clear. Its purpose is to focus the light coming in from the pupil to the retina at the back of the eye. A cataract scatters the incoming light and can make everything look blurry.

Cataracts develop as we age. But patients with diabetes are at a higher risk for cataracts. Diabetics can develop what is known as “sugar cataracts,” a cataract that appears suddenly and grows to such a point that the entire lens is clouded. High levels of glucose react with proteins found in the eye and form a byproduct that settles on the lens.

Glaucoma

Glaucoma affects the optic nerve at the back of the eye. The optic nerve sends impulses to the brain, and the brain translates these impulses into images. When too much pressure builds up in the eye, the optic nerve can become damaged. This damage could lead to partial or total vision loss.

Increased pressure occurs when the clear fluid inside the eye (called the aqueous humor) does not drain properly. This pressure pushes against the blood vessels which supply the optic nerve with oxygen and nutrients. Over time the nerves are starved of these essentials and die. As the nerves die, there is a gradual loss of peripheral vision.

High blood pressure and diabetes are possible risk factors for glaucoma.

Diagnosing eye damage

When you have an eye exam, your eye doctor (an optometrist or an ophthalmologist) will check your vision as well as the health of your eyes.

If anything abnormal is found, your eye doctor may refer you to your primary doctor. If your eye doctor is an optometrist, you may be sent to an ophthalmologist. Tell the members of your healthcare team right away if you notice any changes in your vision:

• Blurry, double or cloudy vision
• Pain or pressure in one or both eyes
• Trouble seeing things out of the corner of your eyes
• Floating or flashing lights
• Dark spots

Keeping your eyes healthy

Managing conditions such as hypertension or diabetes is important not only for the health of your kidneys, but also the health of your eyes. Follow your doctor’s instructions regarding diet and exercise, take your prescribed medicines and check your glucose levels or blood pressure as recommended by your doctor. If you smoke, your doctor may ask you to quit. Smoking is an added risk factor for cataracts and glaucoma.