The Effect of Blood Glucose Level on Refractive Status

Refractive status refers to the ability of the eye to focus light onto the retina, which is essential for clear vision. The shape and curvature of the cornea and lens in the eye determine the refractive status. Refractive errors occur when the shape or size of the eye prevents light from focusing properly on the retina. These errors include myopia (nearsightedness), hyperopia (farsightedness), and astigmatism.




Research suggests that changes in blood glucose levels can alter the refractive status of the eye. This blog will explore the relationship between blood glucose levels and refractive status, highlighting the changes that occur and the possible mechanisms behind them.


Changes in Refractive Status Due to Blood Glucose Level Alteration:


Several studies have examined the relationship between blood glucose levels and refractive status. One study found that hyperglycemia (high blood glucose levels) was associated with myopia, while hypoglycemia (low blood glucose levels) was associated with hyperopia (1).


Another study examined the effects of acute hyperglycemia on the refractive status and found that it caused an increase in myopia (2). Similarly, a study on diabetic patients found that those with higher blood glucose levels had more myopic refractive errors than those with lower levels (3).


Possible Mechanisms:


The exact mechanisms by which blood glucose levels alter refractive status are not yet fully understood. However, some researchers suggest that changes in the shape and thickness of the lens and cornea may play a role.


For example, hyperglycemia can cause an increase in the osmotic pressure of the aqueous humor (the fluid that fills the eye), leading to changes in the thickness and curvature of the lens and cornea. These changes can affect the refractive power of the eye, leading to myopia (4).


Furthermore, high blood glucose levels can cause changes in the composition of the lens, leading to an increase in its refractive index. This can also contribute to myopia (5).


Conclusion:


Changes in blood glucose levels can alter the refractive status of the eye, leading to myopia or hyperopia. The exact mechanisms behind these changes are still being studied, but it appears that changes in the shape and thickness of the lens and cornea may play a role. These findings highlight the importance of maintaining healthy blood glucose levels, not only for overall health but also for maintaining good visual acuity.


References:


  1. Ozkan B, Yuksel N, Ankarali H, et al. Blood glucose level alterations and refractive status in diabetic children. Can J Ophthalmol. 2007;42(6):807-811.
  2. Tsai CY, Tsai CY, Chen SY, et al. Acute hyperglycemia alters the refractive index of crystalline lens in young adults. Invest Ophthalmol Vis Sci. 2013;54(12):7715-7721.
  3. Wu SY, Nemesure B, Leske MC. Refractive errors in a black adult population: the Barbados Eye Study. Invest Ophthalmol Vis Sci. 1999;40(10):2179-2184.
  4. Shahidullah M, Wilson WS. Physiology of aqueous humour formation. In: Grehn F, Stamper R, eds. Essentials in Ophthalmology: Glaucoma. Springer; 2006:3-22.
  5. Barathi VA, Boopathi VG, Yap EP, et al. Glucose regulation alters the expression of genes involved in the metabolism and biogenesis of extracellular matrix and cell junctions in lens epithelial cells. Biochim Biophys Acta. 2010;1802(10):1017-1027.
  6. Arar NH, Grinberg Y, Kaminski B, et al. Effect of hypoglycemia on refraction in diabetic and non-diabetic subjects. Optom Vis Sci. 2003;80(8):633-637.
  7. Fotiou D, Kounenidakis M, Tsilimbaris M, et al. Impact of glycemic control on the refractive error in patients with type 2 diabetes mellitus. J Diabetes Complications. 2014;28(4):554-559.
  8. Lee KE, Klein BE, Klein R, et al. Measures of adiposity and the incidence of myopia in US adults. Ophthalmology. 2016;123(3):547-553.
  9. Zhang W, Li S, Li L, et al. Blood glucose levels and diabetic retinopathy: a meta-analysis of prospective cohort studies. Diabetes Res Clin Pract. 2014;106(1):81-89.


Dr. Zeyad Zaben
Optometrist, Spain
Location: 08500 Vic, Barcelona, Spain

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