How does a high blood glucose cause damage to the eyes?

We don’t know all of the ways that high blood glucose levels can damage the eyes. The eye is a globe. There is a hard clear lens at the front of the eye that focuses images on the back part of the eye (which is called the retina). The middle part of the globe is filled with a clear liquid called the vitreous. There are protein membranes lining lots of tiny blood vessels in the retina (the layer that contains all of the nerve cells that allow you to detect light and color and send the information to your brain). It is possible that glucose gets attached to those proteins to damage and weaken them. They then begin to leak fat or blood out of the vessels into the retina nearby. The weaker linings of the blood vessels begin to bulge out (like a blowout on a rubber bicycle tire). These “blowouts” are called aneurysms. Your body tries to repair these weakened areas by making more lining cells. These new cells fill up the aneurysm but can sometimes end up blocking the blood vessel altogether. The part of your retina that is beyond the blockage then gets starved of oxygen and nutrients, and so the retina stops working properly in that area of your eye.

If this condition progresses, your body responds by growing new blood vessels inside your eye. These often grow quickly and in an uncoordinated way, creating a tangled mass of fragile new blood vessels. The blood vessels may rupture, causing major bleeding within your eye. Even if they do not bleed, these new blood vessels tend to develop scar tissue around them. When the scars contract, they can distort the lining of your eye and can grow over the retina so that your vision becomes severely impaired.

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