Lifestyle changes may prevent ocular manifestations linked to obesity, diabetes
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ATLANTA — Lifestyle modifications that can prevent or reverse conditions like obesity and prediabetes are equally important in lowering the associated risks for ocular manifestations.
“We’re going to talk about some diseases that can be modified,” Tammy P. Than, OD, MS, FAAO, said during her SECO presentation. “I’m all for medicine and traditional therapies, but I think we have control over a lot of things, and we can talk to our patients about what they can change. We as a country are terribly unhealthy, and I think the time to make a change is now.”
She addressed three common and often comorbid conditions that can lead to ocular complications: obstructive sleep apnea, obesity and diabetes.
Obstructive sleep apnea has several risk factors that are not easily modifiable such as large neck size, large tongue or narrow palate, but obesity as a risk factor can be controlled. Patients with obstructive sleep apnea can develop floppy eyelid syndrome, along with other serious conditions such as central serous retinopathy, retinal vein occlusion and glaucoma.
Because the upper lid in floppy eyelid syndrome becomes easily everted, patients often complain about ocular irritation, even seeking treatment for dry eye that may be unsuccessful, she said. Than added that management is usually somewhat aggressive, including shield or lid taping overnight and surgery in severe cases, whereas weight loss offers a less intrusive treatment.
She also addressed obesity itself. Obesity can increase the risk for cataract, glaucoma, diabetic retinopathy and age-related macular degeneration. While risk factors for obesity include things that are difficult to alter such as genetics and certain diseases, lifestyle modification including diet and moderate exercise can help most patients, she said.
Diabetes can increase the risk for cataract, retinopathy and macular edema along with blurry vision. Modifying diet is also integral to improving type 2 diabetes, Than said. Spotting the signs of prediabetes with fasting blood sugar and A1C tests is key for prevention.
“Prediabetes is the target that we should be spending time talking to our patients about,” Than said. “Or look at your own labs. Are we in a category where I can make some changes and prevent myself from becoming a type 2 diabetic?”
Than concluded that diet and exercise can be the most useful tool in preventing ocular manifestations associated with obesity and other conditions often related to weight. She pointed the audience to the “Life’s Simple 7” concept, developed by the American Heart Association, which recommends activity, healthy diet, weight loss; the management of cholesterol, blood pressure and blood sugar; and stopping smoking for a healthy lifestyle.
“There are things that are genetic, but there are a lot of things that aren’t,” she said. “The bottom line here is that your family history does not have to be your personal destiny, because we can change things.”
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Than TP. The vision and wellness connection. Presented at: SECO; Atlanta, Georgia; April 28-May 2, 2021.
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