Good hba1c but blurred vision

[allen-uk]

Hello there.

My GP doesn't really know that much about diabetes, and his 'diabetes nurse' is just his old practice nurse plus a few new leaflets, so I think I'm best off asking you, as fellow 'sufferers' (not that I'm suffering much!)

I have been borderline type II for years. Glucose intolerant, etc. My hba1c is consistently very good, i.e. below 6% (with very rare figures above 6). My finger-tip blood is consistently not brilliant (glucose intolerance being the major cause, I infer), running around 7 to 9 fasting, 9 to 11 pprandial.

I have blurred vision, which the optician can't cure. The Moorfields consultant (treating me for diabetic retinopathy which he describes as currently not invasive) says that mechanically my eyes are sound.

So, what I'm wondering is this: even though my hba1c is apparently good, does my FINGERTIP blood adversely affect my lenses and thus cause this blurring?

If it's not those temporary glucose bursts (i.e. high glucose which takes longer than it should to clear), then it's just old age, and I can cope with that!

Your help is appreciated.


Allen, London.

 

[Northerner]

Hi Allen, welcome to the forum 🙂 With numbers like those I wouldn't have expected that diabetes would be te cause of the blurring, unless you are particularly sensitive to slightly above normal levels (ideally, 8.5 mmol/l post-prandial). I only really experienced very blurry vision in the weeks after diagnosis when my levels had been very high or swinging (HbA1c 11.8% and levels going from 2.5-30 mmol/l). I know a lot of people report blurred vision when levels go into the teens or 20s, but yours are well below this. At what time after your meals are you testing to get the post-prandial readings? It's possible you may be missing the peak and may be going higher than the readings appear to portray.

As for age, my eyesight started to worsen from about the age of 47, as did most of my family's.

 

[Copepod]

Welcome to the board Allen-UK.

You have the advantage of knowing your age, so given your decent HbA1c and finger pricks results, plus inability of optician to cure blurry vision and absence of mechanical problems as searched for by Moorfields consultant, that seems to leave only age. Only other possible line of enquiry might be asking optician about contact lenses, if you've only considered glasses so far?

 

[MeanMom]

When you say the optician cant fix it - do you mean he doesnt know the cause? Is it blurred or 'snow'? Assume cataracts also ruled out? You can have these at any age - my daughter has them aged twelve and we have recently had it confirmed that they are (probably) due to high blood sugars for some time prior to dx. Her HbA1c is good for a child of her age but her vision does vary with her levels and I would expect the 'snow' to get worse if she had the levels you mention for more than a day or two. And then get a bit better 🙄

Good luck with this - I know not being able to see properly can get you down, and that it can be tiring too. See if you can get hold of some vision aids if glasses dont help enough (or contacts🙂)

Edit; My Dad had these Eschenbach TV Spectacles and my daughter inherited them
http://www.magnifyingglasses.co.uk/acatalog/Online_Catalogue_Text_Magnifiers___Reading_Aids_10.html (although he didnt have to pay the price quoted here and I would hope you wouldnt either!)

 

[Robster65]

Hi Allen. Welcome 🙂

Can't really suggest anything, I'm afraid. But hope that you find the answer.

Rob

 

[allen-uk]

Thanks for the replies.

I'm 64 (so no spring chicken). Blurred as in slightly out-of-focus, not snowy.

My optician gives me a most thorough eye-test, using all the usual charts, and comes to a prescription, which is okay to an extent for vision up to about 5 metres. But when I get outside into the street, longer vision is the problem. He has tried slightly stronger lenses than the prescription calls for, but this just makes it worse.

My feeling (which I know isn't the best yardstick) is that my lenses aren't functioning properly over a certain range. Looking in a mirror is fine (because I'm only focusing on the image a yard away, even though it SHOWS 500 yards), but without the mirror, my lenses have to try and accommodate that 500 yard view, and fail.

I might try really pushing the bloods harder so that they are right down in the 'normal' range, just to eliminate it as a factor.

Interesting to talk to you - I knew I'd get a more informed discussion here than in my GP's surgery!


Allen.

 

[MeanMom]

Allen - this sound like my vision problems (I'm not diabetic) - which are caused by astigmatism but again assume the optician has ruled this out too? I can 'see' for very long distances (the horizon really) but cant really 'focus' at all. Glasses help - contacts are better but you need 'special' ones as the eye ball is more like a rugby ball than a football.
Getting those readings down a bit cant do any harm anyway!

 

[falcon123]

Try a different optician. My girlfriend went to a different optician (on my recommendation) and he found a) that the prescription needed changing and b) the early stages of a cataract in one eye (this was first spotted in A&E after she got something in her eye but the original optican said they were wrong). NOT all opticians are equalI If they have Optical Coherence Tomography (OCT) equipment they can see retinal problems developing before they are visible by examination/photgraphy.

 

[margie]

I would agree with Falcon that opticians vary. I go to a franchise and have seen several different opticians. Some tick the box to say I am a suitable candidate for contacts and some say that I am unsuitable. I don't want contacts but if I did I would be confused.

 

[kojack]

Have had similar problems. Consultant thinks it is as good as they can get it.
Vision always more blurred in sunshine.

Was easily cleared for driving by both optician and medic.
Both say it's a mixture of age (74) - past the spring chicken, more like a stewing cockerel!

If tired or hungry, always worse. It is also forgotten that the specs of bg testing units and strips are only guidelines +/- up to 10%

 

[allen-uk]

Again thanks for the input; it really is very useful.

Timing of postprandials: it varies between 1.5 hrs and 2.5 hrs, but I make a note of the variations. Even if it is on the high side at 2 hrs (say 11.5), come 3 hrs it's usually down to 8s or less.

Opticians: yes, I have changed twice in the past couple of years. And last week my Moorfields bloke sent me to their 'Low Vision Unit', which is basically an optician who checks your glasses and prescription to make sure all is well, and it was. But it was nice to get an objective opinion again.

One thing the Low Vision man said was that varifocals might not be helping. Not that single-vision glasses would solve anything, but they might help a bit - so step one is to get some distance-only specs (apart from anything else, the varifocals come out at about ?400 with all the coatings etc, whereas distance-only are about sixty quid!)

Up until 9 years ago I was an alcoholic, with all the stuff that goes with that condition - for example, my diabetic retinopathy isn't; in fact it's alcoholic retinopathy. The damage I did to my body for 30-odd years did not, of course, go away when I gave up the drink, but at least I'm still here telling the tale.


Allen.

 

[Bolddog]

There are no end of possible of causes of blurred vision in addition to diabetes.

My age is similar to yours

For decades I had purrrfect vision

Vision gradually declined originally slightly and then rapidly to the point that I could not read a car number plate at any distance and was unable to read as I wrote regardless of what glasses I was using. My IOP at this stage was 18-20 ( so nothing crazy going on there )

In my case there seem to have been multiple causes

- Discovering I am coeliac started me living gluten free. Within 4 weeks of this there was a significant improvement in vision

- Some time later, even though my BP was (just) 'normal' ( for years it was 'really low normal') I gave up booze and went ultra low salt diet. This put BP 'nice and normal' and another improvement in vision followed

- Of late I have been following the S.C. Diet and it would seem that my vision has improved a bit more ( today I was able to read a car number plate from "as far as" 60M without glasses)

I suspect that 'leaky gut' ( AKA hyperpermeable intestine ) is involved in the link between diet and vision. The link between eye issues and high BP is well established.

Do you know of eye issues such as Uveitis, corneal abrasion or Scleritis ? If so, have you experienced any of them ?

Do you have any reason to suspect that you have any autoimmune disease(s) ?

Have your IOPs have been ( er ) 'unremarkable' ( how I hate that word when its used in a medical context ) all along ?

Bolddog

 

[allen-uk]

Hello Bolddog,

And thanks for those ideas.

More information (I didn't want to churn it all out originally - overload!)

I have had glaucoma for some years, too, although my good eye doesn't have much damage - very few dodgy spots on the retina.

The retinopathy was also entirely in my bad eye - several bleeds, loads of laser, followed by a vitrectomy, more bleeds, followed by a vitreous wash and 'scattergun' laser (i.e. not pointed at anything specific, just pounding the retina over a suspect area), a tube insert for the glaucoma pressure. No bleeds since 4+ years ago now.

The result of all that lot, goes without saying almost, is that my 'bad' eye is not very useful - about 25% vision. Handy for peripherals still, but not a lot of good as an eye.

We did investigate to see why my left eye was virtually untouched, when my right eye was so poor, but blood supply wasn't an issue, so eventually decided it was just Luck (or lack of it).

Intra-ocular pressures in good eye have never been high - low teens mainly..

BP - I'm overweight and 64, so of course I take Ramipril, which maintains it at about 135/75. I'm also on statins and have low cholesterol. No good reasons to be on statins (i.e. no previous cardiac problems), but I get too tired to argue sometimes.

Even though I'm still only part-diabetic, I take 2 x 500mg Metformin plus 1 x 80mg Gliclazide.

My biggest problem (apart from being blind in one eye and only having one leg!) is probably weight, currently running at about 115kg. I've been 90kg (8 years ago), but painful prostheses mean I only walk a little, although I do cycle.

There, you can see why I DIDN'T churn it all out to start with, can't you.

Allen