**18. Conclusions**

*Sugar Intake - Risks and Benefits and the Global Diabetes Epidemic*

develop colour vision impairment [50].

**15.3 Sugar and contrast sensitivity**

**15.4 Sugar and visual field**

and interventions.

pronounced as diabetic retinopathy progresses, and is worse among patients who may have undergone laser treatment. The association between colour vision deficit and diabetes may be because diabetes irrespective of stage gradually affects the optic nerve as well as the retina, therefore resulting in abnormalities. Tan et al. also showed that more than 6 duration of type two diabetes may predispose patients to

Contrast sensitivity is a measure of the amount of contrast required to detect or recognize a visual target. It is a very important visual function in a person.

Unfortunately, contrast sensitivity has been reported to decline with sustained hyperglycaemia. This has been attributed to retinal neurosensorial losses which may precede the occurrence of retinopathy in diabetic patients [51]. According to studies by Alberto et al. the occurrence of reduced contrast sensitivity is more in type 1 diabetic patients with retinopathy than with those without retinopathy [52]. Reduced contrast sensitivity can also be found in patients with type 2 diabetes. Safi *et al.* showed that contrast

sensitivity decline was aggravated with the progression of retinopathy [53].

as reasons for visual field defects in diabetic patients [43].

after death it is often protected against putrefaction.

**17. Effect of low sugar intake on vision**

Visual field defects have been reported as one of the notable low vision abnormalities that can occur in diabetic patients. Patrick and Lavin reported the occurrence of reversible homonymous hemianopia caused by non-ketotic hyperglycaemia in four patients with type 2 diabetes mellitus. [54]. Their report also noted that among the patients, homonymous hemianopia was the first manifestation of diabetes mellitus type 2 in two of the patients. Other factors such cerebrovascular accident, coexisting glaucoma, and pan-retinal photocoagulation has been reported

Visual processing disorders may also be seen in diabetic patients following cerebrovascular accident. Processing defects such as visual neglect and extinction has been reported to be partially reversible in these patients following treatment,

**16. Role of vitreous sugar in the determination of post-mortal interval**

Sugar in the vitreous has found its usefulness in forensic medicine, where it can be used to determine the time of death and possible causes of death. The fact that there are biochemical changes in the blood glucose pathway after death makes the use of blood glucose in the biochemical analysis of the state of a cadaver difficult [55]. However, this difficulty can be overcome if the vitreous humor is used, given that, it is better preserved after death. Use of the concentration of sugar in the vitreous to determine the time of death has gradually gained some level of acceptance in forensic medicine and has been determined to have major advantages over other body fluids. Some of its advantages include its accessibility and the fact that

Although most of the emphasis of the impact of sugar in the eye is often placed on high sugar level, however low sugar level can also be detrimental to the eye.

**32**

Sugar forms a component part of the eye. Its presence at normal concentration is very important for the normal visual function, however when low or high, sugar can have very negative impact on vision.
