Diabetic Eye Care

Diabetes can affect the eye in several ways. For an overview of conditions and a list of ways to prevent vision loss from diabetic eye disease, read below:

Diabetic Eye Disease

Diabetic eye disease is a term for several eye problems that can all result from diabetes. Diabetic eye disease includes:

  • Diabetic macular edema,
  • Diabetic retinopathy,
  • Glaucoma, and
  • Cataract

Diabetic macular edema

Macular edema happens when fluid builds up in the retina and causes swelling and blurry vision. Diabetes can cause macular edema. Diabetic macular edema can lead to permanent vision loss.

Diabetic Retinopathy

Diabetes is a disease that affects the body’s ability to produce or to use insulin effectively to control blood sugar (glucose) levels. Diabetes affects the blood vessels throughout the body, particularly vessels in the kidney and in the eye.

When the blood vessels in the eye’s retina (the light sensitive tissue lining the back of the eye) swell, leak or close off completely — or if abnormal new blood vessels grow on the surface of the retina — it is called Diabetic Retinopathy.

There are 2 stages of Diabetic Retinopathy.

This is the early stage of diabetic eye disease. Many people with diabetes have it. If not detected it can advance and cause severe vision problems. Treatment for nonproliferative retinopathy is typically not necessary. Regular dilated eye exams to monitor any progression along with management and control of blood sugar, blood pressure, and cholesterol levels can greatly reduce or prevent diabetic retinopathy.

PDR is the more advanced stage of diabetic eye disease. It happens when new blood vessels start growing from the retina. This is called neovascularization. These fragile new vessels often bleed into the vitreous. If they only bleed a little, you might see a few dark floaters. If they bleed a lot, it might block all vision.

These new blood vessels can form scar tissue. Scar tissue can cause problems with the macula or lead to a detached retina.

PDR is very serious, and can affect both your central and peripheral (side) vision.

Diabetes and glaucoma

Glaucoma is a group of diseases that cause damage to your eye's optic nerve. This damage leads to irreversible loss of vision. Having diabetes doubles your chance of getting glaucoma.

Neovascular Glaucoma

Neovascular glaucoma is a type of glaucoma caused by new blood vessels growing in the outflow area of the eye, leading to closure of the outflow and resulting in elevated eye pressure. This type of glaucoma can be seen in diabetic eye disease or in other conditions that cause reduced blood flow to the retina.

Cataract

There is also a link between diabetes and cataracts. Permanent blurring of vision due to cataracts can result from changes to the lens due to excess blood sugar. Cataract surgery may be necessary to remove lenses that are clouded by the effects of diabetes and to replace them with clear intraocular lenses (IOLs) to restore clear vision. Maintaining good control of your blood sugar helps reduce episodes of temporary blurred vision and prevent the permanent clouding of the lens that would require surgery to correct.

Medical control

Controlling your blood sugar and blood pressure can stop vision loss. Carefully follow the diet your nutritionist has recommended. Take the medicine your diabetes doctor prescribed for you. Sometimes, good sugar control can even bring some of your vision back. Controlling your blood pressure keeps your eye’s blood vessels healthy.

Medicine

One type of medication is called anti-VEGF medication. Anti-VEGF medication helps to reduce swelling of the macula, slowing vision loss and perhaps improving vision. This drug is given by injections (shots) in the eye. Steroid medicine is another option to reduce macular swelling. This is also given as injections in the eye.

Laser surgery

Laser surgery might be used to help seal off leaking blood vessels. This can reduce swelling of the retina. Laser surgery can also help shrink blood vessels and prevent them from growing again.

Vitrectomy

If you have advanced PDR, your ophthalmologist may recommend surgery called vitrectomy. Your ophthalmologist removes vitreous gel and blood from leaking vessels in the back of your eye.

Prevention

  • If you have diabetes, talk with your primary care doctor about controlling your blood sugar. High blood sugar damages retinal blood vessels. That causes vision loss.
  • Do you have high blood pressure or kidney problems? Ask your doctor about ways to manage and treat these problems.
  • See your ophthalmologist regularly for dilated eye exams. Diabetic retinopathy may be found before you even notice any vision problems.
  • If you notice vision changes in one or both eyes, call your ophthalmologist right away.
  • Get treatment for diabetic retinopathy as soon as possible. This is the best way to prevent vision loss.

A large majority of people who have diabetes will develop diabetic retinopathy, but with the available medical treatments, only a small percentage of people have serious vision problems. Early symptoms of diabetic retinopathy include floaters, blurriness, dark areas of vision, and difficulty perceiving colors.

Retina problems are often treatable, and early detection increases the chances for success. Even if you haven’t experienced any vision problems, it’s essential to get a retina exam with pupil dilation once a year.

According to the Centers for Disease Control and Prevention (CDC), about 90 percent of diabetes-related vision loss can be prevented, but early detection is key. People with diabetes should get critical, annual eye exams even before they have signs of vision loss. However, studies show that sixty percent of diabetics are not getting the exams their doctors recommend.