Diabetes and Eye Care

If you have type 1 or type 2 diabetes, you're more likely to have eye and vision problems. High blood sugar over time can damage the tiny blood vessels in your eyes and lead to an eye disease called diabetic retinopathy. High blood sugars can also lead to cataracts and glaucoma.

Diabetes and Eye Problems

Diabetic retinopathy: Nearly one out of three people with diabetes eventually develop retinopathy, damage to the blood vessels in the retina, the lining of tissue at the back of your eye. Most will develop a condition called non-proliferative retinopathy, which doesn't usually threaten their sight.
   Over the course of several years, some people with retinopathy may develop proliferative diabetic retinopathy. It's called "proliferative" because new blood vessels start to grow (proliferate) on the surface of the retina. These new blood vessels are fragile and can leak blood or fluid, causing scarring that results in vision loss. Diabetic retinopathy may also cause macular edema, which happens when fluid leaks into the part of the retina that is responsible for sharp, central vision needed for reading, driving and seeing fine details. As a result, things look blurry.
    Several studies have shown that you can reduce your risk of severe vision loss from retinopathy and macular edema with strict control of blood sugars, blood pressure, and cholesterol.
    Early diagnosis and treatment of diabetic retinopathy can slow or even reverse some forms of vision loss. All people with diabetes should see an eye doctor at least once a year. If these annual exams are normal, people at low risk may be able to have follow-up exams every 2-3 years.
   There are several ways to treat diabetic proliferative retinopathy. In one type of therapy, a doctor targets the retina with a specially designed laser that helps shrink the new blood vessels, often slowing the loss of sight. This treatment works best if used before the fragile new vessels have started to bleed.
    If diabetic retinopathy gets worse and bleeding has already occurred, you may need a procedure called a vitrectomy to remove blood from the middle of your eye. Or you may need treatment to repair a detached retina or damaged macula. Macular edema is also treated with a form of laser surgery that slows the leakage around the macula.

Diabetes and cataracts: Diabetes puts you at higher risk of developing cataracts -- and at a younger age. Cataracts cloud the eye's lens and cause cloudy vision. Sunglasses and glare-control glasses can help with mild cataracts. For severe cases, cataract surgery replaces the cloudy lens with an artificial lens to improve vision.

Diabetes and glaucoma: Having diabetes doubles the risk of glaucoma, a condition marked by increased pressure in the fluid of your eye. This extra pressure can damage the retina and the optic nerve, the primary nerve in your eye that allows you to see. Glaucoma usually causes no symptoms early on, although some people can have gradual vision loss or see bright haloes or colored rings around lights. Glaucoma treatment includes the use of prescription eye drops to lower the pressure in your eyes, and in some cases, laser surgery.

Eye Care: 6 Steps to Prevent Eye Problems

Protect your eyesight with these eye care tips:

1. Manage your blood glucose.
One of the best things you can do for your eyes is to keep your blood sugar at near-normal levels. Consistent blood sugar control can slow the damage to the tiny blood vessels in your eyes, and help prevent or delay the start of eye problems associated with diabetes. Two to four times a year, have an A1c blood test, which measures your glucose levels for the past two to three months and allows doctors to make decisions about your treatment. Aim for a test result of less than 7%, the goal for most people with diabetes.

2. Manage your blood pressure.
Blood pressure control can help slow or prevent eye disease caused by diabetes. Protect your eyesight by keeping your blood pressure under control, and have your blood pressure checked by your doctor at every visit. If a low-salt diet, staying at a healthy weight, and exercise aren't enough to keep your blood pressure under control, you may need medication to bring your blood pressure down to a healthier level. The goal for most people with diabetes should be a blood pressure of less than 130/80.

3. Watch for warning signs.
The sooner you notice an eye problem, the more likely treatment will help maintain your vision. Call your doctor if you have any of these symptoms:
  • Blurry, cloudy, or double vision
  • Flashing lights or rings around lights
  • Blank spots, dark spots, or floating spots in your vision
  • Pain, pressure, or persistent redness in your eyes
  • Trouble seeing signs or straight lines
  • Trouble seeing out of the corner of your eyes
  • Any sudden change in your vision
4. Have yearly "dilated" eye exams.
Only when your pupils are dilated with special eye drops can an optometrist or ophthalmologist evaluate your eyes for early signs of damage to tiny blood vessels in your eyes. Early diagnosis and prompt treatment are key to maintaining your vision.
Women with diabetes who are planning a pregnancy or are pregnant should have an eye exam in the earliest parts of pregnancy and stay in touch with their eye doctor throughout the pregnancy.

5. Quit smoking.
Smoking damages your blood vessels and increases your risk of eye problems -- a risk that's already higher for people with diabetes. If you smoke, get help from your doctor, a support group, or a smoking cessation program so you have professional support to help you quit -- and stay quit. The American Cancer Society and other qualified groups sponsor 1-800-QUIT-NOW, a web site and phone service offering free advice and support on how to quit.

6. Take heart: diabetes care and eye care work together.
The same steps you take for your overall diabetes management also reduce your risk of eye problems. Your positive efforts and hard work to follow your diabetes meal plan, get enough exercise, and take any diabetes medications correctly all contribute to healthy blood sugar levels -- and that gives you the best possible chance of protecting your eyesight.

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