Diabetes


What is diabetes?

Diabetes, a disease that prevents your body from making or using insulin to break down sugar in your bloodstream, can affect your eyes and your vision. When blood surgae remains high over a long period of time, complications can ofccur throughout the body. It is a leading cause of death, disbaility, and blindness in te US for adults aged 20-74. 

Diabetic Eye Disease is the leading cause of new cases of blindness among working-aged adults. It impacts roughly 40-45% of patients with diabetes. It is possible to reduce the risk of blindness by 90%. You may have 0 initial warning signs. This includes: 

  • Diabetic retinopathy occurs when there is a weakening or swelling of the tiny blood vessels in the retina of your eye, resulting in blood leakage, the growth of new blood vessels, and other changes. This is the most common diabetic eye disease. 

  • Diabetic Macular Edema

  • Glaucoma

  • Cataract

Both T1D and T2D can develop diabetic eye disease. 


What are the symptoms of diabetes and diabetic eye disease?

Fluctuating or blurring of vision, occassional double vision, loss of peripheral vision, as well as flashes and floaters within the eyes may be symptoms related to diabetes. Straight lines can look crooked. Colors may appear to be waashed out. Night vision problems. 

Diabetes can cause changes in nearsightedness and farsightedness and lead to premature presbyopia (the inability to focus on close objects). It can result in cataracts, glaucoma, a lack of eye muscle coordination (strabismus) and decreased corneal sensitivity. The most serious eye problem associated with diabetes is diabetic retinopathy, which, if not controlled, can lead to blindness.

Unfortunately there are no warning signs for DR. 

What causes diabetes and diabetic eye disease?

Diabetes occurs when your body fails to make or use insulin.

 

Blindess occurs when fluid leaks into the macular, caqusing it to swell/ 
 

Who develops diabetes and diabetic eye disease?

According to the ADA, nearly 21 million Americans are affected by diabetes and another 54 million are considered pre-diabetic. The CDC estimates that 4.1 million people currently have DR and 7.2million have some form of diabetic eye disease. 

Several factors that increase the risk of developing retinopathy include smoking, high blood pressure, excessive alcohol intake, and pregnancy.

How is diabetes diagnosed?

Early detection is important. Early signs of diabetes sometimes can be detected in comprehnsice eye examinations. In a dilated eye examination, the back surface of your eye is examined with a magnifying lens. It allows the optometrist to see things that cannot be detected otherwise. And the sooner the optometrist detects DR or DME the better it will be for your vision. So be sure to get a dilated eye examination every year, whether you have symptoms or not! 

How is diabetes and diabetic retinopathy treated?
Monitoring and maintaing control of diabetes is crucial. Regular visits to your physician are neccessary, along with adherence to te doctor's instructions on diet, exercise, and medication. Follwoing these steps can lower one's risk of dveeloping DR by as much as 76%. It is also importabnt to see your optometrist at least annually when you have been diagnosed with diabetes.

 

Changes in vision can be treated with new eyeglasses or contact lenses.

 

In the early stages, diabetic retinopathy can be treated with laser therapy. A bright beam of light is focused on the retina, causing a burn that seals off leaking blood vessels.This usually requires more than one session and you may notice some loss of peripheral vision. Laser surgery is not a cure for DR, but it can prevent further vision loss. 

In other cases, surgery inside the eye may be necessary.

Anti-VEGF drugs can be injected in the  eye to keep the blood vessels from leaking. 

Vitrectomy for bleeding in vitreous. 

Steroids can redufce the swelling and inflammation. 

Once damage occurs, the effects are usually permanent. For this reason, it is critical to follow your octor's instructions and have annual eye examinations to monitor the progress of the eye disease. Low vision devices. 

Can vision loss from diabetes be prevented?

Yes, in a routine eye examination, our optometrists can diagnose potential vision-threatening changes in your eyes that may be treated to prevent blindness. However, once damage has occurred, the effects are usually permanent. It is important to control your diabetes as much as possible to minimize the risk of developing retinopathy.


How can diabetes-related eye problems be prevented?
Diabetes-related eye problems can be prevented by monitoring and maintaining control of your diabetes. See your physician regularly and follow instructions about diet, exercise, and medication. A thorough eye examination when first diagnosed as a diabetic, and at least annually thereafter, is recommended.

What is the prognosis for diabetes and diabetic eye disease?

Other Resources

  • vsp.com/ADA

  • diabetes.org