In talking to people with diabetes on a daily basis, my goal is to help them understand the importance of testing their blood sugars to achieve control and to prevent complications. And when it comes to their eyesight, I remind them that it is not just high blood sugars, but also high blood pressure and smoking that can cause damage to their eyes.
Since February is Low Vision Awareness Month, we are "focusing" on the eyes. The American Diabetes Association recommends an annual comprehensive dilated eye exam for those with diabetes. While most people with diabetes realize that the disease can affect their sight, many don't think it will happen to them. When asked about their annual eye appointment, often their reply is, "I don't have a problem. I see just fine."
Don't Wait! The result is that their eye exam is ignored until they start to have vision problems. These can include spots or floaters, double vision, blurred vision, seeing black areas in their field of vision, pressure in their eyes, and trouble reading.
Diabetes eye disease is a group of disorders that includes:
- Glaucoma - damage to optic nerve/elevated pressure
- Diabetic macular edema - swelling of macula in retina
- Cataracts - clouding of lens
- Retinopathy - damaged blood vessels.
These often occur at an earlier age in people with diabetes and go undetected until there is vision loss. Any one of these can result in severe vision loss and even blindness if treatment is delayed.
The most common one is diabetic retinopathy. Between 40 to 45 percent of Americans with diabetes have some form of retinopathy, but only half of them are aware of it, according to the National Institutes of Health (NIH) and the National Eye Institute (NEI).
The retina is a nerve layer at the back of the eye that senses light, and helps to send images to the brain. Over time, the tiny blood vessels can be damaged in the retina by high blood sugars. These fragile blood vessels start to leak blood and form deposits. Initially, there may not be any symptoms of vision loss. However, if it is not treated, the macula in the center of the retina will swell and thicken, resulting in vision loss.
A dilated eye exam once a year is the best way to detect any changes inside the eyes. It is a simple procedure in which eye drops are placed in each eye to dilate them. The doctor then uses special lenses and equipment to look inside the eyes. The retina is checked for changes in the blood vessels and leakage, swelling of the macula, damage to nerve tissue, and lens changes.
NIH and NEI note that early detection and treatment will reduce the risk of blindness by 95 percent!
There are several types of treatment available:
- Steroid or other medication injections to shrink swelling of the macula or reduce vessel growth
- Laser surgery directly to the leaky blood vessels around the macula to reduce fluid leakage
- Pan retinal laser surgery directed at a larger area
- Photocoagulation to reduce growth of abnormal vessels decreasing bleeds
- Daily eye drops for glaucoma and monthly visits to the eye doctor.
For more information about diabetic eye disease, click here.
The information provided within this site is for educational purposes only and is not a substitute for consultation with your physician or healthcare provider.