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.

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