People with diabetes type 1 or 2 are at increased risk to develop a few different types of eye diseases that affect vision. This is because if a person has diabetes, the body does not respond or does not produce enough insulin, the hormone that delivers sugar to the cells. Too much blood sugar in the blood damages the nerves and blood vessels in the whole body, including the eyes.
You may have heard that the number one reason for blindness between 20-74 years of age is diabetes. While this is true, most of the time people with diabetes experience mild eye diseases, especially if the blood sugar levels are well managed and regular eye exams are followed.
Glaucoma develops when excessive pressure builds up in the eye. This extra pressure irritates the optic nerve and the blood vessels that supply the retina. Diabetes is one of the main risk factors for glaucoma, as more individuals with high blood sugar levels have this problem compared with those with healthy blood sugar levels. The risk further increases with age and the duration of diabetes.
Symptoms of glaucoma include blurry vision, aches and pains in the eye, halos around lights, watery eyes, and progressive vision loss. Glaucoma is treated with eye drops, other medication, surgery, or laser treatments.
High blood sugar levels damage the small blood vessels that supply the retina, causing diabetic retinopathy. These changes in the retina’s blood vessels make the vessels either leaky or cause abnormal growth of new vessels on the surface of the retina. Diabetic retinopathy develops in roughly half of people with diabetes and is the leading cause of blindness in American adults
The longer a person has diabetes, the more likely it is to develop these conditions. However, keeping the blood sugar levels under control can help lower the risk. High blood pressure, high cholesterol levels, and smoking are also risk factors for diabetic retinopathy. During the early stages, people with this condition may have no symptoms. Later on, blurry vision, dark, floating spots, streaks that look like cobwebs may be seen or fluctuating vision develop.
This condition requires regular eye exams and early treatment to prevent blindness, retinal detachment, bleeding in the eye, or glaucoma. Signs and symptoms of retinal detachment include blurred vision, flashes of light in the eyes, the sudden appearance of several floaters, shadows over the visual field, loss of peripheral vision.
In case of bleeding in the eye, a person may experience a few dark spots or floaters in mild cases, and even complete loss of vision. This blood clears within a few weeks to months and typically does not cause permanent damage to the eye.
Advanced forms of diabetic retinopathy are treated with prescription drugs injected in the eyes and laser surgery.
Cataracts are typically seen in the general population in the elderly. However, those with diabetes are also at increased risk to develop cataracts, usually at an earlier age and the disease gets worse faster. Symptoms of cataracts include blurred vision and glare. Mild forms are managed with sunglasses and glare control lenses. More severe cases are treated with artificial lenses that replace the natural lens of the eyes. Although cataract surgery is considered a safe procedure for most people, it can cause complications in those with diabetes- particularly infections, macular edema, glaucoma, or aggravation of the retinopathy.
How can you tell if diabetes is affecting your eyes?
The best way to know if diabetes affects the eyes is to see a doctor, see an eye specialist once a year and get eye tests.
Optometrists apply a solution that dilates the pupils so they can take a closer look at the blood vessels of the eyes and look for possible complications of diabetes.
Sometimes the blurry vision is the only symptom and is caused by higher than normal blood sugar levels. Although many people tend to go buy a pair of glasses, this problem can be reversed within weeks to a few months by keeping the glucose levels in the healthy range.
Symptoms like blurred vision, dark spots, fluctuating vision, eye pain, and any changes in the vision suggest eye disease and should be evaluated by a medical professional.
Everyone who has diabetes should pay special attention to eye health and keep the blood sugar levels well under control. Treating the eye complications of diabetes involve not only medication or laser surgery, but also managing the underlying problem– diabetes. Diet, along with exercise, sleep, and stress management is all-important to keep the blood sugar levels in an optimal range which is 70-130 mg/dL, before meals, and less than 180 mg/dL 1-2 hours after a meal. For best results, eye diseases related to diabetes are best managed by a team of healthcare professionals including family physicians, optometrists, dieticians, endocrinologists (for diabetes management) and if needed, eye surgeons.