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Diabetic Eye Disease Awareness

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People with diabetes are more likely to develop blinding eye diseases, such as diabetic retinopathy, glaucoma and cataracts. Yet recent studies have revealed low awareness of the issue among those at high risk for diabetes. With the findings signaling that many Americans may not be defending themselves against diabetes-related vision loss, the American Academy of Ophthalmology encourages those with diabetes to take proactive steps to protect their vision.

What is diabetic eye disease?

Diabetic eye disease is a group of eye problems that can affect people with diabetes. These conditions include diabetic retinopathy, diabetic macular edema, cataracts, and glaucoma.

Over time, diabetes can cause damage to your eyes that can lead to poor vision or even blindness. But you can take steps to prevent diabetic eye disease, or keep it from getting worse, by taking care of your diabetes.

The best ways to manage your diabetes and keep your eyes healthy are to

• manage your blood glucose, blood pressure, and cholesterol, sometimes called the diabetes ABCs

• If you smoke, get help to quit smoking

• have a dilated eye exam at least once a year

Often, there are no warning signs of diabetic eye disease or vision loss when damage first develops. A full, dilated eye exam helps your doctor find and treat eye problems early—often before much vision loss can occur.

How does diabetes affect my eyes?

Diabetes affects your eyes when your blood glucose, also called blood sugar, is too high. In the short term, you are not likely to have vision loss from high blood glucose.

People sometimes have blurry vision for a few days or weeks when they’re changing their diabetes care plan or medicines. High glucose can change fluid levels or cause swelling in the tissues of your eyes that help you to focus, causing blurred vision. This type of blurry vision is temporary and goes away when your glucose level gets closer to normal.

If your blood glucose stays high over time, it can damage the tiny blood vessels in the back of your eyes. This damage can begin during pre-diabetes, when blood glucose is higher than normal, but not high enough for you to be diagnosed with diabetes.

Damaged blood vessels may leak fluid and cause swelling. New, weak blood vessels may also begin to grow. These blood vessels can bleed into the middle part of the eye, lead to scarring, or cause dangerously high pressure inside your eye.

Diabetic retinopathy

The retina is the inner lining at the back of each eye. The retina senses light and turns it into signals that your brain decodes, so you can see the world around you. Damaged blood vessels can harm the retina, causing a disease called diabetic retinopathy.

In early diabetic retinopathy, blood vessels can weaken, bulge, or leak into the retina. This stage is called non-proliferative diabetic retinopathy. If the disease gets worse, some blood vessels close off, which causes new blood vessels to grow, or proliferate, on the surface of the retina. This stage is called proliferative diabetic retinopathy.

These abnormal new blood vessels can lead to serious vision problems. About one in three people with diabetes who are older than age 40 already have some signs of diabetic retinopathy—the most common cause of vision loss in people with diabetes.

Each person’s outlook for the future, however, depends in large part on regular care. Finding and treating diabetic retinopathy early can reduce the risk of blindness by 95 percent.

Diabetic macular edema

The part of your retina that you need for reading, driving, and seeing faces is called the macula. Diabetes can lead to swelling in the macula, which is called diabetic macular edema.

Over time, this disease can destroy the sharp vision in this part of the eye, leading to partial vision loss or blindness. Macular edema usually develops in people who already have other signs of diabetic retinopathy.

Glaucoma

Glaucoma is a group of eye diseases that can damage the optic nerve—the bundle of nerves that connects the eye to the brain. Diabetes doubles the chances of having glaucoma, which can lead to vision loss and blindness if not treated early. Symptoms depend on which type of glaucoma you have.

Cataracts

The lenses within our eyes are clear structures that help provide sharp vision—but they tend to become cloudy as we age. People with diabetes are more likely to develop cloudy lenses, called cataracts. People with diabetes can develop cataracts at an earlier age than people without diabetes. Researchers think that high glucose levels cause deposits to build up in the lenses of your eyes. A diabetics chances of developing glaucoma or cataracts are about twice that of someone without diabetes.

What are the symptoms of diabetic eye disease?

Often there are no early symptoms of diabetic eye disease. You may have no pain and no change in your vision as damage begins to grow inside your eyes, particularly with diabetic retinopathy.

When symptoms do occur, they may include:

  • blurry or wavy vision

  • frequently changing vision—sometimes from day to day

  • dark areas or vision loss

  • poor color vision

  • spots or dark strings (also called floaters)

  • flashes of light

Talk with your eye doctor if you have any of these symptoms.

When should I see a doctor right away?

Call a doctor right away if you notice sudden changes to your vision, including flashes of light or many more spots (floaters) than usual. You also should see a doctor right away if it looks like a curtain is pulled over your eyes. These changes in your sight can be symptoms of a detached retina, which is a medical emergency.

How do doctors treat diabetic eye disease?

Your doctor may recommend having eye exams more often than once a year, along with management of your diabetes. This means managing your diabetes ABCs, which include your A1c, blood pressure, and cholesterol; and quitting smoking. Ask your health care team what you can do to reach your goals.

Please contact us today if you'd like to schedule an eye exam.

Laura Branstetter