I Have Diabetes-What Eye Problems Do I Need to be Concerned About?

Focal Pointe Eye Care

What does diabetes do to my eyes?

       

In the United States in 2021, approximately 38.4 million people were diagnosed with diabetes. Nearly 23% of those people were unaware that they had the disease. Every year, another 1.2 million Americans are diagnosed with diabetes. The prevalence of diabetes has been increasing at an alarming rate, so let’s learn more about this disease and the effects it can have on our eyes and vision.

FLUCTUATIONS IN VISION AND BLURRED VISION are common complaints. When the blood sugar is high, it will cause a swelling of the lens inside the eye resulting in blurred vision. As the blood sugar normalizes, the swelling will decrease allowing you to see normally again. This instability of vision will make it challenging for your eye doctor to give you the correct glasses prescription. Often your prescription for the glasses will not be finalized until the blood sugar is under control.

DIABETIC RETINOPATHY occurs when elevated blood sugar causes a breakdown of the blood vessel walls. This causes blood or fluid to bleed into the retina. 1 in 3 diabetics have diabetic retinopathy and 1 in 10 patients will experience vision-related complications from the disease. In the mild stages, most patients are asymptomatic. As the condition advances, patients may experience blurred or distorted vision. The most advanced stages will cause new blood vessels to form in the retina, increasing the risk of retinal detachment. Without proper control, diabetic retinopathy can cause permanent vision loss and blindness.

DIABETIC RETINOPATHY occurs when elevated blood sugar causes a breakdown of the blood vessel walls. This causes blood or fluid to bleed into the retina. 1 in 3 diabetics have diabetic retinopathy and 1 in 10 patients will experience vision-related complications from the disease. In the mild stages, most patients are asymptomatic. As the condition advances, patients may experience blurred or distorted vision. The most advanced stages will cause new blood vessels to form in the retina, increasing the risk of retinal detachment. Without proper control, diabetic retinopathy can cause permanent vision loss and blindness.


MACULAR EDEMA is the term for swelling in the macula from leaking blood or fluid, resulting in blurred or distorted vision. This is a complication of diabetic retinopathy in which the central, most fine tuned visual area of the retina is affected. This is typically a sign that the disease has advanced and blood sugar levels are uncontrolled.


A computer generated image of the inside of a human eye.

DRY EYE  is a common complication of diabetes due to neuropathy that occurs in the nerves within the cornea. The corneal nerves are responsible for producing tears.They are also responsible for the blinking reflex, which activates in response to unwanted stimuli, like dust or wind in the eyes.  neuropathy exists, those protective reflexes do not exist, therefore increasing the risk of potential damage to the eye. Neuropathy can also be caused from uncontrolled dry eye disease. Interestingly, the front of the eye supplies healing and nutrients to the corneal nerves, and then the nerves give them right back to the front of the eye! When the cycle is broken and the cornea is unable to heal properly, dry eye symptoms increase. Learn more about neurotrophic keratitis and treatments here.

DRY EYE  is a common complication of diabetes due to neuropathy that occurs in the nerves within the cornea. The corneal nerves are responsible for producing tears.They are also responsible for the blinking reflex, which activates in response to unwanted stimuli, like dust or wind in the eyes.  neuropathy exists, those protective reflexes do not exist, therefore increasing the risk of potential damage to the eye. Neuropathy can also be caused from uncontrolled dry eye disease. Interestingly, the front of the eye supplies healing and nutrients to the corneal nerves, and then the nerves give them right back to the front of the eye! When the cycle is broken and the cornea is unable to heal properly, dry eye symptoms increase. Learn more about neurotrophic keratitis and treatments here.

DRY EYE  is a common complication of diabetes due to neuropathy that occurs in the nerves within the cornea. The corneal nerves are responsible for producing tears.They are also responsible for the blinking reflex, which activates in response to unwanted stimuli, like dust or wind in the eyes.  neuropathy exists, those protective reflexes do not exist, therefore increasing the risk of potential damage to the eye. Neuropathy can also be caused from uncontrolled dry eye disease. Interestingly, the front of the eye supplies healing and nutrients to the corneal nerves, and then the nerves give them right back to the front of the eye! When the cycle is broken and the cornea is unable to heal properly, dry eye symptoms increase. Learn more about neurotrophic keratitis and treatments here.

CATARACTS are a normal change in the eye in which the lens becomes clouded slowly over time with age, typically beginning around 60. Patients with diabetes can develop cataracts at younger ages and tend to progress at a much quicker rate. In fact, the rate of development is 2 to 5 times greater in those that have diabetes compared to the rest of the population.

A computer generated image of a person 's eye

GLAUCOMA is an eye disease that causes damage to the optic nerve, often related to increased intraocular pressure (IOP). It does not show any symptoms until irreversible vision loss occurs, beginning peripherally and increasing with severity to total blindness. Those with elevated IOP have a greater risk of developing glaucoma.  Those with Diabetes have double the risk of developing glaucoma. link connecting the two is diabetic retinopathy; weakened blood vessels cannot carry the nutrients and oxygen the optic nerve needs, making it more susceptible to damage.

GLAUCOMA is an eye disease that causes damage to the optic nerve, often related to increased intraocular pressure (IOP). It does not show any symptoms until irreversible vision loss occurs, beginning peripherally and increasing with severity to total blindness. Those with elevated IOP have a greater risk of developing glaucoma.  Those with Diabetes have double the risk of developing glaucoma. link connecting the two is diabetic retinopathy; weakened blood vessels cannot carry the nutrients and oxygen the optic nerve needs, making it more susceptible to damage.

A computer generated image of a person 's eye

Understanding Diabetes


Diabetes is a chronic disease that affects the way your body turns food into energy. Specifically, the pancreas does not produce enough insulin or is unable to effectively use the insulin that it produces. Insulin is important because it regulates the glucose (sugar) in your blood by moving the sugar from your blood to the other cells throughout the body. Glucose provides energy to our muscles and tissues, and it is the main source of fuel for the brain. When insulin is not working properly, the glucose builds up in the bloodstream, leading to diabetes. 


As many of us know, there are two types of diabetes: Type 1 diabetes (also known as juvenile-onset or insulin-dependent diabetes) is an autoimmune condition where the body’s immune system destroys the cells in the pancreas that produce insulin. Type 2 diabetes (also known as adult-onset or non-insulin-dependent diabetes) occurs when the pancreas produces less than the normal amount of insulin or the body becomes resistant to insulin. Both types of diabetes result in unbalanced glucose that can negatively impact your eyes, vision, and overall health.


General health providers and endocrinologists are great advocates for healthy eyes in their diabetic patients, typically requiring a dilated eye exam annually. Your eye doctor may recommend more frequent visits if there are any signs of diabetic eye disease.


To keep your eyes healthy, it is important to monitor blood sugar and Hemoglobin A1c as instructed by your treating physician. The American Diabetes Association recommends keeping HbA1c at or below 6.5-7.0% depending on the target that is individually set for each patient.


 If you experience any of the symptoms listed here, please call our office as soon as possible to schedule a dilated eye exam. Dr. Lyons and Dr. Fisher will discuss in depth how diabetes may be affecting your eyes and vision.

 

Relax, See Well, and Look Good.