Diabetes and Your Eyes

By
Richard W. Lucius, MD, FACS

There are over 20 million people in the United States who have diabetes. While only about 14.6 million have been diagnosed with diabetes, there are an estimated 6.2 million people that are unaware that they have the disease. It has been estimated that only one third of those diagnosed with diabetes get routine eye exams.

Diabetes is one of the leading causes of blindness in the United States. About 12,000 to 24,000 people with diabetes lose their vision each year.

There are several areas in the eye that are affected by this disease. This includes the retina, the lens, and the internal fluid drain in the eye. Symptoms of diabetic eye change may include floaters, difficulty reading or doing close work, double vision, and fluctuating vision. You may also experience difficulty distinguishing colors, halos and glare with lights, poor night vision, frequent prescription changes for glasses, and eye pain and redness.
Diabetes is a disease that affects blood vessels throughout the body, particularly vessels in the kidneys and eyes. When the blood vessels in the eyes are affected, this is called diabetic retinopathy.

The retina is in the back of the eye. It detects visual images and transmits them to the brain. Major blood vessels lie on the front portion of the retina. When these blood vessels are damaged due to diabetes, they may leak fluid or blood and grow scar tissue. This leakage affects the ability of the retina to detect and transmit images.

During the early stages of diabetic retinopathy, reading vision is typically not affected. However, when retinopathy becomes advanced, new blood vessels grow in the retina. These new vessels are the body's attempt to overcome and replace the vessels that have been damaged by diabetes. However, these new vessels are not normal. They may bleed and cause the vision to become hazy, occasionally resulting in a complete loss of vision. The new vessels also may damage the retina by forming scar tissue and pulling the retina away from its proper location. This is called retinal detachment and can lead to blindness if left untreated.

The growth of abnormal blood vessels on the iris of the eye can lead to glaucoma. This usually occurs in those with severe diabetic eye disease. Cataracts are much more likely to develop in those with diabetes. All of these conditions may lead to vision loss and blindness. The good news is that treatment can reduce the loss of vision by 94%.

There are usually no symptoms in the early stages of diabetic retinopathy. Vision may not change until the disease becomes severe. An exam is often the only way to diagnose changes in the vessels of your eyes. If the diabetic changes inside of your eyes require treatment, your ophthalmologist may recommend laser, cataract surgery, or some other form of surgery. This is why regular eye exams for people with diabetes are extremely important. If you have diabetes and have not had an eye exam in the past year, please schedule one.

There are several things that you can do to reduce the risk of developing the complications of diabetes. You should keep your blood sugar under good control with minimal fluctuations. Monitoring your blood pressure, maintaining a healthy diet, and exercising regularly will also help keep your diabetes under better control.

There are several good sources of diabetic information on the internet. They include:

1.    www.stcloudeye.com
2.    www.diabetes.org
3.    www.jdrf.org
4.    www.diabetes.niddk.nih.gov
5.    www.cdc.gov/Diabetesast once a year.