Diabetes is a chronic disease that affects how the body processes glucose, also known as blood sugar. Over time, high blood sugar levels can damage blood vessels and nerves throughout the body, including in the eyes. So yes, diabetes is a leading cause of eye problems and vision loss.
How does diabetes affect the eyes?
There are two main ways diabetes impacts the eyes:
- Diabetic retinopathy – damage to the blood vessels in the retina at the back of the eye
- Diabetic macular edema – swelling and leakage of blood vessels in the macula, the part of the retina responsible for sharp central vision
High blood sugar from diabetes can damage the tiny blood vessels that nourish the retina. This can impair blood flow and allow fluid to leak into the retina, causing it to swell. The macula is especially vulnerable to fluid accumulation.
What are the stages of diabetic retinopathy?
There are different stages of diabetic retinopathy:
- Mild nonproliferative retinopathy – microaneurysms and small dot hemorrhages in the retina
- Moderate nonproliferative retinopathy – more extensive bleeding and blocked blood vessels
- Severe nonproliferative retinopathy – many blocked blood vessels and diminished blood flow
- Proliferative retinopathy – harmful growth of new abnormal blood vessels on the retina and into the vitreous jelly that fills the eye
Without treatment, these new blood vessels can bleed and cloud vision. The stages reflect increasing severity of damage to retinal blood vessels.
What are common symptoms of diabetic eye disease?
Many people do not notice symptoms in the early stages of diabetic retinopathy. That’s why regular eye exams are so important for people with diabetes. Some common symptoms that may develop include:
- Blurry vision
- Difficulty reading
- Dark or empty areas (floaters) in vision
- Vision loss
- Eye pain or redness
Who is at risk for diabetic eye problems?
Anyone with diabetes is at risk for diabetic retinopathy and other eye complications, but some factors can increase risk:
- Having diabetes for a long time
- High blood sugar levels that are uncontrolled
- High blood pressure
- High cholesterol
- Pregnancy
The longer someone has diabetes and the less controlled their blood sugar levels are, the more likely they are to develop diabetic retinopathy. That’s why it’s so important to properly manage diabetes through medication, diet, exercise and regular monitoring of blood sugar levels.
Can diabetic retinopathy cause blindness?
Yes, uncontrolled diabetic retinopathy can lead to severe vision loss and blindness. Diabetes is one of the leading causes of blindness in American adults.
Fluid and blood leaking into the center of the eye from damaged retinal blood vessels can cause blurry central vision or dark spots. New abnormal blood vessels can bleed into the vitreous, causing spots or strings of blood to float in the vision.
Over time, the retina can become detached or scar tissue can form, which can lead to permanent vision loss. If bleeding or retinal detachment affects the macula, central vision loss occurs.
How is diabetic retinopathy diagnosed?
Diabetic retinopathy is diagnosed through a comprehensive dilated eye exam by an ophthalmologist or optometrist. The pupils are dilated with eye drops to allow for a better view inside the eye, including a clear look at the retina.
The eye doctor will look for:
- Retinal swelling
- Retinal bleeding
- Leaking blood vessels
- Damaged blood vessels
- Abnormal new blood vessel growth
- Changes in optic nerve appearance
Sometimes photos of the retina or additional tests like optical coherence tomography (OCT) are used. OCT can provide cross-sectional 3D images of the layers of the retina to help see leakage and damage.
How is diabetic retinopathy treated?
Treatment for diabetic retinopathy depends on the stage and aims to prevent further vision loss. Steps include:
- Strict control of blood sugar, blood pressure and cholesterol levels
- Laser surgery to shrink abnormal blood vessels or reduce fluid leakage
- Steroid injections in the eye to reduce inflammation
- Vitrectomy surgery to remove scar tissue or blood from inside the eye
- Medications like anti-VEGF drugs to inhibit abnormal blood vessels
The earlier retinopathy is detected, the more options are available to preserve vision. That’s why regular dilated eye exams are so important for people with diabetes.
Can diabetic retinopathy be prevented?
Proper management of diabetes is key to preventing vision loss from diabetic retinopathy. Steps to reduce risk include:
- Maintaining healthy blood sugar levels through diet, exercise, medication and routine monitoring
- Controlling blood pressure and cholesterol
- Getting a comprehensive dilated eye exam every year, or more often if recommended
- Seeing an endocrinologist regularly to properly manage diabetes
- Eating a healthy diet and exercising regularly
- Avoiding smoking
While these steps cannot guarantee diabetic retinopathy won’t develop, they can significantly reduce the risk of eye complications.
Can diabetic retinopathy be cured?
Currently, there is no cure for diabetic retinopathy. However, treatment can often prevent severe vision loss or slow the progression of eye damage. Options like laser surgery can minimize existing blood vessel leakage and abnormal vessel growth.
That’s why early detection and timely treatment to address changes in the retinal blood vessels is so important. This gives the best chance of preserving sight.
With proper monitoring and care, many people with diabetic retinopathy can maintain usable vision and good quality of life.
What is the outlook for people with diabetic retinopathy?
The outlook for people with diabetic retinopathy varies depending on the amount of damage that has already occurred. With early detection and prompt treatment, good vision can be maintained in many cases.
Mild to moderate nonproliferative retinopathy often does not significantly impact vision. But severe nonproliferative retinopathy can progress to vision loss if left untreated. Proliferative retinopathy also needs quick treatment to prevent blindness.
For advanced retinopathy, treatments like vitrectomy surgery can sometimes improve vision but may not restore it completely. However, treatments can often stabilize remaining vision.
Regular eye exams to monitor diabetic retinopathy and manage it early provide the best outlook. Good communication with eye doctors and diabetes doctors also improves long-term eye health for people with diabetes.
Key takeaways
- Diabetes can damage the retina’s blood vessels and lead to diabetic retinopathy
- High blood sugar and high blood pressure increase the risk for diabetic eye problems
- Symptoms may not occur until significant damage is done
- Regular dilated eye exams can detect issues early
- Prompt treatment can prevent significant vision loss
- Managing diabetes, blood pressure and cholesterol can reduce risk
The bottom line
Diabetes is a leading cause of blindness due to damage to the retina’s blood vessels. But with diligent monitoring and care, severe vision loss from diabetic retinopathy can often be prevented. The keys are managing diabetes well and getting regular comprehensive eye exams to catch problems early.
| Stage of Diabetic Retinopathy | Description |
|---|---|
| Mild Nonproliferative Retinopathy | Microaneurysms and small retinal dot hemorrhages |
| Moderate Nonproliferative Retinopathy | More extensive bleeding and blocked retinal blood vessels |
| Severe Nonproliferative Retinopathy | Widespread blocked retinal vessels and decreased blood flow |
| Proliferative Retinopathy | Growth of new abnormal retinal blood vessels that can bleed into the eye |
| Risk Factor | Details |
|---|---|
| Duration of diabetes | Longer duration increases risk |
| High blood sugar | Poor control of blood sugar increases risk |
| High blood pressure | Poor control of blood pressure increases risk |
| High cholesterol | Poor control of cholesterol increases risk |
| Pregnancy | Pregnancy in women with diabetes increases risk |
| Prevention Tips |
|---|
| Control blood sugar levels through medication, diet and exercise |
| Control blood pressure and cholesterol levels |
| Get a dilated eye exam every year |
| See an endocrinologist regularly to manage diabetes |
| Eat a healthy diet and exercise regularly |
| Avoid smoking |