Diabetic Eye Problems

What are diabetic eye problems?

Eye problems are a long-term complication of diabetes. High blood sugar and high blood pressure can damage the eye's retina, lens, and optic nerve. Diabetes is the leading cause of blindness in younger Americans even though good treatments and preventive measures are available. Excellent control of diabetes and blood pressure, along with regular visits with your eye care provider can greatly reduce the chance of vision loss from diabetes.

What are the most common eye problems?

• Temporarily blurred vision: When your blood sugar is out of control and goes from high levels to low levels a lot, the shape of the lens of the eye changes and vision becomes blurry. Steady control of blood sugar can prevent this. Blurred vision that does not go away should be checked by your eye provider.
• Diabetic retinopathy: This is a problem with the blood vessels at the back of the retina. The retina is the lining at the back of the eye that senses light coming into the eye. The retina has tiny blood vessels that are easily damaged by high blood sugar and high blood pressure. The longer you have diabetes, the greater your chances of having this problem. In the early stages, symptoms are not noticeable. As it worsens over the years, symptoms may include blurred vision or floaters, which are small black spots or cobweb-type spots in your field of vision. Bleeding inside the eye and retinal detachments can occur sometimes. Retinal detachments require surgery to repair. This is the most common cause of permanent blindness from diabetes.
• Glaucoma: Anyone can get glaucoma, but people with diabetes are much more likely to have glaucoma. Glaucoma is a disease of the optic nerve that can be treated by lowering the eye pressure. Your eye care provider will check your eye pressure. However, it is possible for glaucoma to happen at any eye pressure, so your eye provider may look at other factors as well to decide if you have glaucoma.
• Cataracts: Cataracts occur in nearly everyone as they get older. A cataract is when the lens, which is behind the pupil in the eye, becomes cloudy. Cataracts are more common and happen earlier in people who have diabetes. As the lens gets cloudier, double or blurred vision is noticed. At first, stronger eyeglasses may help. Eventually the lens will have to be removed and replaced with a plastic lens. Cataract operations are very common.

How can I prevent eye problems?

Regular visits to your ophthalmologist are critical in preventing diabetes-related eye problems. If you have type 2 diabetes, you should have annual visits to the eye care provider starting the year that you are diagnosed. If you have type 1 diabetes, annual eye check-ups should start within 5 years of diagnosis if you are under 30, and right away if you are over 30. If you have eye changes due to diabetes, your eye care provider may recommend more frequent visits. Your eye care provider may recommend laser treatments that may reduce your risk of vision loss.

To prevent eye problems you can also:

• Keep your blood sugar levels under control (the closer to normal the better).
• Keep your blood pressure under control.
• Keep your cholesterol under control.
• Do not smoke.
• Immediately report any changes in vision to your eye care provider.
• If you are pregnant or planning to become pregnant, have an eye exam before you become pregnant and during the first 3 months of the pregnancy.

Reviewed for medical accuracy by faculty at the Wilmer Eye Institute at Johns Hopkins. Web site: http://www.hopkinsmedicine.org/wilmer/

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