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One of the most feared complications of diabetes is damage to the eye. This fear is justified, since nearly half of all people with diabetes will develop some degree of diabetic retinopathy, the most common diabetic eye disease, during their lifetime.
Diabetic retinopathy
Retinopathy develops when the tiny blood vessels, which provide oxygen to the retina, become damaged. Retina damage happens slowly. It is promoted by experiencing high blood pressure and high blood sugar over a long period of time. Diabetic retinopathy is the leading cause of new cases of blindness among adults in the United States each year. The longer a person has diabetes, the more likely he or she will get diabetic retinopathy.
Often there are no symptoms in the early stages of the disease. Even in more advanced cases, the disease may progress a long way without symptoms. Unless an eye exam is done, most people are unaware that they have eye damage.
When signs do occur they may include: blurry or double vision, dark or floating spots, pain or pressure in one or both eyes, trouble seeing things out of the corners of the eyes, rings, flashing lights or blank spots. Blurred vision can occur when the part of the retina that provides sharp, central vision swells from the leaking fluid. This condition is called macular edema. If new vessels have grown on the surface of the retina, they can bleed into the eye, blocking vision.
Finding diabetic retinopathy early is the best way to prevent vision loss. Don't wait for symptoms. People with diabetes should have their eyes examined at least once a year by an ophthalmologist (eye physician). Those who have diabetic retinopathy may need an eye exam more often than once a year, and should talk with their doctor about ways to keep blood sugar and blood pressure levels normal.
Treatment
The eye care professional may suggest laser surgery in which a strong light beam is aimed onto the retina to shrink the abnormal vessels. Laser surgery has been shown to reduce the risk of severe vision loss from this type of diabetic retinopathy by 60 percent.
For those with macular edema, laser surgery may also be used to seal the leaking blood vessels. Laser treatment is fairly painless. Laser surgery, however, typically cannot restore vision that has already been lost.
Other diabetic eye diseases
People with diabetes are also at risk for other diabetic eye diseases, including cataracts and glaucoma. A cataract is a clouding of the eye's lens, and studies show that a person with diabetes is twice as likely to get a cataract as someone who does not have the disease. Cataracts also develop at an earlier age in people with diabetes. They can usually be treated by surgery. Symptoms associated with cataracts include: painless blurring of vision, frequent eyeglass prescription changes, colors look dulled and brownish, poor night vision, glare and/or haloes, rays or spokes around lights.
Glaucoma may also become a problem for those with diabetes. Glaucoma starts with an increase in fluid pressure inside the eye that can lead to optic nerve damage and loss of vision. A person with diabetes is nearly twice as likely to get glaucoma as other adults. The longer someone has had diabetes, the greater the risk of getting glaucoma. Glaucoma may be treated with medications, laser or other forms of surgery. Cataracts and glaucoma also affect many people who do not have diabetes.
The bottom line
Keeping your blood glucose and blood pressure readings as close to normal as possible and getting regular eye exams are the best defenses against diabetic eye diseases. If you have diabetes, get a dilated eye examination at least once a year.
For more information
Information included in this article and additional information can be obtained from the following resources: American Academy of Ophthalmology; American Diabetes Association; Colorado Department of Public Health and Environment, Prevention Division and Diabetes Control Program; National Diabetes Information Clearinghouse; National Eye Institute.
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