How does diabetes effect your eyes?
You probably know that diabetes effects your blood sugar levels, but did you know that it can impact your eyes. What exactly happens that leads to eye damage? What is the treatment? Can you do anything to prevent it from occurring?
Diabetic retinopathy is a complication of diabetes that involves your eyes. It occurs when you have high blood sugar for extended periods of time. This leads to blockages, cutting off the blood supply to the tiny blood vessels that go to your retina (the layer of tissue in the back of your eye that senses light and sends images to your brain). Your eye attempts to grow new blood vessels, but they don’t develop correctly and often leak. Due to these abnormal blood vessels, you are at greater risk for several complications. Sometimes, when these blood vessels leak, they do so into the interior part of your eye (vitreous cavity), which is known as a vitreous hemorrhage. Typically, the bleeding stops fairly quickly and the blood will be reabsorbed, but this process can take weeks or months. It is common to have some form of vision loss during this time. It isn’t usually permanent unless your retina was damaged. The abnormal blood vessels also form scar tissue and this can cause your retina to pull away from the back of your eye (retinal detachment), which is consider an emergency. Since the abnormal blood vessels grow in areas where there usually aren’t blood vessels, it is possible for them to interfere with the normal flow of fluid within your eye. This can cause pressure to buildup resulting in glaucoma and this puts pressure on your optic nerve resulting in damage that is usually permanent. Diabetic retinopathy can result in blindness due to any one of these factors.
The early stages of diabetic retinopathy don’t have symptoms. As it advances, symptoms include floaters (spots/dark strings floating in your vision), blurred vision, fluctuating vision, impaired color vision, dark/empty areas in your vision and vision loss. It will affect both eyes. You are at greater risk of developing diabetic retinopathy if you have had diabetes for a long period of time, your blood sugar is poorly controlled, you have high blood pressure, you have high cholesterol, are pregnant, use tobacco or are African-American, Hispanic or Native American (diabetes is more prevalent among individuals in these demographics).
Treatment for diabetic retinopathy depends on the severity. If it is in early stages, you might not need treatment immediately, but your doctor will monitor your eyes closely to see when you will. It is essential to work with your endocrinologist (diabetes doctor) to keep your blood sugar under control to help slow the progression of your diabetic retinopathy. If it is in advance stages, you will need to have immediate surgery. The type of surgery will depend on what is wrong with your eyes. Your doctor will discuss with you all the available surgical options and together you’ll decide the best one for your symptoms.
While diabetic retinopathy can’t always be prevented, there are steps you can take to reduce your chances of developing it. It is key to get regular eye exams and let your doctor know of any vision changes you have when they occur (don’t wait until your next scheduled appointment). It is essential to manage your diabetes by checking your blood sugar several times a day, eating healthy and getting regularly exercise. By doing this, your blood pressure and cholesterol levels should also be under control. You can ask your doctor to do a glycosylated hemoglobin (A1C) test, which measures your average blood sugar for a couple month period (the goal is to have an A1C under 7 percent). This will allow you to see how you are doing managing your blood sugar over a longer period of time, not just day-to-day. If you smoke, it is important you quit because it can dramatically increase your risk of diabetic retinopathy and other complications of diabetes.
Diabetic retinopathy is not something that you want to have. While you may not be able to completely prevent it, there are things you can do to lessen your risk. If you have any questions or concerns, please speak with your doctor. If you would like more information, please visit the American Academy of Ophthalmology’s Diabetic Retinopathy page at https://www.aao.org/eye-health/diseases/what-is-diabetic-retinopathy