Diabetes affects hundreds of thousands of Alabamians, many of whom are unaware of the impact it has on their vision. The month of November is Diabetic Eye Disease Awareness Month, a time to remind people with diabetes to schedule regular comprehensive eye exams to help detect and treat vision problems early. People with diabetes are more likely than others to develop diseases that lead to vision-threatening conditions such as diabetic retinopathy, glaucoma, and cataracts. Diabetic eye disease is a leading cause of preventable blindness in adults.
Early detection is crucial to preventing vision loss. Sadly, too many people only seek care after their vision has already been affected. The Centers for Disease Control and Prevention (CDC) describes the causes of diabetic eye disease, their diagnoses, their treatment, and offers ways to prevent or delay vision loss as follows.
Diabetic retinopathy happens when high blood sugar damages blood vessels in the eye’s retina. Damaged blood vessels can swell and leak, causing blurry vision. It typically affects both eyes. The main risk factors are having type 1 diabetes, type 2 diabetes, or gestational diabetes. The longer one has diabetes, the more likely problems will develop.
These factors can also increase risk:
Symptoms can include:
During your eye exam, your ophthalmologist will assess how well you see from a distance. Your eye doctor will also dilate your eyes to examine the retina and blood vessels inside. If you have diabetic retinopathy, your doctor may recommend more frequent vision checkups.
Early diagnosis is so important, even if you have no symptoms yet. You should have an eye exam to check for diabetes retinopathy immediately if you're diagnosed with type 2 diabetes. For type 1 diabetes, it is recommended to have an eye exam within 5 years of diagnosis.
Contact your ophthalmologist if you notice any changes in your vision, especially sudden changes such as the following:
Treatment can repair damage to the eye and even prevent blindness in cases where sight is affected. Options include:
A cataract is the clouding of the normally clear lens in the eye. Everyone’s lenses tend to get cloudy as they age, but people with diabetes are more likely to have cataracts and at a younger age. One reason is that high blood sugar can cause deposits to build up in the lenses and make them cloudy.
Other risk factors include high blood pressure, obesity, too much sun exposure over time, and smoking. Surgery is the only way to treat cataracts, but surgery might not be necessary right away unless vision loss is getting the way of daily activities. Using brighter lights in your home and anti-glare sunglasses outside can help early on.
Glaucoma is a group of eye diseases that damage the optic nerve, usually because of too much pressure in the eye. Many types of glaucoma have no symptoms, and vision loss can happen very slowly.
People with diabetes are twice as likely to develop open-angle glaucoma, the most common type. Other risk factors include:
Diabetes can also cause neovascular glaucoma. This happens sometimes with diabetic retinopathy when new and abnormal blood vessels grow on the iris. The new vessels can block off the flow of fluid out of the eye, which raises eye pressure.
Glaucoma cannot be prevented, but treatment can help stop it from worsening. Treatment options include medicine, laser treatment, and surgery. Consult with your eye doctor to determine the best choices for you.
The CDC offers these tips to prevent or delay diabetic eye diseases:
To protect your vision and lower your chance for vision loss:
To learn more information about diabetes, visit ADPH's Diabetes website.
Scott Harris, M.D., M.P.H.
State Health Officer