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Diagnosed with Diabetes?

Here’s how to protect your vision. 

Whether you have just been told you have diabetes or have been diagnosed for many years – you probably have experienced the feeling of being overwhelmed.  

During times like this, it is important to remember that your eye doctor is an important member of your diabetes health care team, just like your medical doctor, diabetes educator, or dietician.  

Diabetes causes problems when excess amounts of glucose stay in the bloodstream. Just like the heart, blood vessels, and other systems of your body, vision can be permanently damaged by these higher levels of blood sugar. Yet, many of the harmful effects to the eyes can only be detected during a regular eye exam.  

For this reason, it’s a good idea to establish yourself with a trusted eye doctor after learning you have diabetes. Plan to see them at least once a year to spot any internal damage before it causes vision loss. Your eyes may seem fine, but having a full, dilated eye exam is the only way to know for sure. You will come to know your ophthalmologist as the ‘primary care doctor’ for your vision! 

How does diabetes affect your eyes? 

Diabetes can be stealth, meaning it can cause damage without pain or symptoms in preliminary stages.  

When blood sugar stays high over time, it weakens the tiny blood vessels at the back of the eye, eventually causing them to break and leak fluid.  

These damaging changes can also occur during prediabetes, when blood sugar levels are higher than normal, but not high enough to be diagnosed with diabetes.   

What are early symptoms of diabetic eye disease? 

Often there are no early symptoms of diabetic eye disease. The changes to the retina at the back of the eye may only be visible during a dilated eye exam. You may experience no pain and observe no significant changes to your vision as damage begins to grow inside your eyes, particularly with diabetic retinopathy. 

When symptoms do occur, they often include: 

  • Blurry or wavy vision 
  • Frequently changes in vision—sometimes from day to day 
  • Dark areas or vision loss 
  • Poor color vision 
  • Spots or dark strings (also called floaters) 
  • Flashes of light 

If you have any of these symptoms, it’s important to talk with your eye doctor right away.  

Can diabetes permanently damage my eyes? 

Yes. Diabetes can have long-term damaging effects on vision and even cause blindness. In fact, diabetes is the leading cause of blindness in the US for working age adults. Permanent vision loss can be prevented through regular checkups and following your diabetes care regimen.  

Short term vision changes from high blood sugar. 

When blood sugar levels are too high within the body, fluid levels are altered and can cause tissues and blood vessels to swell. In the short term, this can cause the lens of the eye to swell resulting in blurry vision. This condition can occur for a few days or weeks in those who do not know they have diabetes or when medications have changed.  

Typically, this type of blurred vision is temporary and goes away when blood sugar levels return to normal.  

Long-term damage to the eye from continued high blood sugar levels. 

More serious diabetic eye complications begin with blood vessel problems. This occurs when uncontrolled blood sugar damages the tiny blood vessels within the retina at the back of the eye. The process starts a very destructive internal cascade that can permanently damage vision.  

  • Damaged blood vessels leak fluid and cause swelling within the eye. 
  • New, weaker blood vessels begin to grow to replace damaged vessels. 
  • The new, inferior vessels break and bleed into the middle of the eye. 
  • Excess fluid and blood within the eye lead to scarring and can contribute to dangerously high eye pressure. 

Types of Diabetic Eye Disease 

The term ‘Diabetic Eye Disease’ is a group of eye conditions that can result from diabetes and threaten your sight. The group includes diabetic retinopathy, diabetic macular edema, glaucoma, and cataracts.  

  • Diabetic Retinopathy. Known as the leading cause of blindness in working-age adults, retinopathy occurs when changes in the retina’s vessels cause leaking or growth of abnormal vessels on the retina’s surface. There are several options to treat diabetic retinopathy, so it is important to get regular eye exams to start treatment as soon as problems are discovered.  
  • Macular Edema. The macula — the center of the retina that provides sharp, straight vision — can swell due to leaky blood vessels in the eye caused by diabetes, resulting in blurred or distorted vision.  
  • Glaucoma. One form of glaucoma, neovascular glaucoma, is caused by diabetes. High sugar levels can damage the retina’s blood vessels and result in the creation of abnormal new ones. When new blood vessels grow it can cause an increase in eye pressure leading to glaucoma. 
  • Cataracts. Cataracts can form earlier and progress faster in people with diabetes due to increases in blood sugar of sugar. This creates a cloudy buildup in the eye’s lens, resulting in a cataract earlier than normal.  

How to take care of your eyes when you have diabetes. 

While there is no cure for diabetes, there are ways to successfully manage it and prevent health complications through a balanced diet, active lifestyle, and medication management. 

The most important steps you can take to manage your diabetes and keep your eyes healthy are: 

  • Make sure you understand the benchmarks your physician has set for you to control the ABCs of diabetes: blood sugar, blood pressure, and cholesterol.  
  • If you smoke, STOP. It is the greatest controllable risk factor in your long-term health. There are many free resources to help you quit smoking, you can find them HERE 
  • Have a dilated eye exam once a year. Often, there are no warning signs of diabetic eye disease or vision loss when damage first develops. A full, dilated eye exam helps your ophthalmologist find and treat eye problems early—before permanent loss has occurred. 

When should you see an eye doctor if you have diabetes? 

Call your eye doctor right away if you notice sudden changes to your vision, including flashes of light or   more spots (floaters) within your vision than usual.  

Contact your eye doctor right away if it appears as if a curtain is falling over your vision. This can signal a detached retina, which is a medical emergency. 

Need a good eye doctor? 

The physicians at St Lucie Eye are comprehensive ophthalmologists, trained to manage the aspects of diabetes on your eye health. If additional treatment or consultation is needed, they also have retina and cornea specialists on staff to manage your vision.