Diabetes and Eye Disease

By Thomas P. Finley, OD

Dr. Finley's Family Eyecare

. http://visionsource-drfinley.net/

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Diabetes and Eye Disease

Diabetes is a leading cause of blindness among working-age adults in the United States. Nearly half of all people with diabetes will develop some degree of diabetic retinopathy during their lifetime.  The longer a person has diabetes, the more likely they are to develop sight threatening diabetic retinopathy.

Early diagnosis and treatment is extremely important to control diabetic retinopathy.  As the disease progresses, a person may notice their vision getting worse, or fluctuating throughout the day, or changing from day to day.  Oftentimes, there are no noticeable symptoms.

What happens to the
eye in diabetes?

In diabetic retinopathy, blood vessels in the back of the eye (retina) become weakened and begin leaking blood and fluid.  Your eye doctor may be first to detect that you have diabetes based on your eye health observed during your eye exam.

Other changes in the eye may also occur.  The macula of the eye can become swollen from leaking fluids and cause blurred or distorted vision.  In more advanced stages, new fragile blood vessels may begin growing.  These new vessels are very weak and prone to leak which leads to more damage and significant vision loss.  Once the damage begins, it becomes more difficult to control.

What should a person
with diabetes do?

People with diabetes must manage their condition by monitoring their blood sugar regularly and maintaining a good diet and weight control.  Medication must be taken as prescribed. Exercise regularly.  Unfortunately, diabetes is a lifetime disease in most cases, so there’s no quick fix.  Daily lifestyle changes and diligence are required for best management.

All diabetics should have a thorough eye examination with pupil dilation at least every year.  Your doctor should explain all findings and communicate with your other doctors.  Studies demonstrate diabetics receiving yearly comprehensive eye health examinations tend to maintain better control of their condition.

When diabetic eye changes become more severe, it may be necessary to see a retinal specialist to discuss advanced treatment options and help reduce the risk of severe vision loss.  There is usually no need to see a specialist unless your eye disease becomes more advanced.  New advanced ophthalmic instrumentation allows doctors to closely monitor diabetic eye health.

Other eye problems can occur more frequently in people with diabetes.  Glaucoma and early cataracts are twice as likely to occur in people with diabetes.

Conditions like high blood pressure, smoking, and pregnancy may cause diabetic eye disease to worsen. Yearly eye examinations (or sometimes more frequent exams) are the best way to guard against debilitating vision loss from diabetes.

To summarize:

Keep your A1C (blood glucose), blood pressure, and cholesterol controlled and as close to normal as possible.

Take your medications as prescribed;

Have a comprehensive eye examination with pupil dilation at least every year.

Maintain a healthy diet and weight, exercise, and don’t smoke.

Can people with diabetes wear contact lenses safely?

Diabetics are more susceptible to infections than non-diabetics, and this is a concern with contact lenses.  Eye infections can be very serious and cause permanent vision loss.  However, with proper care and wearing, people with diabetes can wear contact lenses safely.