Diabetes: Eye Problems

What are diabetic eye problems?

Eye problems can be a long-term complication of diabetes. High blood sugar and high blood pressure can damage the eye's retina, lens, cornea, and optic nerve. Diabetes is the leading cause of blindness in younger Americans.

What are the most common eye problems?

• Blurred vision: When your blood sugar is out of control and often goes from high levels to low levels, the shape of the lens of the eye changes and vision becomes blurry. Good control of blood sugar can prevent this. Blurred vision that does not go away should be checked by your eye provider.
• Diabetic retinopathy: This is a problem with the blood vessels in the retina. The retina is the lining at the back of the eye that senses light coming into the eye. The retina has tiny blood vessels that can be damaged by high blood sugar and high blood pressure. The longer you have diabetes, and the poorer your blood sugar control, the greater your chances of having this problem. High blood pressure also makes diabetic retinopathy worse. In the early stages, you may not have symptoms. As it gets worse over the years, symptoms may include blurred vision or floaters. Floaters are small black spots or cobweb-type spots in your field of vision. Sometimes people have bleeding inside the eye or the retina can pull away from the back of the eye. This is called a retinal detachment and it must be repaired with surgery. Diabetic retinopathy is the most common cause of permanent blindness from diabetes.
• Glaucoma: Glaucoma is an eye disease in which the nerve that carries visual messages to the brain (optic nerve) is damaged. This is usually caused by high pressure inside the eye. Damage to the optic nerve can cause a permanent loss of vision. Glaucoma needs to be diagnosed and treated early to prevent blindness. Anyone can get glaucoma, but people with diabetes are much more likely to have glaucoma. Your eye care provider will check your eyes at every visit to see if you have glaucoma.
• Cataracts: Almost everyone gets cataracts as they get older. A cataract is a cloudy area in the lens of the eye. The lens is located inside the eye behind the colored part of the eye. For some people, the lens gets cloudier over time and causes vision problems. Cataracts are more common and happen earlier in people who have diabetes. At first, stronger eyeglasses may help. Eventually the lens will have to be removed and replaced with a plastic lens. Cataract surgery is very common.
• Diabetic keratopathy: Diabetes can affect many nerves in your body, including the ones in your cornea. When the nerves of the cornea are damaged, the cornea can be at risk for dryness, infection, and corneal ulcers.

How can I prevent eye problems?

It is best to treat diabetes early, before these serious problems develop. If you have diabetes, see your eye care provider regularly, even if you do not have problems with your vision.

• If you have type 2 diabetes, you should have annual visits to the eye care provider starting the year that you are diagnosed.
• If you have type 1 diabetes, annual eye check-ups should start within 5 years of diagnosis if you are under 30, and right away if you are over 30.
• If you have eye changes due to diabetes, your eye care provider may advise more frequent visits. Your eye care provider may recommend laser treatments that may reduce your risk of vision loss.

To prevent eye problems you can also:

• Keep your blood sugar levels under control (the closer to normal the better).
• Keep your blood pressure under control.
• Keep your cholesterol under control.
• Do not smoke.
• Report any changes in vision to your eye care provider right away.
• If you are pregnant or planning to become pregnant, have an eye exam before you become pregnant and during the first 3 months of the pregnancy.