Diabetes In Your Eyes?

By John Choi, MD

Diabetes is a disease in which you have too much sugar in your blood, which damages your body. According to the American Diabetes Association, in 2018 10% of all Americans and 25% of senior Americans aged 65 or older had diabetes. For 2017, diabetes cost Americans $327 billion in medical costs and lost productivity. More than half of people with diabetes eventually will get diabetes in their eyes. Often diabetes will show up in the eyes first. Eye diabetes is the leading cause of blindness among working-age adults.

How Does Diabetes Affect the Eye?

Diabetes can cause cataracts and glaucoma, but the most common cause of vision loss is diabetic retinopathy.

What Is Diabetic Retinopathy?

The retina is the inner lining of our eyeballs. It contains the vision machinery such as photoreceptors—it’s the vision “engine”. Like a car engine needs gas, the retina needs blood to work and allow you to see. In diabetic retinopathy, high blood sugars damage the blood vessels in the retina. These injured blood vessels leak blood and fluid into the retina, affecting its function. Damaged blood vessels also carry less blood to the retina so the vision engine “sputters”, affecting sight.

I Have Diabetes and See Fine, What Should I Do?

Controlling your diabetes by taking your medications, staying physically active, and eating a healthy diet can prevent or delay vision loss. Because diabetic retinopathy is often unnoticed until you lose vision, you should get a dilated eye exam once a year.

How Can I Tell If I Have
Diabetic Retinopathy?

Common symptoms are:

1. Blurred or double vision

2. Difficulty reading or seeing up close

3. Floaters (spots) in your vision

If you have any of these symptoms, you should see your eye doctor for a dilated eye exam to check for diabetic retinopathy. If your eye doctor suspects you have diabetic retinopathy, he or she will refer you to a retina specialist to manage it.

What Happens If I Have Diabetic Retinopathy?

If the diabetic retinopathy is mild and doesn’t affect your vision, you may not need any treatment. If your vision is affected, you will need treatment. The most common therapies are tiny shots of medicine to the eye and laser treatments. Sometimes surgery is needed. Your retina specialist will discuss treatment options to get your best vision. Your retina specialist will also work with your primary eye doctor, primary care physician, and endocrinologist to manage your diabetic retinopathy. This is a lifelong condition, so you will need to be examined for the rest of your life and treated as necessary to preserve your vision. With proper care, many patients with diabetic retinopathy see well and live fruitful, productive lives.