Diabetes and Eye Health

By Khurram Malik, MD

Diabetes is a disease that affects the body’s ability to produce or use insulin effectively to control blood sugar (glucose) levels. Although glucose is an important source of energy for the body’s cells, too much glucose in the blood for a long time can cause damage in many parts of the body, including the heart, kidneys, blood vessels, and the small blood vessels in the eyes.
When the blood vessels in the eye’s retina swell, leak, or close off completely – or if abnormal new blood vessels grow on the surface of the retina – it is called diabetic retinopathy. The severity of diabetic retinopathy is characterized as mild, moderate, or severe. When new blood vessels grow in response to worsening of diabetic retinopathy, it is called proliferative diabetic retinopathy – the most severe form.
People who are at greater risk of developing diabetic retinopathy are those who have diabetes or poor blood sugar control, women who are pregnant, and people with high blood pressure and/or high blood lipids. People who are from certain ethnic groups, such as African-Americans, Hispanics and Native Americans, are more likely to develop diabetic retinopathy.
According to the Centers for Disease Control and Prevention (CDC), about 90 percent of diabetes-related vision loss can be prevented, but early detection is key. People with diabetes should get annual eye exams even before they have signs of vision loss. Primary care physicians will frequently remind their patients to have obtain a diabetic screening or annual follow up with their eye doctors. However, studies show that sixty percent of diabetics are not getting the exams their doctors recommend.
Something to remember: diabetes can cause vision in your eyes to change even if you do not have retinopathy. If your blood sugar levels change quickly, it can affect the shape of your eye’s lens, causing blurry vision, which returns to normal after your blood sugar stabilizes. Vision loss from diabetes often occurs secondary to swelling in the retina or bleeding within the eye. Retina specialists are able to perform laser or medication injections to reverse these conditions and stabilize the eyes.
The key to prevention of diabetic related eye disease is control of the diabetes itself and secondarily control of other systemic problems, i.e. high blood pressure or high cholesterol. It is important to see your eye doctor and/or retina specialist to monitor and treat your eyes on a regular basis.