People with diabetes should see their eye doctor regularly. High blood sugar can lead to blurred vision, cataracts, glaucoma and retinopathy, among other problems. More frighteningly, diabetes is also the leading cause of blindness in adults aged 20 to 74.
Blurred vision
Don’t get new glasses when your vision is blurry; its probably a minor problem caused by high blood sugar. A swollen lens can affect vision.
To get your vision back to normal, return your blood glucose levels to your target range (70-130 mg/dL before a meal and below 80 mg/dL 1-2 hours after a meal). It may take up to 3 months for vision to return to full normal after blood glucose targets are met.
Be sure to tell your ophthalmologist that you have blurred vision, and he or she will tell you if this is a symptom of worsening disease.
Cataracts
The lens allows the eye to see by focusing the image, just like a camera. People with cataracts can have a cloudy lens as debris obscures the clear lens. Anyone can develop cataracts, but people with diabetes tend to develop them earlier and get worse more quickly.
When the lens is partially clouded, the eye cannot focus as it normally would, and it becomes hard to see. Symptoms of cataracts include blurred vision and glare.
Surgery is needed to remove the cataract, and your doctor will replace the cloudy lens with an artificial lens.
Glaucoma
When fluid in the eye does not drain as it normally would, pressure builds up in the eye, which can damage nerves and blood vessels and cause changes in vision.
Open-angle glaucoma (the most common type of glaucoma) can be treated with medications. Medications lower eye pressure, speed up drainage, and reduce the amount of fluid produced by the eye (what doctors call atrial fluid).
Open-angle glaucoma may not cause any symptoms until it progresses further, and once the disease worsens it can lead to significant loss of vision. Patients with diabetes should be checked once a year for early diagnosis by their doctor.
Less common symptoms of glaucoma also include the following:
- Headache;
- eye pain;
- blurred vision;
- Wet eyes;
- Halo when looking at lights;
- Loss of vision.
Treatment with medications and special eye drops is available. In addition, surgical and laser treatments help to drain the atrial fluid.
People with diabetes are at higher risk of developing a rare form of neovascular glaucoma. This disease causes new blood vessels to grow on the iris (the colored part of the eye). The normal flow of fluid in the eye is blocked, raising eye pressure.
Neovascular glaucoma is difficult to treat, and doctors may try laser surgery to reduce the blood vessels or through the use of implants to help drain the fluid.
Diabetic retinopathy
The retina is a group of cells at the back of the eye that absorbs light. The retina converts light into an image, which is sent to the brain through the optic nerve.
Damage to the small blood vessels in the retina can lead to diabetic retinopathy, a disease associated with high blood sugar. If not caught and treated early, it can lead to blindness. The longer the duration of diabetes, the higher the risk of retinopathy. If blood sugar is controlled in a timely manner, the risk is reduced.
- People with type 1 diabetes rarely develop retinopathy before puberty. In adults, retinopathy is also rare unless they have had type 1 diabetes for at least 5 years. The risk is much lower when blood glucose is tightly controlled with an insulin pump or multiple daily injections of insulin.
- People with type 2 diabetes may develop eye problems at the time of diagnosis. Blood sugar, blood pressure, and cholesterol can be controlled to slow or prevent related disease. Smokers should try to stop smoking. Quitting will improve eye and overall health.
.
There are also a number of other types of retinopathy.
- Background retinopathy: Blood vessels are damaged, but vision is preserved. The condition can worsen if diabetes is not well controlled.
- Macular degeneration: This is damage to the macula (a key area of the retina). Macular degeneration can greatly affect vision.
- Proliferative retinopathy: This disease occurs when cells in the back of the eye do not get enough oxygen and new blood vessels begin to grow. The new blood vessels are fragile and can bleed and lead to blood clots. They can also cause scar formation and separate the retina from the tissue at the back of the eye. When a detached retina develops away from the patient, there may be irrecoverable loss of vision. Sometimes the disease can be treated, and surgery is one option. Laser surgery can cauterize the blood vessels and help prevent up to half of the early retinopathies.
Eye exams
A comprehensive exam once a year can help identify problems early, and early problems are easier to treat, thus protecting your vision.
For those who are preparing for pregnancy, get an eye exam to avoid possible problems. Also, be consistent in getting eye exams when you are pregnant.
Timing of the visit
The following symptoms may be a sign of an emergency, so seek medical attention as soon as possible.
- Dark spots in the visual field.
- Flashes of light when looking at things.
- There are “holes” in the visual field.
- Blurred vision.