Anyone over the age of 50, with or without type 2 diabetes, faces eye diseases such as cataracts and glaucoma, but there are steps people can take to keep their eyes in good health and prevent blindness.
Cataracts and glaucoma
Cataracts, in which the lens of the eye becomes cloudy, are a common cause of blindness and a normal part of the body’s aging process. Glaucoma, a disease that damages the optic nerve, is the leading cause of blindness in people over age 60.
Cataracts and glaucoma are not unique to people with diabetes, but they can develop earlier if they have diabetes, depending entirely on how well the person controls their blood sugar.
And they are two other reasons why patients need to control their diabetes under the guidance of their doctors.
If a patient already has cataracts or glaucoma, consult an ophthalmologist about treatment options. Early treatment can prevent glaucoma and thus blindness, and in addition, surgery can remove cataracts.
Diabetic eye disease and diabetic retinopathy
Diabetic retinopathy is the most common diabetic eye disease. The longer you have diabetes, the more likely you are to develop diabetic retinopathy, and its severity depends on how well the patient controls his or her blood sugar.
High blood sugar levels can damage blood vessels throughout the body, including those in the retina, a thin layer of photosensitive tissue that lines the back of the eye and is responsible for transmitting light to the brain, which allows people to see.
There are two types of diabetic retinopathy:
Simple or non-proliferative diabetic retinopathy (NPDR)
This is the earliest form of lesion in which damaged blood vessels begin to leak into the retina. The eye changes that can be caused by NPDR include:
- Macular edema: Blood vessels in the retina leak fluid into the macula, causing swelling.
The macula is located in the center of the retina and provides precise vision. Macular edema does not cause blindness, but it can lead to blurred vision.
Macular edema improves once blood glucose and blood pressure levels are under control, and if they do not, eye-specific laser treatment or direct drug injections may help.
- Macular ischemia: When the small blood vessels in the retina close, they cause a decrease in blood flow, and the patient’s vision is blurred because the macula does not have enough blood to function properly.
Proliferative diabetic retinopathy (PDR)
This advanced lesion occurs mainly when blood vessels in the retina close and thus do not flow. In order to supply blood to the affected area, new abnormal blood vessels grow in the retina and are weaker.
These new vessels grow in the wrong place and break very easily, and blindness is more severe with PDR than with NPDR.
When should I see my eye doctor?
Early in the disease, patients may not notice any changes, which is why regular eye exams are needed, even if there are no signs or risk factors for any eye disease, and a screening at age 40.
If diabetes is present, patients need a dilated eye exam immediately after diagnosis. The doctor will put a drop in the patient’s eye to dilate the pupil, which allows the doctor to better understand the condition of the retina and optic nerve.
Adults with type 2 diabetes should have a dilated eye exam at least once a year, and the eye doctor will inform the patient if more frequent exams are needed.
Tell your doctor if you notice any sudden changes in vision; too much or too little blood sugar can cause blurred vision.