Slideshow: Diabetes Complications: Eye Problems and Blindness
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How Diabetes Affects Your Eyes
Diabetes can increase your risk of eye problems. Your blood sugar (glucose) levels may be high because your body can't make or use insulin properly. Too much blood sugar can build up, damaging nerves and blood vessels in your body. When the damage happens in the blood vessels in your eyes, this can lead to vision loss or blindness. Anyone with diabetes is at risk, so it’s important to get routine eye exams.
Signs and Symptoms of Eye Damage
Diabetes can affect your eyes in different ways. When your blood sugars are high or when you start insulin treatment, you may experience blurry vision or other vision problems. But your eyes may be damaged even if you don’t notice any changes. Don’t wait for symptoms to arise to get your vision checked.
The retina senses light coming into your eye and sends messages to your brain about the things you see. When blood glucose builds up, the blood vessels inside the retina may be damaged -- this is called diabetic retinopathy. At first you may not notice any changes. But over time these blood vessels may develop fragile defects in the blood vessel walls, which can leak fluid. With advanced diabetes, fragile blood vessels grow throughout the retina. This can lead to severe vision loss and even blindness.
Treatment -- Laser Surgery
Retinopathy can be detected during thorough eye exams. A special type of angiogram uses dye to find leaking blood vessels. Early stages of diabetic retinopathy often can be treated with laser surgery called photocoagulation. The laser seals the blood vessels in order to stop them from leaking and growing. The procedure can't restore lost vision. Combined with followup care, however, surgery can lower your chances of blindness by as much as 90%.
Treatment -- Vitrectomy
In advanced stages of diabetic retinopathy -- if the retina has detached or a lot of blood has leaked into your eye -- your doctor may suggest vitrectomy. This surgical treatment removes scar tissue, blood, and cloudy fluid from inside the eye. Vitrectomy can improve your vision, especially if it's done before the disease has progressed very far.
Diabetic Retinopathy Risk Factors
Risk factors for diabetic retinopathy include how well you control your blood sugar and blood pressure. Control of blood cholesterol may also help reduce the risks. Your chances of developing diabetic retinopathy increase the longer you have diabetes. Eventually, nearly everyone with diabetes will develop some degree of retinopathy.
Diabetic Retinopathy Prevention
You can help prevent eye problems by keeping your blood sugar, blood pressure, and cholesterol under control. A major study found that people with diabetes who managed their diabetes intensely had 1/4 the rate of diabetic retinopathy as those who followed standard diabetes treatment. It also helps to stop smoking. And it's very important to get an annual dilated eye exam to detect early signs of the disease.
Glaucoma and Diabetes
While anyone over 40 is at increased risk of glaucoma, people with diabetes are 40% more likely to develop it. Your chances increase the longer you have diabetes. Glaucoma may cause bright halos or colored rings around lights, but usually has no symptoms. Untreated, it can cause an increase in eye pressure that damages the optic nerve, resulting in vision loss and blindness. Glaucoma can be treated with drops to lower eye pressure, or laser or conventional surgery.
Cataracts and Diabetes
If you have diabetes, you're 60% more likely to develop cataracts -- and you're more likely to get them at a younger age than people without diabetes. Poor control of blood sugar can speed up this condition. With a cataract, the lens in the eye becomes cloudy, which blocks light and makes everything look hazy. Cataract surgery -- when the eye's natural lens is replaced with an artificial lens -- can help vision. Sometimes diabetic retinopathy can get worse after cataract surgery.
See Your Doctor
If you have diabetes and have any of these symptoms, see your doctor:
Blurry or hazy vision for more than 2 days
Spots, floaters, or shadows
Severe eye pain or pressure
Sudden vision loss in one or both eyes
Sense that a curtain is coming down over your eyes
National Diabetes Information Clearinghouse, National Institutes of Health: "Prevent diabetes problems: Keep your eyes healthy." FamilyDoctor: "Diabetes: Eye Care." MedlinePlus: "Diabetes - eye care." National Eye Institute, National Institutes of Health: "Diabetic Eye Disease FAQ." American Diabetes Association: "Eye Complications." Fong, D. Diabetes Care, January 2003; vol 26: pp 5099-5102. American Diabetes Association: "Eye Care." National Eye Institute: Facts About Diabetic Retinopathy." US News & World Report: "Diabetes Seems to Heighten Glaucoma Risk."
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