People with diabetes often develop serious eye diseases: diabetic retinopathy, glaucoma, and cataracts. Diabetic retinopathy affects the tiny blood vessels of your retina. The retina is the area at the back of your eye that takes in light and changes it to signals. The signals are sent down the optic nerve to your brain, where they are interpreted as vision.

Diabetic retinopathy can damage vision and cause blindness in two ways: either the small blood vessels in the retina start to swell and leak blood into your eye; or new, abnormal blood vessels start to grow on the outside of the retina. Diabetic retinopathy causes no pain, and usually no symptoms, until the disease is advanced and sight has been lost. You might not even know you have it until blood vessels start leaking blood into your eye. The blood blocks light from reaching your retina and therefore blocks vision.

New and abnormal blood vessels may create scar tissue that pulls the retina from the back of the eye. This is called a detached retina. It may cause you to see flashing lights or feel as though a curtain is blocking part of your vision. A detached retina requires emergency care. In glaucoma, the pressure of the fluid inside your eye builds up because the fluid isn’t draining correctly. You cannot feel this pressure but if it is permitted to build up it will damage the optic nerve. The optic nerve transmits signals to your brain to create vision. Untreated glaucoma causes vision loss and blindness.

Preventing Eye Disease

The best way to prevent diabetic eye disease is to closely control your blood sugar and blood pressure, not smoke, and have a yearly eye exam. More than 90 percent of people with diabetes eventually develop some form of retinopathy, and are almost twice as likely to get glaucoma. The good news is that both diseases can be taken care of if they are diagnosed and treated early. Having a painless eye exam every year can do this. During this exam the pupils of your eyes (the black central portion) are dilated, or opened up, with eye drops. It permits your eye care provider to see into your eyes, all the way back to your retinas. The tiny blood vessels can then be viewed for signs of leaking or abnormal growth.

During your dilated eye exam, your eye care provider will check for glaucoma by looking through your pupil to view the optic nerve for changes. The test for glaucoma includes applying quick, painless pressure to your eye with a tiny instrument to check the fluid pressure inside your eye.

Another test checks your peripheral or side vision. Even a small loss of peripheral vision can indicate glaucoma. You may also be checked for cataracts which cloud the lens at the front of your eye. If you have diabetes, you are twice as likely to develop a cataract, and the blurred vision it causes, at an earlier age.

Treatment for Eye Disease

  • Diabetic Retinopathy
    If you have signs of diabetic retinopathy, your eye care provider may suggest painless treatment with a laser. A laser is a powerful beam of light. It is used to seal the broken, leaking blood vessels serving the retina and to shrink and stop the growth of new and abnormal blood vessels on the surface of the retina. The laser can also be used to reattach a detached retina. Laser surgery is extremely successful in repairing early damage to the blood vessels of the retina, and is usually done in your eye care provider’s office. Having this surgery can save your vision.
  • Glaucoma
    Glaucoma can also be treated with a laser to open up the drain in your eye so the built-up fluid can drain away. This reduces pressure on the optic nerve. Most people with glaucoma do not need to have laser surgery, however they do need to use eye drops daily to reduce the pressure in their eyes. Eye drops for glaucoma contain strong drugs that can interact with other medicines. Tell your eye care provider about all drugs you are taking so a harmful interaction can be avoided.
  • Cataracts
    Cataracts, which cause your vision to be cloudy or blurry, will be monitored during periodic eye exams. Surgery can be done to fix the cloudy lens.

What to Do

  • Keep your blood sugar and blood pressure within the limits recommended by your healthcare provider.
  • Follow the advice of your health care provider regarding diet, exercise, limiting alcohol, and weight loss.
  • Have a dilated eye exam every year so your eye care provider can look inside your eyes.
  • Have an eye exam if you are just pregnant or planning to become pregnant.

What Not to Do

  • Do not wait until you have symptoms to see your healthcare provider. The first symptoms can indicate vision loss that cannot be restored.
  • Do not ignore symptoms of eye disease, including floating spots, flashing lights, blurred vision, double vision, or problems seeing at the sides of your eyes. Call your healthcare provider immediately.

Things to Remember

  • It is far easier to prevent diabetic eye disease than it is to cure it once it has progressed.

What We Have Learned

  1. The only way to detect diabetic retinopathy and glaucoma early is by having a dilated eye exam once every year.
    True or False
    Answer: True
  2. Diabetic retinopathy can cause vision loss or blindness by damaging tiny blood vessels that keep the retina healthy.
    True or False
    Answer: True
  3. In glaucoma the increased pressure of the fluid inside your eye causes pain.
    True or False
    Answer: False

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