Diabetes And Your Vision

Diabetes and Eye Health

People who suffer from diabetes, both Type A and Type B, are at an increased risk for several types of eye complications.  In fact, diabetes is one of the leading causes of blindness in the U.S.  If you have diabetes, it is essential that you maintain a routine eye exam schedule with your ophthalmologist, in order to monitor your overall eye health.  Early detection could mean the difference in a minor problem and major vision loss. 

Although people with diabetes are at a higher risk for eye disease, it’s important to note that not everyone with diabetes will develop an eye disorder, and for those that do, the condition is usually minor and can be treated or maintained easily.
There are three types of eye conditions that people with diabetes are at a higher risk of developing:  Glaucoma, Cataracts and Diabetic Retinopathy.

Glaucoma

The exact relationship between diabetes and glaucoma has puzzled doctors for years, but the fact remains: diabetes sufferers are twice as likely to develop glaucoma than people without.  The likelihood increases even further the longer that person has had diabetes.

Glaucoma occurs when pressure builds up in the eye, damaging the optic nerve as a result.  They call glaucoma the ‘silent thief’ because vision loss is so gradual, that symptoms are hardly noticeable.  In many cases, a person has been suffering from the onset of glaucoma for years without knowing it.  That’s why routine eye exams are so important, especially for diabetes sufferers.  Only a thorough eye exam from a licensed ophthalmologist can diagnose glaucoma.  Although there is no permanent cure for glaucoma, early detection is key to developing a treatment plan that can control the pressure in your eye and save any permanent vision loss down the road.
Learn more about glaucoma detection and treatment options 

Cataracts

A cataract is diagnosed when the lens of the eye becomes cloudy and impairs light rays from passing through.  The result is blurry or hazy vision.  Cataracts are also an unfortunate part of the aging process.   The lens of our eye is made up of protein and water, and over time will naturally begin to calcify and become cloudy. 

Although cataracts will eventually affect everyone should you live long enough, those with diabetes are more than 60% likely to develop the condition, and at a much younger age than normal.  The speed of vision loss due to cataracts is also faster in those patients with diabetes.  The good news is that cataracts are easily treatable, with several common visual aids improving vision until the lens becomes too cloudy, and cataract surgery is needed.  Cataract surgery is a popular, safe and effective permanent correction option, with over 95% of patients enjoying clear vision after surgery. 

Learn more about cataracts and cataract surgery, including premium lenses that could give you clear vision without glasses after the procedure.  

Diabetic Retinopathy

The most common eye disease associated with diabetes is called diabetic retinopathy.  This condition exists when abnormally high blood-sugar levels cause the tiny blood vessels in the retina to become damaged.  The retina is located on the back portion of the eye, and plays an essential part in one’s vision.  When the blood vessels of the retina become damaged, they can bleed or become constricted.  This can damage the surface of the retina, which in turn can lead to severe vision loss or even blindness. 

The term diabetic retinopathy is actually a general term referring to several types of retinal disorders brought on by diabetes. 
The two most common types of diabetic retinopathy are:

Nonproliferative retinopathy
 
Nonproliferative retinopathy is the most common type of retinopathy.  This condition exists when high blood sugar levels cause the tiny capillaries to become clogged and expand.  This expansion forms pouches out of the blood vessels, and weaken the walls of the capillary.  Vision loss isn’t common at this point, but the weakening of the vessel walls can cause fluid to pass through the walls into the retina.  If this fluid reaches the part of the retina where focusing happens, called the macula, then vision loss can occur.  Called macula edema, a person’s vision will become blurry and vision loss will occur without treatment.

Nonproliferative retinopathy doesn’t require treatment, only monitoring.  But when the condition progresses to the stage of macula edema, then treatment is essential.  The good news is that there are several safe and effective treatment options that can stop and even reverse any potential vision loss.  

Proliferative retinopathy

Proliferative retinopathy
 exists when the retinopathy becomes so bad that the tiny blood vessels in the back of the eye are completely blocked, and no blood can pass through.  When this occurs, you body’s response is to create new blood vessels to continue to supply blood to the retina.  The problem is that these new blood vessels are often very weak, and are susceptible to hemorrhaging and leaking blood into the retina, causing vision damage.  These new blood vessels may also create new scar tissue, which could lead to retinal shifting or even detachment, once the scar tissue dissipates.
With both versions of retinopathy, symptoms are not present.  Often times it isn’t until vision loss has occurred the patient notice something is wrong.  However, the disease is treatable, and easily detectable through general eye exams.  That is why it is important that anyone with diabetes maintains a routine exam schedule to ensure lasting eye health.

Am I at risk for retinopathy?

Once you have been diagnosed with diabetes, you are at some risk.  The risk for developing the disease increases the higher your blood sugar levels are, as well as time with the disease.  Most people with diabetes do not develop any form of retinopathy for at least ten years, but any individual with diabetes should hold fast to a yearly eye exam schedule starting the moment they are diagnosed. 

Even if you do have diabetes, there are several things you can do to decrease your risk of ever developing the disease, such as:

• Controlling your blood sugar levels
• Monitoring your blood pressure
• Eating healthy
• Exercising

These are common healthy behaviors that we all should engage in, but they become even more important when you consider the effect it could have on your vision.

How is diabetic retinopathy treated?

If detected early, treatment for retinopathy is extremely successful at stopping and reversing any potential vision loss.  But the key once again is early detection. The sooner retinopathy is diagnosed; the more likely treatment will succeed.
Diabetic retinopathy is most commonly treated with laser photocoagulation.  In this procedure, your surgeon uses a laser beam to seal off leaking blood vessels, and burn off the development of new vessels.  The procedure is fairly simple, and painless because the retina doesn’t contain any nerve endings.  You may experience some blurry vision for a few days afterwards, but the end result should be the stoppage of any vision loss. 

A procedure called a vitrectomy may be performed if retinopathy has progressed to the point where blood has leaked into the eye.  This procedure manually removes the blood from the eye, and attempts to repair any shift or detachment in the retina.  The procedure is very successful at restoring vision when only blood removal is needed.  However, any attempt at reattachment of the retina is less successful, with only about half of the cases resulting in restored vision. 

Can I prevent diabetic eye problems?

The most obvious prevention to any diabetic eye disease is to lead a healthy lifestyle that prevents the development of diabetes in the first place.  That means not smoking, maintaining a healthy weight, and exercising regularly.
If you do have diabetes, then maintaining strict control of blood sugar and blood pressure levels through diet, exercise and medication is the surest way to decrease the risk associated with developing any diabetes related eye conditions.

Finally, maintaining, at a minimum, yearly eye exams with a diabetic eye care specialist is extremely important in that if you should develop any diabetic eye disease, it is detected at it’s earliest stage and treatment can begin immediately to ensure your vision stays normal for life. 

If you would have diabetes and have not received an eye exam in the last year, schedule one today with the Rocky Mountain Ophthalmology.  We are experts at monitoring and treatment of all diabetic eye conditions, and will provide you with the care you need to make certain your vision never comes at risk.