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Diabetic Eye Disease

Diabetic eye disease is a group of eye problems that can affect people with diabetes.
Over time, diabetes can cause damage to your eyes that can lead to poor vision or even blindness. But you can take steps to prevent diabetic eye disease, or keep it from getting worse, by taking care of your diabetes.

Often, there are no warning signs of diabetic eye disease or vision loss when damage first develops. A full, dilated eye exam helps your doctor find and treat eye problems early—often before much vision loss can occur.

How does diabetes affect the eyes?

In the short term, you are not likely to have vision loss from high blood glucose. People sometimes have blurry vision for a few days or weeks when they’re changing their diabetes care plan or medicines. High glucose can change fluid levels or cause swelling in the tissues of your eyes that help you to focus, causing blurred vision. This type of blurry vision is temporary and goes away when your glucose level gets closer to normal.

If your blood glucose stays high over time, it can damage the tiny blood vessels in the back of your eyes. This damage can begin during prediabetes, when blood glucose is higher than normal, but not high enough for you to be diagnosed with diabetes.
Damaged blood vessels may leak fluid and cause swelling. New, weak blood vessels may also begin to grow. These blood vessels can bleed into the middle part of the eye, lead to scarring, or cause dangerously high pressure inside your eye.1

Diabetic retinopathy

Diabetic retinopathy is the most well-known diabetes eye complication and can lead to blindness and vision problems. Diabetic retinopathy progresses through three clear stages: background neuropathy, maculopathy and proliferative retinopathy.2

Glaucoma

Glaucoma is a group of eye diseases that can damage the optic nerve—the bundle of nerves that connects the eye to the brain. Diabetes doubles the chances of having glaucoma, which can lead to vision loss and blindness if not treated early.1

Cataracts

The lenses within our eyes are clear structures that help provide sharp vision—but they tend to become cloudy as we age. People with diabetes are more likely to develop cloudy lenses, called cataracts. People with diabetes can develop cataracts at an earlier age than people without diabetes. Researchers think that high glucose levels cause deposits to build up in the lenses of your eyes.1

Who is more likely to develop diabetic eye disease?

Anyone with diabetes can develop diabetic eye disease. Your risk is greater with

  • high blood glucose that is not treated
  • high blood pressure that is not treated

High blood cholesterol and smoking may also raise your risk for diabetic eye disease. If you have diabetes and become pregnant, you can develop eye problems very quickly during your pregnancy. If you already have some diabetic retinopathy, it can get worse during pregnancy. Changes that help your body support a growing baby may put stress on the blood vessels in your eyes.

When should I see a doctor right away?

Call a doctor right away if you notice sudden changes to your vision, including flashes of light or many more spots (floaters) than usual. You also should see a doctor right away if it looks like a curtain is pulled over your eyes. These changes in your sight can be symptoms of a detached retina, which is a medical emergency.

References:
1
Diabetic Eye Disease | NIDDK [Internet]. National Institute of Diabetes and Digestive and Kidney Diseases. 2021 [cited 12 January 2021]. Available from: https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/diabetic-eye-disease
2 Diabetic retinopathy [Internet]. Diabetes. 2021 [cited 12 January 2021]. Available from: https://www.diabetes.co.uk/diabetes-complications/eye-problems.html

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