Diabetic Eye Complications
Diabetes is one of the fastest-growing epidemics, both at home and worldwide.
In fact, it’s estimated that 1 in 10 Americans (and 1 in 4 seniors) already lives with the disease, whether they know it yet or not. Globally there are more than 400 million people with diabetes—and that number is expected to get a lot bigger in the coming decades.
Whether you count yourself among them or not, you probably know that diabetes can lead to a number of systemic health problems, including heart disease, stroke, kidney disease, nerve damage, skin problems, and more.
But did you know that diabetes is also a major threat to your eye health? That it is, in fact, the leading cause of early blindness among working-age adults?
Let’s take a moment to learn a little bit more about how diabetes affects your eyes, and some of the conditions that can result.
Common Diabetic Eye Complications
The primary instigator for most diabetic eye complications has to do with circulation and blood vessels.
Over a period of time, elevated glucose levels in the bloodstream lead to inflammation and restricted circulation throughout the body—and the tiny blood vessels that supply your eyes are at especially high risk of damage.
The general term “diabetic eye disease” most commonly refers to a group of four eye conditions especially common for people with diabetes—diabetic retinopathy, diabetic macular edema (DME), cataracts, and glaucoma.
While these are obviously separate conditions which affect different aspects of your eyeball, all of them can lead to significant vision impairment, or even total blindness, if not addressed in a timely fashion.
Located at the back of the eyeball, the retina has a critical role to play in vision. Essentially, light that passes through the eyeball gets focused on the surface of the retina, which then “converts” that projected image into electrical impulses that can be sent to, and interpreted by, the brain.
If you have uncontrolled high blood sugar, however, the tiny blood vessels that supply the retina with oxygen and nutrients can become weakened, and start to leak fluid and blood into the retina. Initial symptoms can include blurry or fluctuating vision, impaired ability to see colors, or floaters.
In the more serious stages of diabetic retinopathy, the blood vessels may become totally blocked. When this happens, your body attempts to bypass the blockage by creating new blood vessels.
Unfortunately, if these blood vessels don’t form properly, the vessel walls may again be too weak and start to leak blood and fluid into the retina. Furthermore, scar tissue that results from this process can begin to build up inside the eye, which can damage the optic nerve or even cause the retina to detach entirely.
Diabetic retinopathy is the primary cause in about 12% of all new cases of blindness in the United States, and the leading cause of blindness among adults aged 20-64.
It’s also extremely common. About 1 in 3 people with diabetes older than 40 already has some signs of diabetic retinopathy. Catching and treating it early, however, can cut your risk of developing the most serious complications by more than 90 percent.
Diabetic Macular Edema
Diabetic macular edema (DME) is one of the most serious potential complications of diabetic retinopathy, and can actually occur at any stage of the disease—including relatively early on.
The retina itself is divided into different regions, one of which is the macula. This is a small but critically important oval-shaped region right near the center of the back of the eye, and it’s responsible for providing sharp, high-detail, highly color-accurate central vision during daytime light conditions.
If the macula starts to swell with fluid due to diabetic retinopathy, it becomes difficult-to-impossible to clearly focus your vision, impairing tasks such as reading or driving. Double vision, blurry vision, and a sudden increase in “floaters” are very common symptoms.
Cataracts, it should be said, are not exclusively associated with diabetes. In fact, given enough time, pretty much everyone will develop cataracts to some degree, regardless of their physical health. It’s just a natural consequence of aging.
That being said, those with diabetes are significantly more likely to develop more serious cataracts at younger ages, and the cataracts are likely to progress faster—although the reasons why are not fully understood.
In this condition, the flexible proteins that make up the lens of your eye start to degrade and clump together, which in turn makes the lens thicker and cloudier. The result is cloudy, blurry, and dim vision that may begin in one spot, but slowly get worse and cover a larger percentage of your visual field.
As with cataracts, glaucoma is not exclusively associated with diabetes. But glaucoma is a possible complication of diabetic retinopathy, and people with diabetes are overall twice as likely to develop the condition than those without.
The term “glaucoma” actually can refer to any of a group of conditions that involve damage to the optic nerve, which directly connects to the retina and carries the visual information it processes directly to the brain.
Most often, this damage is caused by pressure buildup within the eye. The inflammation associated with diabetes can be at least partially responsible for excess fluid leaking into the eye, as well as drainage pathways becoming blocked.
Open-angle glaucoma, which is the type that is most closely associated with diabetes, often results in patchy blind spots that can appear in either peripheral or central vision. More advanced cases may cause tunnel vision, and eventually blindness.
Protect Your Eyes if You Have Diabetes
Your eyes are far too precious and irreplaceable a resource to lose, especially to preventable diseases. And while there’s currently no known cure for diabetes, properly regulating your blood sugar levels and getting routine preventative checkups can drastically reduce your risk of major issues with your long-term eye health.
In addition to working closely with your general physician to implement a diabetic management program—and of course, seeing your podiatrist at least yearly for preventative foot care—we also strongly encourage anyone with diabetes to visit their eye doctor more frequently. For example, come see us every 6-12 months, rather than every 1-2 years.
Aside from providing the same comprehensive eye exam we recommend for all patients, we also strongly recommend retinal photography to our diabetic patients. This allows us to establish a “baseline” to better track subtle changes to the appearance and health of the retina over time.
Finally, if you ever notice any changes in your vision—whether they happen suddenly or develop slowly over a long period of time—contact us as soon as you can so we can perform an evaluation. Quick action is the best way to prevent long-term damage to your eyes and maintain healthy vision!
To schedule an appointment with Dr. Zuraida Zainalabidin at Tucson Eye Institute, please call our office today at (520) 585-5717.
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8:00AM - 5:00PM
By Appointment Only:
First Saturday of the month from 8:00AM - 2:00PM