Diabetes and the Eye

Diabetes is a disease that prevents your body from making or using insulin to break down sugar in your bloodstream.

How Does Diabetes Affect The Eye?
Diabetes and its complications can affect many parts of the eye. Diabetes can cause changes in nearsightedness, farsightedness and premature presbyopia (the inability to focus on close objects). It can result in cataracts, glaucoma, a lack of eye muscle coordination (strabismus) and decreased corneal sensitivity.

Visual symptoms of diabetes include fluctuating or blurring of vision, occasional double vision, loss of visual field and flashes and floaters within the eyes. Sometimes these early signs of diabetes are detected in a thorough optometric examination. The most serious eye problem associated with diabetes is diabetic retinopathy.

What Is Retinopathy?
Diabetic retinopathy occurs when there is a weakening or swelling of the tiny blood vessels in the retina of your eye, resulting in blood leakage, the growth of new blood vessels and other changes. If diabetic retinopathy is left untreated, blindness can result. Several factors that increase the risk of developing retinopathy include smoking, high blood pressure, drinking alcohol and pregnancy.

Diabetic Retinopathy Damages the Retina
When blood sugar levels become too high, blood vessels in the retina weaken. The blood and fluid inside the blood vessels begins to leak out. New blood vessels grow, but they are fragile and may leak fluid. This causes the retina to swell and become deprived of nutrients and oxygen, causing vision loss and possibly blindness. Please see the images on this page.

Can Vision Loss From Diabetes Be Prevented?

Yes, in a routine eye examination, your optometrist can diagnose potential vision threatening changes in your eye that may be treated to prevent blindness. However, once damage has occurred, the effects are usually permanent. It is important to control your diabetes as much as possible to minimize your risk of developing retinopathy.

How Is Diabetic Retinopathy Treated?
n the early stages diabetic retinopathy can be treated with laser therapy. A bright beam of light is focused on the retina, causing a burn which seals off leaking blood vessels. In other cases, surgery inside the eye may be necessary. Early detection of diabetic retinopathy is crucial.

How Can Diabetes Related Eye Problems Be Prevented?
Monitor and maintain control of your diabetes. See your physician regularly and follow instructions about diet, exercise and medication. See your optometrist, for a thorough eye examination when you are first diagnosed as a diabetic, at least annually thereafter, and more frequently if recommended.

There May Be No Warning

Some people receive no warning signs of diabetic eye disease, but sometimes the following symptoms develop:

-> Blurry vision
-> Double vision
-> Rings, flashing lights, or blank spots
-> Dark spots or floaters
-> Pain or pressure in the eyes
-> Trouble seeing out of the corners of your eyes

Also, have your doctor regularly check your cholesterol and blood fat (triglyceride) levels.

People with Diabetes May Develop Glaucoma
People with diabetes are at very high risk of People with diabetes are 40% more likely to suffer from glaucoma(increased pressures within the eyeball – can actually destroy the vision) than people without diabetes. The longer someone has had diabetes, the more common glaucoma is. Risk also increases with age.

People with Diabetes May Develop Cataracts Early

If you have diabetes, your chances of developing cataracts is increased. People with diabetes tend to get cataracts at a younger age and have them progress faster.

Laser Surgery Slows the Progression of Diabetic Eye Disease
Laser surgery can be used to shrink the abnormal blood vessels or seal leaking blood vessels in the retina. The risk of vision loss from diabetic retinopathy is greatly reduced in some people after having laser surgery. BUT every laser session may leave some scar on retina, so it is a trade off ! You allow some vision loss to prevent bigger losses !

What is diabetic Nephropathy?
Nephropathy is the deterioration of the kidneys. The final stage of nephropathy is called end-stage renal disease, or ESRD.

Diabetes is the most common cause of ESRD, accounting for more than 44 percent of cases. About 20 million people in the US have diabetes, and more than 44,000 people have ESRD as a result of diabetes. Both type 1 and type 2 diabetes can lead to diabetic nephropathy, although type 1 is more likely to lead to ESRD.

There are five stages of diabetic nephropathy, or deterioration of the kidneys. The fifth stage is ESRD. Progress from one stage to the next can take many years, with 23 years being the average length of time to reach stage five.

What causes diabetic nephropathy?

Hypertension, or high blood pressure, is a complication of diabetes that is believed to contribute most directly to diabetic nephropathy. Hypertension is believed to be both the cause of diabetic nephropathy, as well as the result of damage that is created by the disease. As kidney disease progresses, physical changes in the kidneys often lead to increased blood pressure.

Uncontrolled hypertension can make the progress toward stage five diabetic nephropathy occur more rapidly.

Can diabetic nephropathy be prevented?
The onset and progression of diabetic nephropathy can be slowed by intensive management of diabetes and its symptoms, including taking medications to lower blood pressure.

Treatment for diabetic nephropathy:
Specific treatment for diabetic nephropathy will be determined by your physician based on:

your age, overall health, and medical history extent of the disease
your tolerance for specific medications, procedures, or therapies
expectations for the course of the disease
your opinion or preference
Treatment may include any, or a combination of, the following:
proper diet

strict monitoring and controlling of blood glucose levels, often with medication and insulin injections medication (to lower blood pressure)
Treatment for ESRD often initially includes dialysis to cleanse the blood, and, eventually, kidney transplantation.

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