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Living with diabetes means constantly monitoring for complications. As a condition, diabetes has the potential to lead to a number of further health problems. When your blood sugar is too high for long periods, it can damage different parts of your body. This could be your heart, kidney, nerves, skin or even your eyes. If it is not managed, diabetes can lead to a few different eye conditions that can cause vision problems or even blindness.
How Does Diabetes Affect Your Eyes?
Your eyes rely on tiny blood vessels to supply them with oxygen and nutrients. Arteries bring blood to the eyes, and veins carry the deoxygenated supply back to the heart. The ophthalmic artery is the primary channel all this blood flows through, which itself is divided into the orbital and optical group. The orbital group supplies the orbit and related structures with blood, while the optical group supplies the eye itself.
The ophthalmic artery branches off into a number of smaller arteries. There are an additional five in the orbital group, and four in the optical group. Knowing the names and functions of all of these is not important - what matters is you understand just how many of these arteries there are! There is a lot of blood, relative to its size, flowing through your eyes. That is every second of every day of your life. With diabetes, high blood sugar can damage these blood vessels. An issue in any one channel can lead to problems in different parts of the eye. The main areas that are affected are:
- The Retina: The layer of tissue at the back of your eye that senses light and sends signals to your brain.
- The Macula: The central part of the retina that helps you see details clearly.
- The Lens: The part of the eye that focuses light so you can see sharp images.
- The Optic Nerve: The nerve that connects your eye to your brain.
When these parts of the eye are damaged, your vision can become blurry, distorted, or even lost completely. So, what are the most common diseases to watch for?
Diabetic Eye Diseases
Diabetic Retinopathy
Affecting almost 10 million Americans in 2021, diabetic retinopathy is where the blood vessels in the retina become weak, swell, and start to leak fluid. In more severe cases, new, abnormal blood vessels can actually grow on the retina. This can lead to serious vision problems. In the early stages, you may not notice any symptoms. But as the disease progresses, you might have:
- Blurry vision.
- Dark spots or floaters in your vision.
- Difficulty seeing at night.
- Vision loss.
If untreated, diabetic retinopathy can eventually cause blindness. Anyone with diabetes can get diabetic retinopathy, but the risk gets higher the longer you have diabetes, especially if your blood sugar is not well-controlled.
Diabetic Macular Edema (DME)
DME happens when the macula, the part of the retina responsible for sharp vision, swells because of fluid leaking from damaged blood vessels. Around 750,000 Americans have this condition, and it is only getting more common as a diagnosis. DME can cause:
- Blurred or wavy vision.
- Difficulty seeing fine details.
- Vision loss in the center of your vision.
DME usually happens in people who already have diabetic retinopathy.
Glaucoma
Glaucoma is a group of eye diseases that damage the optic nerve. This is often because of increased pressure inside the eye. The most common form is called open-angle glaucoma. However, diabetes can also lead to a rare type of glaucoma called neovascular glaucoma. This is where abnormal blood vessels grow on the iris, which is the colored part of the eye. This blocks fluid from draining the way it is supposed to. The most common symptoms of glaucoma are:
- Gradual vision loss, starting with peripheral vision.
- Eye pain.
- Redness in the eye.
- Halos around lights.
If untreated, glaucoma can eventually lead to blindness. People with diabetes are twice as likely to develop glaucoma than non-diabetics. If you have diabetes, make sure you are getting regular eye exams.
Cataracts
A cataract is when the lens in your eye becomes clouded. People with this condition describe it like they are looking through a frosty or fogged-up window. Most cataracts develop slowly over time and are common as you age. They do tend to develop earlier and progress faster in people with diabetes, however. Cataracts can cause:
- Cloudy or blurry vision.
- Sensitivity to bright lights.
- Difficulty seeing at night.
Cataracts can only be treated with surgery, where the cloudy lens is replaced with an artificial one. However, you can take steps to manage them as they start to develop! This can be through things like corrective lenses or brighter lights at home for reading.
How to Protect Your Eyes
Diabetes does increase your risk of getting eye problems. Fortunately, there are steps you can take to keep your eyes healthy!
Control Your Blood Sugar
All things diabetes eventually come back to your blood sugar levels. Keeping your blood sugar within your target range can help prevent or slow down eye damage. Talk to your doctor about managing your diabetes through diet, exercise and medication.
Monitor Blood Pressure and Cholesterol
High blood pressure and cholesterol can make diabetic eye diseases worse. Just like how blood sugar damages the blood vessels in your eye, high blood pressure does the same. This can go hand in hand with cholesterol. As cholesterol levels rise, so does blood pressure. Work with your doctor to keep these under control.
Stop Smoking
There have been a number of studies looking at how smoking affects vision. Besides the cardiovascular and other associated health risks, the results are clear - smoking damages your eyes. It affects your retina, lens and macula. Smoking puts you at a higher risk of developing cataracts and a condition called age-related macular degeneration. Stopping smoking is an important part of overall health.
Protect Your Eyes from the Sun
Ultraviolet rays from the sun can speed up the development of cataracts. Wearing sunglasses with UV protection can help, as well as taking regular breaks from direct sunlight. It is important to note that this does not mean avoiding the sun altogether! Being outside and enjoying the outdoors is important. But try to protect your skin and eyes from direct sunlight.
Get Regular Eye Exams
Even if your vision seems fine, it’s important to have an eye exam at least once a year. This allows your eye doctor to look for early signs of eye disease before you notice symptoms. Many of these conditions can start without you knowing! DME in particular is often called a silent disease.
When to See a Doctor
Some eye problems caused by diabetes can become emergencies. Call your eye doctor right away if you experience:
- Many new floaters (dark spots in your vision).
- Flashes or showers of sparkling light.
- A dark shadow over part of your vision.
- Sudden vision loss.
- Severe eye pain or redness.
These could be signs of a detached retina or another serious development that needs immediate treatment.
Diabetes can have a serious impact on your vision, but early detection and proper management can help protect your eyesight! By keeping your blood sugar, blood pressure, and cholesterol under control and getting regular eye exams, you can reduce your risk of vision problems. If you have diabetes, make your eye health a priority. Take steps today to keep your eyes healthy for the future.
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