Here Are the Top Ways Diabetes Might Hurt Your Vision

How does diabetes affect the eyes?

From the head to the toes, diabetes can affect the body in multiple ways, leading to significant impacts on a patient’s health.

Many people may not realize that diabetes greatly influences eye health and vision. With diabetes, too much glucose (sugar) can build up in the bloodstream, leading to damage to blood vessels, nerves and various tissues, including the eyes. In fact, blurred vision is a common symptom of diabetes, even in those with Type 2 diabetes.

Diabetic eye disease includes a broad collection of conditions that can evolve throughout one’s life. As the effects of diabetes involve areas from the front to the back of the eye, it is helpful to think of the eye as a camera with multiple parts. Diabetes can cause the clear front part of the eye, or cornea, to demonstrate severe symptoms of “dry eye,” or “keratopathy.” Typically, patients will experience tearing and burning in the eyes, and — while it may seem contradictory — a “dry” eye will likely be wet and watery. This is because the body produces unhealthy tears to try to lubricate itself. The natural balance of water and oil is lost in this situation, as the body attempts to make “reflex” tears. These tears leave the patient feeling like their eyes are dry, watery or burning.

The area deeper inside the eye is known as the “lens.” With time, the eye’s lens will gradually start to age and slowly become a cataract. This is a natural aging process, and it is quite common — even dogs and horses get cataracts. However, if you have diabetes, there is a higher chance that you may develop early changes in your natural lens that lead to a cataract sooner than someone else your age who does not have diabetes. The cataract may cause night vision issues and glare. When diagnosed with cataracts, glasses will typically help for a time until the cataract must be addressed with surgery.

More complex forms of diabetic eye disease impact the eye’s retina, leading to diabetic retinopathy. The retina is essentially the film in the camera; it allows our brain to change the light into images. The center part of the retina, the macula, is one of the most vital areas in the eye. This is where light focuses, like a magnifying glass focusing upon one central point. Any abnormality in this focal area may decrease vision.

When diabetes affects the retina and macula, it can also cause tiny pinpoint dots of blood within the retina. Having a few mild bleeding spots is not dangerous, but still requires routine examination with an ophthalmologist. However, when the bleeding areas spread to the macula, the vision starts to decline, and an intervention may be necessary.

How is diabetic eye disease treated?

There are several interventions provided for diabetic macular changes. Scans in our ophthalmology clinic will show swelling and fluid within the macula. When this occurs, we typically start a series of multiple monthly injections of medication into the eye (with much anesthesia) to help resolve the swelling. These areas of fluid can severely impact vision, and routine injections of medications target bleeding and leaky blood vessels. Keeping one’s A1C and blood sugars under better control can help to reduce this type of damage to the retina. However, at times, the damage may already be too far advanced and require continued therapy.

At times, diabetes can progress beyond just swelling in the eye. Poorly controlled blood sugar can lead to abnormal blood vessels, which grow from the bleeding spots within the retina. These abnormal blood vessels grow because the eye is starving of normal nutrients and blood flow due to uncontrolled diabetes. This is critical and can cause the eye to fill with blood or even lead to retinal detachment and blindness. In these situations, we further treat the eye with injections of medication or, possibly, laser therapy to stop abnormal bleeding. Sometimes these treatments are not enough, and we must resort to surgery.

Importance of screenings

We highly stress that those living with diabetes take vision loss seriously. Get screened by an ophthalmologist routinely and keep diabetes and A1C well controlled. Urgent treatment with continued follow-up may be the only thing standing between an individual and possible blindness. Schedule an ophthalmology appointment with Ochsner.

Have you been diagnosed with Type 2 diabetes? Enroll in the Ochsner Digital Medicine program to control your condition and prevent further side effects of diabetes. As a member of the program, you’ll have the support of a professional health coach and licensed clinician, who will encourage you to stay up to date with annual screenings, manage your medications and provide lifestyle support. Easy digital tools allow you to take care of yourself at home, limiting extra trips to the clinic.