Top Ways Diabetes Might Hurt Your Eyes and How to Protect Them

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. But there are many ways to manage your health proactively.

Diabetes can greatly influence your eye health and vision. Managing diabetes can help protect your eyes. With diabetes, too much glucose (sugar) can build up in the bloodstream, damaging the blood vessels, nerves and various tissues, including in the eyes. In fact, blurred vision is a common symptom of diabetes, even in those with Type 2 diabetes.

Diabetic eye disease covers many conditions that can change over time. As diabetes affects 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.” Patients will experience tearing and burning in the eyes. It may seem contradictory, but 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, so the body attempts to make “reflex” tears. The imbalance causes the patient discomfort.

Deeper inside the eye is the “lens.” Over time, the eye’s lens will 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 initially help, but surgery may eventually be needed.

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, turning the light into images for our brain. 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. A problem in this focal area may reduce eyesight.

When diabetes affects the retina and macula, it can also cause tiny pinpoint dots of blood within the retina. While a few mild bleeding spots are not usually harmful, they still need an examination with an eye doctor (ophthalmologist). If the bleeding areas spread to the macula, the vision starts to decline, requiring intervention.

How is diabetic eye disease treated?

There are several interventions provided for diabetic macular changes. Scans in our Ochsner ophthalmology clinic will detect swelling and fluid within the macula.

When swelling is identified, we typically start a series of multiple monthly injections of medication into the eye (with much anesthesia for the patient’s comfort) 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, advanced damage may 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. Routines screening by an ophthalmologist help keep diabetes and A1C well controlled. Prompt treatment with continued follow-up can be the key to preventing blindness. The good news is that being aware of the symptoms can empower patients to take preventive measures and enjoy better health. 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 Type 2 diabetes. As a member of the program, you’ll have the support of a panel of professional health coaches and a licensed clinician, who will provide lifestyle support, encourage you to stay up to date with annual screenings and manage your medications. Easy digital tools allow you to take care of yourself at home, limiting extra trips to the clinic.

The Ochsner Digital Medicine program also helps to manage high blood pressure and weight.

By joining Digital Medicine, you are taking a significant step to be more proactive in your Type 2 diabetes management. Keeping your blood sugar under control is an important aspect of living a healthy lifestyle and enjoying the things you love — and seeing things more clearly. Enrollment is highly encouraged.