Diabetes & the Eye

The month of November has been established as National Diabetes Month and Diabetic Eye Disease Month as an effort to educate more Americans about the types, symptoms, and risks of diabetes, since it has become an epidemic in the United States. According to the National Eye Institute, in the past 30 years, the number of adults diagnosed with diabetes has increased by more than 150%. That means more than 30 million people in the United States have diabetes… but what exactly is it?

Diabetes is a disease in which the glucose levels in a person’s blood (also known as blood sugar) is high. Blood glucose is the body’s main source of energy, which comes from the food one eats. The glucose from food gets into the body’s cells with the help of insulin, a hormone that the body produces. However, the body of someone with diabetes may not make enough insulin or any insulin at all, or the body is unable to use insulin well. As a result, glucose stays in the blood instead of moving into cells for energy. High glucose levels in blood can cause damage to one’s heart, kidneys, feet, ears, and eyes. The good news is that diabetes can be managed through a healthy diet, regular exercise, and taking medications as prescribed, helping many people with diabetes live long and healthy lives.

Diabetes can damage a person’s eyes to the point of vision loss or even blindness. It can affect anyone with type 1 or type 2 diabetes, and the longer a person has diabetes, the higher the risk of developing a diabetic eye disease. An alarming statistic is that half of all people with diabetes do not get comprehensive eye exams. If you have diabetes, a yearly comprehensive eye exam is necessary in order to detect a diabetic eye disease early enough to treat and manage it. There are two forms of diabetic eye diseases:

  • Diabetic retinopathy – Occurs when small blood vessels leak and bleed in the retina or when new blood vessels row on the surface of the retina when bleed into the eye and block vision. The retina is the layer of light-sensitive tissue in the back of the eye that acts like the film in the camera of the eye to help you see. This is the leading cause of blindness in American adults, and it affects over one in four people living with diabetes.
  • Diabetic macular edema – A swelling that can occur with retinopathy. It occurs when the small blood vessels in the center of the retina, called the macula, become leaky and cause the retina to swell. It can cause your vision to become blurry.

In addition to the two forms of diabetic eye diseases, there are all two other eye diseases that are common among people living with diabetes:

  • Cataract – The clouding of the lens in the eye, which can cause vision to become blurry and colors to become dull. Cataracts are generally treatable with surgery that can help restore your vision. Aside from aging, diabetes is the most common risk factor for cataract.
  • Glaucoma – Causes damage to the optic nerve and possible loss of side vision, usually caused by an increase in fluid pressure inside the eye. Vision loss will start without any noticeable symptoms leading to tunnel vision. Once vision is lost to glaucoma, it cannot be restored, hence it being known as “the silent thief of sight.” Medications and surgery can delay progression of this disease.

To help prevent vision loss and blindness, it is important for people with diabetes to have a comprehensive eye exam at least once a year. During a comprehensive eye exam, drops are placed in the eyes to widen (or dilate) the pupils. A special lens is then used to look at the retina in the back of the eye to check for damage to the blood vessels or anything else that might be unusual.

Diabetic retinopathy is the most common of the diabetic eye diseases, and it is also the leading cause of blindness in adults aged 20 to 74 with diabetes. According to the National Eye Institute, diabetic retinopathy currently affects about 7.7 million Americans, but that number is expected to increase to more than 14.8 million Americans by just 2030. Keeping diabetes in control is key to slowing vision complications such as diabetic retinopathy. There are important steps that people with diabetes can add to their self-management routine to keep their health on TRACK:

  • T – Take your medications as prescribed.
  • R – Reach and maintain a healthy weight.
  • A – Add physical activity to your daily routine.
  • C – Control your diabetes ABCs – A1C. blood pressure, and cholesterol levels.
  • K – Kick the smoking habit.

You can’t feel it. You can’t see it… until it’s too late. In the early stages of the disease, there are typically no symptoms or pain, then as the disease advances and some blood vessels get weak and leak fluid or bleed, vision may start to blur. Though there are typically no symptoms in the early stages of the diabetic eye diseases, a yearly comprehensive eye exam will be able to catch the disease early so that it can be treated before noticeable vision loss. Early detection, timely treatment, and appropriate follow-up care can reduce a person’s risk for severe vision loss from diabetic eye disease by 95%. Living with diabetes can be challenging, but you don’t have to lose your vision or go blind because of it.

Keeping an eye on your eye health is even more essential for those with diabetes. If you or a loved one has diabetes and needs to schedule a comprehensive eye exam, please give one of Coastal Eye Group’s five offices a call to set up an appointment.