4 Blinding Eye Diseases Caused by Diabetes by Brittany McNeely, OD

According to the Centers for Disease Control (CDC), more than 100 million adults living in the United States live with diabetes or pre-diabetes. The CDC released a report indicating 30.3 million Americans, nearly 10%, have diabetes. The report also indicated 84.1 million have prediabetes and non-treatment of prediabetes often leads to type 2 diabetes within five years.

What is Diabetes?

Diabetes is a disease affecting the body’s ability to produce or use insulin effectively to control blood sugar (glucose) levels. Glucose, when elevated for prolonged periods of time, can cause damage in many parts of the body. Diabetes can damage the heart, kidneys, and blood vessels – including important, small blood vessels in the eyes. This damage leads to vision loss and is highly preventable. The CDC states about 90% of vision loss from diabetes can be prevented.

How do You Prevent Vision Loss?

The key to prevention of permanent vision loss is early detection. Annual eye exams are absolutely critical to catching eye disease related to diabetes. Comprehensive eye exams need to occur prior to the onset of vision loss. Studies have show up to 60% of diabetes patients are not getting eye exams at the frequency recommended by the medical community, placing themselves at a much higher risk of permanent, partial or full vision loss.

Eye Problems and Diseases Caused by Diabetes

Diabetic eye disease is a blanket term for specific diseases or problems arising from diabetes, both type 1 and type 2 diabetes. Diabetes increases the risk of many conditions including four common eye diseases: diabetic retinopathy, diabetic macular edema, cataract, and glaucoma. Diabetic retinopathy occurs when blood vessels in the retina swell, leak, or completely close. Additionally, new blood vessels might grow on the surface of the retina. Risk of diabetic retinopathy increases the longer a person lives with diabetes. Diabetic macular edema occurs when fluid builds up on the retina which causes swelling and blurry vision. This condition can lead to permanent vision loss. Cataract is a clouding of the natural lens in your eye which causes many types of vision disturbance including cloudiness, double vision, and poor night vision. The excess blood sugar from diabetes causes cataracts to form. Glaucoma is a group of diseases which cause damage to the optic nerve bringing signals from the eye to the brain. The damage caused by these diseases leads to irreversible loss of vision and the risk of developing glaucoma doubles with diabetes.

Eye Exam Guidelines While Living with Diabetes

People living with diabetes should strictly follow the instructions of their eye care provider to effectively combat permanent vision loss. Here are some key guidelines to follow:

• If you have Type 1 diabetes, then you should have annual screenings for diabetic retinopathy beginning immediately upon diagnosis.
• If you have Type 2 diabetes, then you should have a prompt examination at the time of diagnosis and at least yearly examinations after the first examination.

Women who develop gestational diabetes do not require an eye examination during pregnancy and do not appear to be at increased risk of developing diabetic retinopathy during pregnancy. However, patients with diabetes who become pregnant should be examined early in the course of the pregnancy.

Watch Your Sugar to Protect Your Eyes

Maintaining near-normal glucose levels and near-normal blood pressure lowers the risk of retinopathy developing and progressing. As a result, you should keep at the top of your mind the importance of maintaining good glycosylated hemoglobin levels, serum lipids, and blood pressure.

References and Additional Resources

The American Academy of Ophthalmology (AAO) (https://www.aao.org/eye-health) is the world’s largest association of eye physicians and surgeons. They describe themselves as a “global community of 32,000 medical doctors who protect sight and empower lives by setting the standards for ophthalmic education and advocating for our patients and the public.”  Their website is a great resource to learn more about how to care for your eyes.

The American Optometric Association (AOA) (https://www.aoa.org/) The AOA describes itself as the leading authority on quality care and an advocate for our nation’s health, representing more than 44,000 doctors of optometry (O.D.), optometric professionals, and optometry students.

Diabetic Eye Disease at https://www.aao.org/eye-health/diseases/diabetic-eye-disease.

New CDC report: More than 100 million Americans have diabetes or prediabetes at https://www.cdc.gov/media/releases/2017/p0718-diabetes-report.html.

Screening for Diabetic Retinopathy – 2014 at https://www.aao.org/clinical-statement/screening-diabetic-retinopathy.

Diabetic Retinopathy PPP – Updated 2017 at https://www.aao.org/preferred-practice-pattern/diabetic-retinopathy-ppp-updated-2017.