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4 Ways Diabetes Could Lead to Blindness by Kayla Akers, O.D.

March 8, 2020

Dr. Akers is an optometrist and ocular disease specialist at the Marietta Eye Clinic.

More than 30.3 million adults in the United States have diabetes, according to the Centers for Disease Control and Prevention (CDC). The CDC also indicates that 84.1 million Americans have prediabetes, though non-treatment of prediabetes often leads to type 2 diabetes within 5 years. In addition to affecting blood sugar levels, diabetes can also have devastating effects on your eyes.

What Does Diabetes Have to Do with Eye Disease?

Diabetes is a disease that interrupts the body’s ability to produce or use insulin effectively to control blood sugar (glucose) levels. When elevated for prolonged periods of time, high blood sugar can cause damage in many parts of the body. Diabetes can damage the heart, kidneys, and blood vessels – including blood vessels in the eyes. Damage to these blood vessels is what causes diabetes-related vision loss.

How Can You Prevent Vision Loss?

The key to preventing permanent vision loss is early detection. The CDC states that about 90% of vision loss due to diabetes can be prevented. Regular comprehensive eye exams are integral to catching eye diabetes-related eye disease. Comprehensive eye exams should occur prior to the onset of vision loss and should be performed annually. Studies have shown that up to 60% of diabetes patients do not get eye exams as often as recommended, putting them at a much higher risk of permanent partial or full vision loss.

Eye Diseases Caused by Diabetes

Diabetic eye disease is a blanket term for specific diabetes-related eye diseases. Both type 1 and type 2 diabetes increase the risk of many eye conditions.

The eye diseases most commonly associated with diabetes are:

  • Diabetic retinopathy — Diabetic retinopathy occurs when blood vessels in the retina swell, leak, or close. New blood vessels may also grow on the surface of the retina. Risk of diabetic retinopathy increases the longer a person lives with diabetes.
  • Diabetic macular edema — Diabetic macular edema occurs when fluid builds up on the retina, causing swelling and blurry vision. This condition can lead to permanent vision loss.
  • Cataracts — Cataract is a clouding of the natural lens in your eye that causes many types of vision disturbance including double vision and poor night vision. The excess blood sugar from diabetes can exacerbate the progression of cataracts.
  • Glaucoma — Glaucoma is a group of diseases that cause damage to the optic nerve, which carries signals from the eye to the brain. The risk of developing glaucoma doubles with diabetes.

General Guidelines for Living with Diabetes

Those with diabetes should follow the instructions of their eye care provider to avoid permanent vision loss.

Here are some general guidelines to follow:

  • If you have type 1 diabetes, you should have annual screenings for diabetic retinopathy beginning immediately upon diagnosis.
  • If you have type 2 diabetes, 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.

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.

More About Ocular Disease Specialist Kayla Akers, O.D.

Dr. Akers is a primary care optometrist with the Marietta Eye Clinic. She also specializes in ocular diseases and works with eye surgeons to provide ocular surgery co-management. She serves the Kennestone and Towne Lake offices. Dr. Akers received her doctor of optometry from the University of Alabama School of Optometry. She completed an ocular disease residency with the Jesse Brown VA Medical Center and a low vision rehabilitation residency with the Edward Hines Jr. VA Hospital Blind Rehabilitation Center. She is a member of the American Academy of Optometry. Read more about Dr. Akers here.

References and Additional Resources

The American Academy of Ophthalmology (AAO) is the world’s largest association of eye physicians and surgeons. It describes itself 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.” Its website is a great resource to learn more about how to care for your eyes.

The American Optometric Association (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

https://www.aao.org/eye-health/diseases/diabetic-eye-disease

New CDC report: More than 100 million Americans have diabetes or prediabetes

https://www.cdc.gov/media/releases/2017/p0718-diabetes-report.html

Screening for Diabetic Retinopathy

https://www.aao.org/clinical-statement/screening-diabetic-retinopathy

Diabetic Retinopathy PPP – Updated 2017

https://www.aao.org/preferred-practice-pattern/diabetic-retinopathy-ppp-updated-2017

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