Diabetes and Your Eyes by Dhanu Meleth, M.D.

Diabetes is a serious health condition and can cause diabetic eye disease. There are various types of diabetic eye disease and over time these eye diseases can lead to poor vision or even blindness. Patients with type 1, type 2, and gestational diabetes are at risk of developing diabetic eye disease, yet most of them do not get annual eye exams. One study found that more than half of diabetes patients over 40 do not have yearly exams. However, in 95% of cases, vision loss can be prevented with early detection of these diseases. 

Eye Diseases Related to Diabetes

Common eye problems that can result from diabetes include diabetic retinopathy, diabetic macular edema, cataracts, and glaucoma.  

Diabetic retinopathy occurs as a result of damage to blood vessels in the retina due to high blood sugar levels. Blood vessels in the eye may swell and leak or close completely, or damaged, fragile blood vessels may grow in the retina and bleed or cause scar tissue. 

Diabetic macular edema occurs when blood vessels in the retina leak. This leaking causes swelling in the macula, which may make objects appear blurry or colors appear faded. 

Cataracts can cause clouding of the lens when proteins in the eye start to break down, a process that may be sped up by high blood sugar. Cloudy lenses can prevent light from focusing in the retina, which may result in blurry vision, seeing double, light sensitivity, inability to see in dim lighting, or seeing faded colors. 

Healthy eyes maintain eye pressure by circulating a clear liquid called aqueous humor. Excess fluid drains from the eye through the drainage angle. Glaucoma results when a buildup of this fluid exerts pressure on the optic nerve and damages its nerve fibers, producing blind spots in a patient’s vision. 

Early Detection and Prevention

An important step in preventing vision loss you can take is early detection. Scheduling a dilated eye exam at least once a year can allow your ophthalmologist to look for signs of damage to your retina and optic nerve. Patients may not notice symptoms for years after an eye disease begins to develop. Many eye diseases are initially painless and cause little to no vision changes. 

You can also prevent vision loss and keep eye disease at bay by managing your overall health.  

• Controlling your blood sugar can prevent damage to blood vessels in your eye, slow down the breakdown of proteins, and prevent pressure on the eye that damages the optic nerve.  
• Maintaining healthy blood pressure and cholesterol levels can prevent diabetic eye diseases or limit their impact.  
• Avoid smoking. 
• Protect your eyes from the sun’s ultraviolet (UV) rays by wearing sunglasses or prescription glasses treated with a clear anti-UV coating.  
• Maintaining a healthy weight can prevent additional damage from diabetes.
• Treating sleep apnea can prevent additional damage from diabetes.

See Dr. Meleth’s Full Bio Here

Symptoms of Diabetic Eye Disease

Knowing the signs of diabetic eye disease can allow you to seek treatment and prevent further damage.  

Common symptoms include: 

• Increased spots or strings floating in vision, also known as floaters. 
• Blurry vision.
• Seeing faded or washed out colors. 
• Yellow vision. 
• Double vision. 
• Light sensitivity. 
• Inability to see at night or in dim lighting. 
• Blind spots.
• Complete vision loss.

What Can Patients Do After Being Diagnosed with an Eye Disease?

There are many options for patients who have been diagnosed with diabetic eye diseases.  

A few treatment options include: 

• Anti-VEGF treatments — Medication can be injected into the eye to reduce the production of abnormal blood vessels. 
• Steroid medication — Steroids in the form of eye drops, pills, or injections may be administered to prevent inflammation in the eye.
• Laser treatment — Laser treatment may be used to shrink blood vessels or seal off leaking blood vessels, or laser surgery may be used to help the drainage angle work better or help get fluid to the drainage angle.
• Vitrectomy — Bleeding or scar tissue may be removed surgically, or your doctor may repair or reattach your retina.

Take Charge of Your Vision

With the risks diabetes brings, the ophthalmologists at the Marietta Eye Clinic strongly encourage you to ensure you see an eye doctor (an optometrist or an ophthalmologist) to determine the frequency you need to see your eye care provider and to discuss any treatment options you need to consider. Preventative care and early intervention can help you keep the best vision possible for the longest time possible. Take action today to care for your eyes if you have diabetes.  

More About Retina Specialist Dhanu Meleth, M.D.

Known as Dhanu among his family and friends, Annal Dhananjayan Meleth was born in Kerala, India, but he admits with a chuckle it is difficult to answer the question of where he is from. This world traveler has lived in 26 different places. But most of his life was spent in India, England, Canada, and now the U.S. Dr. Meleth’s education and medical training have taken him on a meandering journey reaching from Québec, Canada, to Alabama, Washington, D.C., Texas, Australia, and now Atlanta, where his family resides. He spends some time every year teaching courses about medical and surgical management of diabetic retinopathy and provides charitable care for patients with advanced diabetic complications in various parts of the world. Read his full bio 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. 

What is Diabetic Retinopathy? 

https://www.aao.org/eye-health/diseases/what-is-diabetic-retinopathy 

What is Macular Edema? 

https://www.aao.org/eye-health/diseases/what-is-macular-edema 

What are Cataracts?  

https://www.aao.org/eye-health/diseases/what-are-cataracts 

What is Glaucoma? 

https://www.aao.org/eye-health/diseases/what-is-glaucoma 

Cardiovascular Health and its Connection to Eye Disease 

https://www.aao.org/eyenet/article/heart-eye-seeing-links 

Benefits of Controlling Diabetes for Eye Health 

https://www.nei.nih.gov/about/news-and-events/news/eye-study-underscores-long-lasting-benefits-controlling-diabetes 

Dilation in Eye Exams 

https://www.mayoclinic.org/tests-procedures/eye-exam/expert-answers/eye-dilation/faq-20057882