Diabetes: How to Protect Your Vision by Kayla Akers, O.D.

March 8, 2020

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

The Centers for Disease Control and Prevention (CDC) reports that as of 2015, 30.3 million Americans, or 9.4% of the population, are living with diabetes. An additional 84.1 million have prediabetes, which if left untreated, can lead to type 2 diabetes. Although nearly 1 in 4 adults with diabetes don’t even know they have it, diabetes is the leading cause of blindness for adults ages 20-74 in the United States. Fortunately, the CDC also states that around 90% of diabetes-related vision loss can be prevented if caught early.

What is Diabetic Retinopathy?

Diabetic retinopathy is a disease of the retina found in patients of either type 1 or type 2 diabetes. High glucose levels (or blood sugar) cause damage to blood vessels in the eye, leading to permanent partial or complete vision loss.

There are two stages of diabetic retinopathy:

  • Non-proliferative diabetic retinopathy (NPDR): In the earlier stage of diabetic retinopathy, blood vessels in the eye close off (macular ischemia) or leak (macula edema).
  • Proliferative diabetic retinopathy (PDR): In more advanced diabetic retinopathy, the retina begins to grow new blood vessels. These new blood vessels are very fragile and can burst and bleed. Also, scar tissue can lead to other problems with the macula or retinal detachment.

What are the Signs of Diabetic Retinopathy?

People with diabetic retinopathy often don’t notice symptoms in the early stages or don’t take them seriously. Because the retina is located at the back of the eye, there are no visible symptoms.

Here are the most common symptoms to watch for:

  • Seeing more floaters than usual
  • Blurry vision
  • Vision that sometimes changes suddenly from blurry to clear
  • Dark areas in your field of vision
  • Poor night vision
  • Faded-looking or washed out color vision

Vision loss from diabetic retinopathy is in many cases irreversible, so it’s better to catch it sooner than later.

Prevention and Treatment

Maintaining healthy blood sugar levels and blood pressure is the first step in preventing diabetic retinopathy. Some patients with diabetic retinopathy who take steps to control their blood sugar may notice a slight improvement in their vision. However, in some cases, controlling your blood sugar is not enough and treatment may be required.

Treatments recommended may include:

  • Anti-VEGF medication, such as Avastin, Eylea, or Lucentis – Anti-VEGF medication reduces swelling of the macula, which can slow vision loss and potentially improve vision. Anti-VEGF medications are administered via injection to the eye.
  • Steroid medication – Steroids can be used to reduce macular swelling and are administered by injection to the eye.
  • Laser surgery – Laser surgery can be used to seal off leaking blood vessels, preventing floaters or total visual blockage and preventing macular swelling. Laser surgery can also shrink malformed blood vessels and prevent regrowth.
  • Vitrectomy – A vitrectomy is a surgical procedure recommended for advanced stages of diabetic retinopathy in which vitreous gel and blood that is leaking from blood vessels in the eye is removed. Scar tissue may also be removed.

Protect Yourself from Diabetic Retinopathy

Although controlling your blood sugar is important, a study found that healthy glycemic control was not enough to prevent diabetic retinopathy in all cases. The only guarantee to preventing vision loss from diabetic retinopathy is to have yearly comprehensive eye exams. In a dilated eye exam, an eye doctor can see into the back of your eye and look for signs of damaged blood vessels or swelling in the retina, allowing you to take action before vision loss occurs. The best way to maintain your healthy vision is through preventative care.

More About Optometrist 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 Sources

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 Retinopathy

https://eyewiki.org/Diabetic_Retinopathy

Annual Eye Exams Can Save Sight for People with Diabetes

https://www.aao.org/eye-health/news/annual-exams-save-sight-diabetes

What is Diabetic Retinopathy?

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

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

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

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