Prediabetes and Dangers to Your Eyesight by Dhanu Meleth, MD

June 28, 2019

Dhanu Meleth, MD is an ophthalmologist and retina specialist at the Marietta Eye Clinic.

Your vision is fundamental to your quality of life and with proper preventative care you can give yourself every advantage possible in the effort to keep your eyes healthy and your vision clear. Prediabetes is a condition where your blood sugar is higher than normal, but not yet high enough to be type 2 diabetes. Without lifestyle changes, you are very likely to progress from prediabetes to type 2 diabetes.

Prediabetes occurs frequently and is a serious threat to eyesight and ocular health. An estimated 33.9% of U.S. adults aged 18 years or older (84.1 million people) had prediabetes in 2015, based on their fasting glucose or A1C level. Nearly half (48.3%) of adults aged 65 years or older had prediabetes.

Eye Damage from Diabetes: Retinopathy

According to the American Ophthalmology Association (AAO), diabetic retinopathy is a leading cause of visual impairment in working age-adults. Retinopathy refers to when blood vessels in the retina portion of the eyes swell, leak, or close off completely. Additionally, abnormal new blood vessels can grow on the surface of the retina. This can then progress to cause bleeding that obscures your vision or even result in the formation of a retinal detachment or advanced forms of glaucoma. Once people reach the more advanced stage of diabetes in the eye, the risk of blindness starts to increase.

Diabetic retinopathy can occur at any age. The single greatest asset you have in fighting this disease is preventative eye exams. Regular eye exams are vital to avoiding vision loss even if you are not having symptoms you notice. You can have good vision and no ocular symptoms and still have the presence of the disease and need treatment. Effective treatment depends heavily on the timeliness of the treatment. Once certain types of damage occur, the damage is irreversible.

Additional Diabetic Eye Diseases

There are other very serious eye diseases related to diabetes. With these diseases, routine eye care from a comprehensive ophthalmology practice with retina, cataract, and glaucoma specialists is vital to maintaining optimal eye health and clear vision.

• Diabetic Macular Edema – this occurs when fluid builds up on the retina and causes swelling and blurry vision.
• Cataracts – excessive blood sugar can cause cataract which is the clouding of the natural lens in your eye causing various types of visual disturbances.
• Glaucoma – this group of eye diseases causes damage to your optic nerve leading to irreversible loss of vision. Diabetes doubles the risk of getting glaucoma.

How Can I Prevent Diabetic Eye Disease?

The single best way to stay ahead of diabetes-related eye disease is through a comprehensive, dilated eye exam with your ophthalmologist at least once a year. Visits to an ophthalmologist or an ophthalmologist who further specializes in care of the retina (retina specialist with a retina fellowship) might even be recommended more frequently depending on your health condition.

There are additional lifestyle changes you can make to help your body prevent this type of potentially blinding disease:

• Control Your Blood Sugar. High blood sugar can affect the shape of the lens in your eye causing blurry vision – this blurring returns to normal when blood sugar stabilizes. High blood sugar can also damage the blood vessels in your eyes.
• Maintain Healthy Blood Pressure and Cholesterol Levels. In addition to affecting other parts of the body, high blood pressure and high cholesterol can put you at greater risk for eye disease and vision loss.
• Quit Smoking. Smoking increases the risk for diabetic retinopathy and other diabetes-related eye diseases.
• Exercise. Regular exercise is good for your eyes and helps to prevent diabetes and control diabetes once you develop the disease.

All of these changes involve improving the overall health of the blood vessels in your body. The reason that diabetes is such a devastating disease is that it affects the health of your blood vessels. Your blood vessels travel to every organ in the body, and as damage from diabetes accumulates, every organ can be affected. Maximizing the health of your blood vessels not only reduces your risk of blindness, but it also reduces your risk of serious complications such as heart attacks, strokes, kidney failure, and loss of fingers and toes.

References and Additional Resources

The American Academy of Ophthalmology (AAO) 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.

Prevalence of Prediabetes

https://www.cdc.gov/diabetes/data/statistics-report/prevalence.html

Diabetic Eye Disease

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

What is Diabetic Retinopathy

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

Screening for Diabetic Retinopathy – 2014

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

Prediabetes

https://www.mayoclinic.org/diseases-conditions/prediabetes/symptoms-causes/syc-20355278

Top Five Steps to Help Prevent Diabetic Eye Diseases

https://www.aao.org/eye-health/tips-prevention/top-five-diabetes-steps

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