The Effect of Diabetes on Your Vision by Brittany McNeely, O.D.

April 30, 2020

Dr. McNeely is a primary care optometrist with the Marietta Eye Clinic who specializes in ocular disease and provides ocular surgery co-management.

The Centers for Disease Control and Prevention (CDC) reports that over 30 million Americans have diabetes. An additional 84.1 million have prediabetes, which if left untreated, can lead to type 2 diabetes. Diabetes is the leading cause of blindness in the United States and should be taken seriously when it comes to your vision.

Diabetic Retinopathy

Diabetic retinopathy is a retinal disease that affects people with type 1 or type 2 diabetes. High blood sugar levels damage blood vessels in the eye. This damage can cause a variety of vision problems and eventually lead to blindness.

There are two stages of diabetic retinopathy:

  • Non-proliferative diabetic retinopathy (NPDR): This is when blood vessels in the eye close off (macular ischemia) or leak (macular edema).
  • Proliferative diabetic retinopathy (PDR): This is a more advanced stage of diabetic retinopathy, when the retina begins to grow new blood vessels. These new blood vessels are very fragile and can burst and bleed. Scar tissue may develop as more and more damage occurs.

Symptoms of Diabetic Retinopathy

People with diabetic retinopathy often don’t notice symptoms early in the disease. Diabetic retinopathy typically starts with blurry vision. Eventually, some of the following symptoms may appear, as well:

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

Vision loss from diabetic retinopathy is in many cases irreversible, but it can be prevented. It’s much better to catch it sooner than later.

Prevention and Treatment

The first step in preventing vision loss from diabetic retinopathy is to maintain healthy blood sugar levels and blood pressure. In some cases, vision can even improve in patients with diabetic retinopathy who take steps to control their blood sugar. However, in some cases, controlling your blood sugar is not enough and you may still be at risk for developing diabetic retinopathy. In these cases, it is important to have yearly eye examinations so that if diabetic retinopathy is present, it can be caught and treated before irreparable damage occurs.

Advanced treatment options may include:

  • Anti-VEGF medication, such as Avastin, Eylea, or Lucentis – Anti-VEGF medication reduces swelling of the macula, which can slow vision loss or potentially improve vision. Anti-VEGF medications are administered via injection to the eye.
  • Steroid medication – Steroids can also be used to reduce macular swelling. They 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 after being diagnosed with diabetes. 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 early. The best way to maintain your healthy vision is through preventative care.

More About Brittany McNeely, O.D.

Dr. McNeely is a primary care optometrist with the Marietta Eye Clinic who offers primary care optometry. She also specializes in ocular disease and ocular surgery co-management. Dr. McNeely serves the Kennestone, Canton, and East Cobb locations. She graduated summa cum laude from the University of Georgia and received her doctor of optometry degree from the University of Alabama at Birmingham School of Optometry. While graduating from the School of Optometry, she was named class valedictorian. She is a fellow of the American Academy of Optometry as well as a member of the Georgia Optometric Association and the American Optometric Association. Read more about Dr. McNeely 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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