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Patients with diabetes are at a higher risk to develop eye problems due to high blood sugar potentially damaging the eye’s blood vessels. Your eyes can be affected by several different eye diseases related to diabetes. Diabetics are at higher risk of developing glaucoma and are also at risk of developing cataracts at an earlier age.
Diabetic retinopathy
The most common diabetic eye disease and a leading cause of vision loss in adults; it develops over time as high blood sugar damages the retina’s blood vessels.
Proliferative diabetic retinopathy
The advanced stage of retinopathy where fragile new blood vessels grow on the retina and are susceptible to leaking blood and fluid on the retina; it can cause severe vision loss.
Macular edema
Swelling in the center of the retina (the macula) which makes it harder to read, see fine details or perform close work.
A yearly comprehensive eye exam is the best way to catch diabetic eye conditions early, before they threaten your sight. During your visit, Dr. Zelenak takes the time to listen and discuss your concerns. He then checks your vision and uses special dilating drops to carefully examine the health of your eyes. Specialized tests such as Optical Coherence Tomography (OCT) can be used to see the layers of the retina on a microscopic level. Fluid leakage and blood vessel damage can be visualized to enable the doctor to provide the best possible care.
Early detection is your strongest defense against diabetic eye disease. Along with regular exams, you can protect your vision by managing blood sugar and blood pressure, eating well and staying active.
What is diabetic eye disease?
Diabetic eye disease is a group of conditions caused by diabetes that can damage different parts of the eye, including the retina, macula, lens and optic nerve. The main conditions are:
— Diabetic retinopathy: The most common cause of vision loss in people with diabetes. It happens when high blood sugar damages the retina’s blood vessels.
— Diabetic macular edema (DME): Swelling in the macula (the part of the retina needed for sharp, central vision).
— Cataracts: Clouding of the eye’s lens, which tends to occur earlier and more often in people with diabetes.
— Glaucoma: Damage to the optic nerve, sometimes related to increased eye pressure. Diabetes nearly doubles the risk.
All of these can lead to serious vision loss if not detected and treated early.
What causes diabetic retinopathy?
High blood sugar over time damages the small blood vessels in the retina. These vessels can leak, swell, or close off, reducing blood flow. In advanced stages, abnormal new vessels grow, which are fragile and prone to bleeding, leading to scarring and vision loss.
What is diabetic macular edema (DME)?
DME is swelling in the macula, the part of the eye needed for reading, driving, and recognizing faces. It is the most common cause of vision loss in people with diabetic retinopathy and can happen at any stage of the disease.
Who is at risk for diabetic retinopathy?
Anyone with type 1, type 2, or gestational diabetes is at risk. The longer you have diabetes, the greater the risk. Nearly half of people with diabetes develop some form of retinopathy, but many don’t know it. Women who have diabetes during pregnancy are also at higher risk.
Symptoms and Detection
Diabetic retinopathy often has no early symptoms. As it progresses, you may notice:
• Blurred vision
• “Floating” spots in your vision
• Trouble with detail or central vision (if DME is present)
A comprehensive dilated eye exam is the best way to detect problems early. Tests may include vision checks, eye pressure measurement, dilation to view the retina, and imaging scans (OCT or fluorescein angiogram).
How can people with diabetes protect their vision?
• Get a yearly dilated eye exam (or more often if recommended).
• Control blood sugar, blood pressure, and cholesterol.
• Maintain a healthy lifestyle with good nutrition and regular exercise.
Early detection and treatment can reduce the risk of blindness by up to 95%.
How is diabetic eye disease treated?
• DME: May be treated with anti-VEGF injections, laser therapy, or corticosteroid implants.
• Proliferative diabetic retinopathy (PDR): Often treated with anti-VEGF injections or laser therapy to shrink abnormal blood vessels.
• Vitrectomy surgery: Used for severe bleeding or retinal detachment.
What are anti-VEGF injections?
Anti-VEGF (Vascular Endothelial Growth Factor) injections are used to treat a variety of eye conditions that involve abnormal blood vessel growth or leakage in the retina. VEGF is a protein that promotes the growth of new blood vessels. Anti-VEGF injections block the action of VEGF, reducing the abnormal blood vessel formation and associated complications. The injections are given by an ophthalmologist into the back of the eye. Anti-VEGF injections can actually reverse the severity of diabetic macular edema and diabetic retinopathy.
What if vision doesn’t improve with treatment?
Eye care professionals can connect you with low-vision services and devices to help you make the most of your remaining sight. Support groups, rehabilitation services, and vision specialists can also provide valuable resources.