The most common causes of irreversible blindness for people under the age of 65 in the United States, diabetic eye disease is the general term for vision problems related to diabetes. Making an effort to control diabetes through lifestyle adjustments and medication can reduce the risk of developing a diabetic eye disease.
Diabetic eye diseases are specific eye conditions most likely to affect people who have diabetes. All diabetic eye diseases may result in some degree of vision loss. Most diabetic eye diseases are caused by fluid build-up or damage to blood vessels. Some of the more common eye conditions linked to diabetes include:
Affecting blood vessels in the light-sensitive tissue in the back of the eye, diabetic retinopathy is the leading cause of blindness among diabetics.
Diabetic macular edema (DME)
Related to retinopathy, macular edema is a swelling in part of the retina (the macula).
Diabetics are more than twice as likely to have cataracts (clouding of the eyes’ lenses) than non-diabetics.
Referring to conditions affecting the optic nerve, glaucoma is sometimes linked to elevated pressure within the eye.
Diagnosis is often made during a routine eye exam or when a patient is experiencing noticeable vision problems.
Symptoms of diabetic eye disease usually show no signs until severe damage has occurred (affecting the retina before vision).
The chronically high blood sugar levels seen in people with diabetes can cause damage to blood vessels. If blood vessels in the retina of the eye become damaged, they may hemorrhage or leak fluid into the retina itself. This prevents the eye from forming a clear picture, and therefore vision is distorted.
These damaged blood vessels may also become swollen and lose their ability to transport blood to the retina. This means that the retina does not receive the nutrients that are normally delivered to it by the blood. In response, it triggers the growth of more blood vessels. If these new blood vessels also become damaged, a large amount of scar tissue may build up in the area. Scar tissue can contract, pulling at the retina, which may detach it from the tissue it is connected to. Retinal detachment can cause permanent vision loss.
Diabetic eye disease can affect both type 1 and type 2 diabetics at any stage of the disease, although the risk of developing an eye disease is greater the longer a person has diabetes.
Specific treatment depends on the type of eye disease. Cataracts are treated with surgery to remove the cloudy lens and replace it with an artificial one. Corticosteroids are sometimes injected or implanted into the eye to manage DME. Diabetic retinopathy may be treated with laser surgery to shrink abnormal blood vessels.
In some cases, people with diabetic eye disease may not have ever been officially diagnosed as being diabetic if they had no other significant symptoms until experiencing vision problems. Control of diabetic symptoms can help prevent the onset of most eye diseases more prevalent in diabetics. The American Diabetes Association estimates there are about 30 million known diabetics in the United States, along with nearly 10 million more who haven’t been diagnosed.
The steps you can take to prevent diabetic eye disease from developing are the same as you would use to control diabetes overall. Therefore the primary preventive measure is to maintain blood glucose at normal levels – or as close to normal as is possible. This may involve insulin therapy, sulphonylurea therapy, or changes to your diet and lifestyle, such as taking regular exercise.
Some studies have demonstrated an increased risk of diabetic eye disease in individuals who also have high blood pressure and cholesterol levels. Again, this can be managed by dietary and lifestyle factors, with medication, or through a combination of the two.
A key preventive measure against diabetic eye disease is early detection, which can reduce the risk of vision loss by up to 95%. However, the early stages of diabetic eye disease often do not cause any symptoms, therefore at least once per year you should undergo an eye exam specifically looking for signs of the disease.