Diabetes: What You Need To Know To Prevent Vision Loss 0
What You Need To Know To Prevent Vision Loss
Many individuals within the United States have already been diagnosed with diabetes. In addition, there is also a population of people that have diabetes, but that are currently undiagnosed. This is super scary! In either case, your eye doctor can play a role in diagnosing and managing your diabetes. Ultimately, patients at a risk for diabetes, or those already diagnosed, should be seen by their Optometrist at a minimum basis of one time per year for a dilated eye exam.
How diabetes affects your eyes
Diabetes is a condition that causes elevated blood sugar levels, and this can lead to changes in your vision or damage to specific areas of your eyes.
One of the many changes diabetic patients may notice is that their vision fluctuates as their blood sugar fluctuates. In other words, diabetic patients may notice their vision becomes blurry when their blood sugar readings or A1C are high. This is then followed by the vision returning to normal once their sugar is controlled again. This is due to the interaction that diabetes can have with the lens inside of your eye.
The lens inside of our eyes is naturally clear, but becomes more opaque later in life which leads to cataracts. When blood sugar levels increase, the sugar levels of the fluid produced inside of the eye also increase. The lens soaks in this now sugar-rich fluid within the eye, and this can cause the lens to swell. Anytime the lens swells, patients will experience a temporary change in their prescription which then causes blurry vision. As the blood sugar levels become controlled again, the fluid within the eye becomes comprised of less sugar also, and the lens will return to its normal shape and size. When this occurs, patients notice their temporarily blurred vision has resolved. Lastly, because of the stress this process induces on the lens, patients with diabetes are at a greater risk for developing cataracts sooner than the average population.
Although your eye doctor will likely only monitor you when diabetic lens-related changes occur, it is important for both the doctor and yourself to be aware of these findings in order to begin better controlling your diabetes.
In addition to the lens and fluid within the eye, high blood sugar from diabetes can also damage the retina. The retina is a tissue that lines the inside of the eye and is comprised of millions of nerves and small blood vessels that nourish this tissue. When patients are diabetic, these small blood vessels in the retina are at a risk for becoming damaged and this is referred to as diabetic retinopathy.
When diabetic retinopathy occurs, diabetic patients may experience bleeding within certain areas of their retina. The blood vessels can also become occluded leading to a lack of blood flow to the rest of the retina. These findings can resolve if the diabetes is well controlled, and the prognosis can be fairly well if the patient and doctor begin discussing better ways of managing diabetes.
Diabetic retinopathy is a warning sign
When your Optometrist diagnoses you with diabetic retinopathy, they are concerned for more than just your eyes. Because the blood vessels in the retina are so small, they are often the first blood vessels subject to damage from diabetes. However, the severity of a patient’s diabetic retinopathy can also correlate with their likelihood of having damaged blood vessels in the kidneys, leading to diabetic nephropathy. This is because the blood vessels within the kidney are also small and subject to early damage – like the retina. Eek!
Lastly, if a very specific area of your retina, known as the macula, becomes affected by your diabetes, your Optometrist may have to refer you to a Retinal Ophthalmologist for further evaluation and treatment. The macula is an area of the retina with the highest level of detail-resolving vision and is also responsible for our central vision (vs our peripheral vision).
What you can do
As mentioned, patients with diabetes can control their blood sugar and A1C levels. Healthcare providers recommend an A1C value of 6.5 or less taken regularly every 3 months. Diabetic patients should know that the two most important factors regarding their diabetes and likelihood of developing diabetic retinopathy are: duration and control. In many cases, duration of the diabetes, or how long a patient has been diabetic, is something out of the hands of the patient and their healthcare providers. For this reason, control of the diabetes is often targeted as the main management plan.
If you are diabetic or have a risk of developing diabetes, your Optometrist would like to help you prioritize yearly dilated eye exams to help protect your retina and overall vision. Do you currently see an Optometrist for your diabetes? How often do they recommend you see them?
Dr. Travis Zigler
Diabetic Eye Disease: 8 Symptoms You Need To Know 0
The Hidden Symptoms of Diabetic Retinopathy
The most important thing to understand regarding the symptoms of diabetic retinopathy is that early in the progression of the disease, there may not actually be any symptoms of diabetic retinopathy. Most diabetics don’t begin experiencing serious symptoms until at least ten years after their original diabetic diagnosis. However, it’s important to get regular eye exams, since background retinopathy can be detected by an eye doctor even if you haven’t noticed changes to your vision.
The period of time before serious symptoms emerge is known as “background retinopathy.” At this stage, the disease often goes completely undetected. This stage of diabetic retinopathy is technically called “non-proliferative retinopathy,” because at this point the rapid growth of superfluous vessels in the eye has not yet begun. However, the leaking and/or swelling of minuscule blood vessels in the retina can lead to any or all of the following symptoms:
- Vision compromised by “floaters” or spots
- Vision affected by shadows, blur, or distortion
- Vision affected by seeing double
- Pain or tenderness in the eye
- Photophobia, or light sensitivity
- Difficulty focusing on objects close to the eye
- The appearance of cataracts in the eye
- Nystagmus, or involuntary eye twitching
If you’re experiencing any of these symptoms as a diabetic, it is vital that you communicate quickly with your eye doctor to ensure critical and irreparable damage to your vision doesn’t occur.
Once the disease progresses past background retinopathy, it is called proliferative retinopathy. At this point, diabetic patients begin experiencing symptoms associated with the rapid growth of unnecessary blood vessels within the eye. These blood vessels compromise vision severely and may lead quickly to a detached retina.
It’s important for diabetic patients to manage both blood pressure and blood glucose levels, since both of these are correlated with the onset of the symptoms of diabetic retinopathy. Ironically enough, patients who have not managed diabetes well and suddenly begin controlling their blood glucose levels much more tightly may actually see a rapid onset of the more severe symptoms of diabetic retinopathy as their body adjusts to rapid changes in blood glucose and blood pressure.
For this reason, it’s important to maintain regular contact with your physician and eye doctor and make sure you’re getting at least yearly eye exams. During periods of dietary change it may actually be necessary to have eye exams more often to keep tabs on the health of your eyes and prevent irreparable damage. What are you waiting for? Contact your eye doctor today!
Dr. Travis Zigler
Other Dry Eye articles by Dr. Zigler: 4 Tips to Stop Waking Up With Dry, Painful Eyes; Which Antidepressants Cause Dry Eye; Fish Oil for Fighting Dry Eye Inflammation; and What Not To Eat If You Have Dry Eye
- Dr. Travis Zigler
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