Diabetes is a chronic condition that’s characterized by high blood glucose levels. In type 1 diabetes, this is a result of an autoimmune response that attacks the insulin-producing cells in the pancreas, thus leaving the body unable to regulate blood sugar. In type 2 diabetes, high blood sugar levels occur because of the body’s inability to regulate and use insulin efficiently. This, in turn, causes spikes in blood glucose levels. All types of diabetes can be managed with the proper treatment and medication, but when left untreated or undiagnosed, a range of complications can occur. In addition to damaging the heart, blood vessels, kidneys, and nerves, diabetes can cause serious issues with eyesight. For more information, here’s everything you need to know about the importance of eye exams when living with diabetes.
How Diabetes Affects the Eyes
Diabetes can be managed using lifestyle changes and medications. However, you need to be diligent and take the proper care of yourself each and every day. When diabetes isn’t adequately treated, high blood sugar levels can cause damage to the blood vessels throughout the body, including those in the eyes. This can lead to a variety of eye conditions and complications, some of which can lead to vision loss or even blindness. Some of the most common eye-related complications of diabetes are diabetic retinopathy, diabetic macula edema, cataracts, and glaucoma.
Diabetic Retinopathy
Diabetic retinopathy is one of the most notable complications of diabetes that affects the eyes, as it can lead to blindness. High blood sugar causes damage to the blood vessels in the retina, which is the light-sensitive tissue at the back of the eye. Over time, the damaged blood vessels can leak fluid and blood into the retina, leading to swelling and distortion of vision. If left untreated, diabetic retinopathy can cause vision loss and even blindness.
There are two types of diabetic retinopathy: non-proliferative and proliferative. Non-proliferative diabetic retinopathy (NPDR) is an early stage of the disease, where the damaged blood vessels in the retina cause small hemorrhages, fluid buildup, and deposits called exudates. Proliferative diabetic retinopathy (PDR) is a more advanced stage where new abnormal blood vessels grow in the retina, which can lead to bleeding, scarring, and retinal detachment.
The risk of developing diabetic retinopathy increases with the duration of diabetes, poor blood sugar control, high blood pressure, and high cholesterol levels. Early detection and treatment of diabetic retinopathy are crucial to prevent vision loss. However, there are no symptoms of diabetic retinopathy in early stages, which is one of the reasons why regular eye exams are so important for people living with diabetes.
Diabetic Macular Edema
Diabetic macular edema is a complication of diabetes that affects the retina. High blood sugar levels can damage the blood vessels in the retina, causing them to leak fluid into the surrounding tissue. This can cause swelling in the macular area, the part of the retina responsible for sharp, detailed central vision.
Macular edema can lead to blurry vision or even vision loss, particularly in the center of the field of vision. Diabetic macular edema is a common complication of diabetic retinopathy. Regular eye exams can help with early detection and treatment to prevent vision loss.
Cataracts
Cataracts are a common eye condition that causes clouding of the eye's natural lens. This can result in blurry vision or issues with visual acuity. Cataracts can occur due to a variety of factors, including aging, genetics, and certain medical conditions. They’re also a common complication of diabetes.
Cataracts in people with diabetes tend to develop earlier and progress more rapidly than those that develop in people without diabetes. The excess sugar in the blood can cause changes in the lens of the eye, leading to the formation of cataracts. Additionally, people with diabetes are more likely to develop other eye conditions that can subsequently increase the risk of cataracts.
During eye exams, if cataracts are found, they can be treated with surgery to remove the cloudy lens and replace it with an artificial one. The earlier they’re treated, the better.
Glaucoma
Glaucoma is a disease that causes damage to the optic nerve, which is responsible for transmitting visual information from the eye to the brain. This damage can lead to progressive and irreversible vision loss, and in severe cases, complete blindness.
Glaucoma is often caused by an increased pressure in the eye, known as intraocular pressure (IOP), or by other factors that damage the optic nerve. There are several types of glaucoma, but the most common is primary open-angle glaucoma, which develops gradually and typically has no symptoms in the early stages.
People with diabetes are at an increased risk of developing glaucoma compared to those without diabetes. Again, this is caused by high blood sugar levels, which damage the blood vessels in the eye. When blood vessels in the eye are damaged, it decreases blood flow and oxygen supply to the optic nerve. This can increase the risk of developing glaucoma or can worsen an existing glaucoma condition.
During regular eye exams, your doctor can administer a test for glaucoma to detect any potential problems early on. If glaucoma is diagnosed, treatment can include medications to lower IOP, laser therapy, or surgery to improve fluid drainage from the eye. Glaucoma is the leading cause of blindness for people over 60 years old, but early detection can help prevent this from occurring.
Why You Need Regular Eye Exams When Living with Diabetes
There are over 30 million people living with diabetes in the United States. The longer you have the condition, the greater your risk for complications. To make sure that you prioritize your vision and eye health, the American Diabetes Association (ADA) recommends yearly eye exams. They recommend that individuals with type 1 diabetes begin their yearly eye exams within the first five years after diagnosis, but those with type 2 diabetes should schedule an exam shortly after diagnosis. Since type 2 diabetes tends to go unnoticed for longer periods of time, eye exams can catch early signs of complications.
If you’re diagnosed with diabetic retinopathy during your eye exam, your doctor will likely recommend frequent, follow up exams to monitor the condition for changes. More severe cases will require more frequent visits. However, with early detection, treatment can help slow or stop the progression of the disease.
What to Expect at Your Eye Exam
Typically speaking, you’ll see either an ophthalmologist or an optometrist for your eye exam. An ophthalmologist is a doctor who specializes in medical and surgical treatments needed for certain eye conditions. An optometrist is a doctor who is certified to examine, diagnose, and treat eyes. Individuals living with diabetes will typically see an ophthalmologist if they experience any eye-related complications.
Eye exams are fairly straightforward. They’re quick and painless, but they can provide you with valuable insight about your eye health. When you arrive at your appointment, your doctor will likely start with some basic questions about any symptoms, diabetes management, or potential concerns. You may also be asked to read random numbers from a Snellen chart. Individuals with diabetes will then receive a dilated retinal exam and additional diagnostic testing as needed.
Dilated Retinal Exam
This is a test that’s done to examine the back of your eye. Your doctor will administer eye drops that dilate your pupils. Once dilated, your doctor uses a specialized magnifying glass and light to examine the back of your eye, the optic nerve area, and various blood vessels throughout. Images may or may not be taken during this time.
Diagnostic Testing
Your doctor may also recommend undergoing diagnostic testing to check for signs of diabetic retinopathy. This may include an optical coherence tomography (OCT) test, which examines the thickness of your retina through imagery. Another diagnostic test is a fluorescein angiography, which involves injecting a dye to find damaged blood vessels.
One of the best ways to help reduce your risk of developing diabetes related complications is to practice healthy habits, use diabetes medications as prescribed, see your doctor regularly, undergo yearly eye exams, and be aware of any symptoms. By taking a proactive approach to your health, you’ll support stable blood sugar levels, maintain a healthy weight, and lower your chances of complications. To help, Byram Healthcare has a range of continuous blood glucose monitors. We also offer diabetes support and educational materials to give you everything you need for comprehensive care.
