Shedding Light on Diabetic Eye Disease

When people think of the consequences of diabetes, they often think of insulin injections, having to stick their fingers to check their blood sugar, and no longer being able to eat their favorite sweet indulgences. But one of the more severe — and often overlooked — consequences is diabetic eye disease.

Diabetic eye disease is a group of eye problems that people with diabetes may have as one of the complications of diabetes. These eye problems can cause vision loss — and in extreme cases, they can even cause blindness. Diabetic eye disease may include diabetic retinopathy, cataracts, or glaucoma.

A cataract is a cloudiness that forms over the lens of your eye. Because the lens is normally clear, cataracts can make it feel like you’re looking through a foggy window, which can make it difficult to see. Cataracts can fortunately be corrected with surgery.

There are multiple kinds of glaucoma. The most common is a buildup of fluid pressure inside the eye that increases over time and damages the optic nerve, causing loss of vision. There is always fluid inside your eyes, but it normally flows in and out without any problem. But when the fluid can’t filter or flow out of the eye normally, it causes pressure to build. Glaucoma can be managed with special prescription eye drops and/or surgery, but it can’t be cured. Once it causes vision loss, treatment can prevent further vision loss but cannot restore your vision. Diabetics are almost twice as likely to get glaucoma than someone without diabetes.

The most common type of diabetic eye disease is call diabetic retinopathy. This disease is caused by changes to the blood vessels in the retina, part of the eye that is necessary for good vision. It occurs in four stages:

In the first stage, Mild Nonproliferative Retinopathy, small balloons of swelling occur in the tiny blood vessels of the retina. These are miniature aneurysms, just like those that can occur in the brain.

The second stage is Moderate Nonproliferative Retinopathy. As the eye disease reaches this stage, blockages form in some of the slightly larger blood vessels that nourish the retina.

Severe Nonproliferative Retinopathy is the third stage. More and more of the blood vessels in the eye are blocked, which causes areas of the retina that are being deprived of blood flow to signal to the body that they need to grow more blood vessels.

The fourth and most advanced stage is Proliferative Retinopathy. Because of the signals sent in the third stage, new miniature blood vessels grow inside the eye. But these blood vessels are weaker than normal, irregular, and grow in parts of the eye where they aren’t needed. These new blood vessels don’t inherently cause problems, but their walls are weak. If blood leaks out, it can result in severe vision loss or blindness.

If you have been diagnosed with Type 1 or Type 2 diabetes, it’s extremely important that you get a complete eye exam — including getting your pupils dilated — every year. Do your best to follow your management plan, including diet and exercise. If you notice that you have blurry or double vision, see dark spots or floating spots or lights, are having trouble seeing, or are feeling pain or pressure in your eyes, talk to your doctor.

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