5 Ways To Help Prevent Diabetic Eye Diseases

People with diabetes face a number of health challenges related to their condition, and loss of vision is one of them. Having diabetes puts you at higher risk of developing certain eye diseases, including glaucoma, cataracts, diabetic retinopathy and diabetic macular edema. Studies suggest that most diabetes-related vision loss can be significantly reduced with early detection, regular eye exams and good metabolic control.

Key Takeaways: Diabetic Eye Diseases

• Diabetes can impact the blood vessels in your eyes, leading to vision loss.
• The longer a person has diabetes, the greater their risk of having eye disease.
• A yearly dilated eye exam is a must for people living with diabetes.

Causes Of Diabetic Eye Diseases

Anyone with diabetes — including type 1, type 2 and gestational diabetes — is at risk of developing eye diseases. The longer a person has diabetes, the greater their risk.

“The back of your eye (called the retina) that actually captures your entire vision has little tiny blood vessels,"  said Thottathil Gopan, MD, an endocrinologist  at Franciscan Physician Network Munster Medical Center in northwest Indiana. "Over time, high blood sugar levels can cause damage to those tiny blood vessels. The blood vessels in the retina become leaky, and this can trigger a swelling of the macula, the part of the retina at the back of the eye that is responsible for central vision. Swelling of macula or bleeding in the retina can cause sudden vision loss. Controlling diabetes can significantly reduce the incidence of these problems."

Over time, high blood sugar levels can cause damage to those tiny blood vessels.

With diabetes, the blood vessels in the retina often become leaky, and this can trigger a swelling of the macula -- the part of the retina at the back of the eye that is responsible for central vision.

“That's why diabetes has been one of the leading causes of preventable blindness,” Dr. Gopan said.

Factors that increase the risk of a person with diabetes developing eye problems like retinopathy include:

• Poor control of blood sugar levels over time
• High blood pressure
• Kidney disease
• High cholesterol levels
• Pregnancy

Nearly 10 million Americans are at risk for blindness from diabetic retinopathy, according to a study published in JAMA Ophthalmology. In 2021, an estimated 9.6 million people in the United States — 26% of those with diabetes — had the eye illness and nearly 2 million had the most severe form, "vision-threatening diabetic retinopathy" (VTDR), researchers say. That's 5% of those with diabetes.

Symptoms Of Diabetic Eye Diseases

Many people with diabetic retinopathy or other diabetic eye diseases might have eye problems a long time without symptoms, the American Society of Retina Specialists says. By the time symptoms occur, substantial damage to vision might have already happened.

Symptoms of eye disease can include:

• Blurred/ distorted vision
• Difficulty reading
• Spots or "floaters" in your vision
• Shadow across the field of vision
• Eye pressure
• Difficulty with color perception.

People with any of these symptoms should get checked as soon as possible.

Get A Dilated Eye Exam Once A Year

You can have problems with your eyes even if you don’t have trouble seeing. If you have diabetes, your ophthalmologist or specially trained optometrist should give you a dilated eye exam at least once a year. Tell your healthcare provider right away if you:

• See dark spots
• Don't see well in dim light
• Have eye pain or pressure
• Have any other problems

Modern Technology For Eye Disease Detection

Many advanced technologies that ophthalmologists use can help track retinal health.

These include:

• Optical coherence tomography, which provides highly detailed cross-sectional images of the retina.
• Fundus photography, which takes photos to document diabetic retinopathy.
• Fluorescein angiography, which uses a dye injected into the bloodstream to track blood flow within the retina and the rest of the eye.

The ABCs Of Preserving Your Vision

As well as getting an annual dilated eye exam, diabetes patients should follow the ABCs to manage their diabetes and lower their risk for vision loss and other potential complications such as heart attack and stroke.

As well as getting an annual dilated eye exam, diabetes patients should follow the ABCs to manage their diabetes and lower their risk for vision loss and other potential complications such as heart attack and stroke.

A: A1C Test

The hemoglobin A1C test tracks whether blood sugar levels are under control. Routinely high blood sugar can damage retinal blood vessels, causing vision loss. 

For most nonpregnant individuals with diabetes, the target HbA1c is below 7.0%,, though it can be less than 6.5% if can be achieved safely without causing low sugars, according to the  American Diabetes Association.

B: Blood Pressure

Maintaining healthy blood pressure, generally below 130/80 mmHg, unless otherwise advised by your provider.

C: Cholesterol

Manage cholesterol with lifestyle changes and medications such as statins, as recommended by your provider.

In addition, you should quit smoking and continue a regular exercise program for overall heart and vascular health.