Diabetes and the eye

Simulation of diabetic retinopathy

Simulation of diabetic retinopathy. Photo by Quibik, Wikimedia Commons

According to the 2014 National Diabetes Statistics Report, 29.1 million Americans had diabetes in 2012, which equates to nearly 1 in 10 people. This number is not only staggering, but also foretells the amount of medical care many Americans will need in the very near future. Not only will many need to be monitored by their family physician, but also by endocrinologists, podiatrists and optometrists.

There are many different signs and symptoms associated with diabetes and the eye. One of the more frequently noticed being changing eyesight. The most common cause of this change is poorly controlled blood sugar levels. As these levels change, the eyesight will change for better or worse almost daily, which will drive many into the office of an eye care professional. Many of these patients are completely unaware they are already diabetic.

Unfortunately, fluctuating vision is not the only diabetic-related change that happens in the eye. As diabetes progresses, the blood vessels in the eye begin to change and fluid can begin to leak from the vessels and migrate to the retina (the film on the back of the eye allowing us to detect the images entering the eye). This process initially shows up as little spots of blood called dot-blot hemorrhages, and can go on for quite some time without causing a change in vision. However, if left unchecked, this can lead to areas of inflammation, swelling, abnormal blood vessel growth, and possible tissue death. Once this has happened, permanent vision loss has occurred in that area. Any one of these signs by themselves or together is called diabetic retinopathy.

Currently, there are a few treatment options available for those with diabetic retinopathy. The most important is tight blood sugar control through diet and exercise, oral medication, and/or insulin. If the retinopathy continues to progress, laser treatment and be performed or, more commonly, injections in the eye can be done to decrease abnormal vessel growth. Although injections have shown to sometimes restore some eyesight, there is no cure for diabetic retinopathy and no guarantee that vision will return to normal after damage has occurred.

Therefore, most physicians and eye care professionals focus on prevention and early intervention. When diagnosed with diabetes, it is essential that you have an optometrist or ophthalmologist perform a comprehensive eye exam every year. This exam likely will involve the pupils being dilated in order for the doctor to better evaluate the retina, and photos may be taken for documentation. If signs of diabetic retinopathy are observed, your doctor will work with you and your family physician to devise a plan to help control the progression as best as possible.