What Is Diabetes? How Does It Affect the Eyes?

Diabetes is a group of metabolic disorders marked by elevated blood-sugar levels that extend for long periods of time. It usually results from insufficient quantities of insulin or from insulin’s resistance to properly regulating blood-sugar levels. Diabetes is typically a chronic condition, meaning that it can be controlled but not cured by medical intervention and personal behaviors. There are type 1, type 2, and gestational forms of this disease.

If left untreated, diabetes can be a source of critical health issues – including serious vision problems. Included among these are blurred vision, glaucoma, cataracts, retinopathy, macular edema, and, in extreme cases, blindness. At Baptist Health, we care for persons with diabetes every day, helping them manage their condition, and enabling them to lead the lives they want to lead.

What Are the Symptoms of Vision Problems Caused by Diabetes?

Early symptoms often develop simultaneously in both eyes. These include:

• Blurred vision
• Floaters (tiny, visible particles that appear to swim in the vitreous)
• Poor night vision
• Difficulty distinguishing colors
• Declines in visual acuity.

Without effective treatment, more serious, long-term symptoms are:

• Loss of peripheral vision
• Dark spots in the field of vision
• Blindness.

Eye problems are a health risk for anyone with diabetes. This is especially true if you suffer from hyperglycemia (high blood glucose levels) or hypertension (high blood pressure), and fail to address them medically.

Diabetes-Related Eye and Vision Complications

The following conditions are common among individuals with diabetes:

Blurry Vision

Blurry vision is vision that is fuzzy and imprecise. Fine details are difficult to make out. Blurry vision is one possible outcome of hyperglycemia. Fluid leaks into the lens, causing it to change in shape and size, limiting its ability to focus. Starting insulin treatment can also lead to blurry vision. This less serious version usually improves on its own, once your body adjusts to the regular intake of insulin.

Treating the more serious forms of blurry vision requires curtailing your blood glucose levels. Healthy target ranges are 70-130 milligrams per deciliter (mg/dL) before meals and under 180 mg/dL between one and two hours after a meal. Vision improvement may require up to three months upon reaching these targets.

Cataracts

Cataracts are clouded lenses, resulting in obscured sight. They are a common phenomenon with a variety of causes, especially in old age, but persons with diabetes have double the risk of developing them. This is because high glucose levels increase the eye’s production of sorbitol, a carbohydrate that builds up on the surface of the lens.

Treatment of cataracts depends on their severity. A change in eyewear prescription is often sufficient for mild cases. More serious cases require the surgical removal of the lens and its replacement with an artificial one.

Glaucoma

Glaucoma is an increase in eye pressure that damages the blood vessels in the retina and optic nerve, leading to vision loss. Diabetes is one of the risk factors in developing glaucoma. High blood sugar weakens some of the eye’s capillaries, leading to the growth of replacement vessels. These additions to the circulatory network are a source of increased pressure in the eye. High levels of glycoprotein may also interfere with the eye’s natural drainage functions.

Glaucoma is often treated with eyedrops or oral medications that lower eye pressure. There are laser and surgical treatments as well.

Retinopathy

Retinopathy is any retinal disorder resulting from diabetes. It’s the most common eye condition for people with diabetes. There are two major forms of retinopathy: non-proliferative and proliferative. Non-proliferative retinopathy involves the pooling of blood in the capillaries at the back of the eye. The most serious version of this condition is called macular edema, in which some of this fluid leaks into the macula, a small region of the retina that plays a critical role in high-resolution sight. Macular edema can cause a loss of vision and must be treated promptly. Non-proliferative retinopathy is generally more serious; it’s defined by the widespread damage of retinal vessels and their replacement by scar tissue and leaky new vessels. This form of retinopathy can result in vision loss, blindness, and retinal detachment.

There are several treatments available for retinopathy:

• Photocoagulation: In photocoagulation, lasers are used to seal leaky blood vessels and limit their growth. There are different types of photocoagulation, including scatter photocoagulation and focal coagulation.
• Vitrectomy: More advanced cases require vitrectomy, a surgical procedure for removing cloudy fluids and scar tissue from the eye. This procedure is utilized with individuals who have suffered a detached retina.
• Focal laser therapy: Macular edema is sometimes treated with focal laser therapy. The laser terminates leakage into the macula.
• Vascular Endothelial Growth Factor (VEGF) injections: VEGF injections contain a drug that blocks a hormone promoting blood vessel growth in the eye. Decreasing ocular blood-vessel growth actually serves to improve vision.

Can Diabetic Eye Problems be Prevented?

The key to preventing or delaying eye problems is controlling blood-sugar levels. Excessive glucose in the bloodstream harms the interior lining of the arteries, leading to a buildup of plaque, vessel constriction, hypertension, and atherosclerosis. Damage extends to those vessels supplying oxygen and nutrients to the retina and other parts of the eye.

Other positive steps that you can take are:

• Wearing sunglasses with ultraviolet A and B protection
• Limiting high blood pressure with medication, diet, and exercise
• Stopping tobacco use, including cigarette smoking
• Scheduling annual eye exams.

If you’ve experienced partial vision loss, there are low-vision eyecare clinics with medical strategies that help to compensate for lost sight.

When Should I See a Physician?

If you have been diagnosed with type 1 or type 2 diabetes, it is critical to your eye health that you schedule annual physical exams with your doctor and yearly visual checkups with an eyecare specialist. Make sure that everyone on your medical team knows about your condition. If you begin to experience any of the symptoms associated with diabetic eye disease, schedule your appointment immediately.

Learn More About Diabetic Eye Problems at Baptist Health

If you have questions about eye problems related to diabetes, or want to schedule an appointment with one of our specialists, contact your Baptist Health primary care physician.  

Diabetes-Related Eye and Vision Complications

The following conditions are common among individuals with diabetes:

Blurry Vision

Blurry vision is vision that is fuzzy and imprecise. Fine details are difficult to make out. Blurry vision is one possible outcome of hyperglycemia. Fluid leaks into the lens, causing it to change in shape and size, limiting its ability to focus. Starting insulin treatment can also lead to blurry vision. This less serious version usually improves on its own, once your body adjusts to the regular intake of insulin.

Treating the more serious forms of blurry vision requires curtailing your blood glucose levels. Healthy target ranges are 70-130 milligrams per deciliter (mg/dL) before meals and under 180 mg/dL between one and two hours after a meal. Vision improvement may require up to three months upon reaching these targets.

Cataracts

Cataracts are clouded lenses, resulting in obscured sight. They are a common phenomenon with a variety of causes, especially in old age, but persons with diabetes have double the risk of developing them. This is because high glucose levels increase the eye’s production of sorbitol, a carbohydrate that builds up on the surface of the lens.

Treatment of cataracts depends on their severity. A change in eyewear prescription is often sufficient for mild cases. More serious cases require the surgical removal of the lens and its replacement with an artificial one.

Glaucoma

Glaucoma is an increase in eye pressure that damages the blood vessels in the retina and optic nerve, leading to vision loss. Diabetes is one of the risk factors in developing glaucoma. High blood sugar weakens some of the eye’s capillaries, leading to the growth of replacement vessels. These additions to the circulatory network are a source of increased pressure in the eye. High levels of glycoprotein may also interfere with the eye’s natural drainage functions.

Glaucoma is often treated with eyedrops or oral medications that lower eye pressure. There are laser and surgical treatments as well.

Retinopathy

Retinopathy is any retinal disorder resulting from diabetes. It’s the most common eye condition for people with diabetes. There are two major forms of retinopathy: non-proliferative and proliferative. Non-proliferative retinopathy involves the pooling of blood in the capillaries at the back of the eye. The most serious version of this condition is called macular edema, in which some of this fluid leaks into the macula, a small region of the retina that plays a critical role in high-resolution sight. Macular edema can cause a loss of vision and must be treated promptly. Non-proliferative retinopathy is generally more serious; it’s defined by the widespread damage of retinal vessels and their replacement by scar tissue and leaky new vessels. This form of retinopathy can result in vision loss, blindness, and retinal detachment.

There are several treatments available for retinopathy:

• Photocoagulation: In photocoagulation, lasers are used to seal leaky blood vessels and limit their growth. There are different types of photocoagulation, including scatter photocoagulation and focal coagulation.
• Vitrectomy: More advanced cases require vitrectomy, a surgical procedure for removing cloudy fluids and scar tissue from the eye. This procedure is utilized with individuals who have suffered a detached retina.
• Focal laser therapy: Macular edema is sometimes treated with focal laser therapy. The laser terminates leakage into the macula.
• Vascular Endothelial Growth Factor (VEGF) injections: VEGF injections contain a drug that blocks a hormone promoting blood vessel growth in the eye. Decreasing ocular blood-vessel growth actually serves to improve vision.

Can Diabetic Eye Problems be Prevented?

The key to preventing or delaying eye problems is controlling blood-sugar levels. Excessive glucose in the bloodstream harms the interior lining of the arteries, leading to a buildup of plaque, vessel constriction, hypertension, and atherosclerosis. Damage extends to those vessels supplying oxygen and nutrients to the retina and other parts of the eye.

Other positive steps that you can take are:

• Wearing sunglasses with ultraviolet A and B protection
• Limiting high blood pressure with medication, diet, and exercise
• Stopping tobacco use, including cigarette smoking
• Scheduling annual eye exams.

If you’ve experienced partial vision loss, there are low-vision eyecare clinics with medical strategies that help to compensate for lost sight.

When Should I See a Physician?

If you have been diagnosed with type 1 or type 2 diabetes, it is critical to your eye health that you schedule annual physical exams with your doctor and yearly visual checkups with an eyecare specialist. Make sure that everyone on your medical team knows about your condition. If you begin to experience any of the symptoms associated with diabetic eye disease, schedule your appointment immediately.

Learn More About Diabetic Eye Problems at Baptist Health

If you have questions about eye problems related to diabetes, or want to schedule an appointment with one of our specialists, contact your Baptist Health primary care physician.