What The Future Holds
Scientists are studying better ways to find, treat and prevent vision loss in people with diabetes.
The longer you’ve had diabetes, the more likely you are to have retinopathyits a common problem. But if you keep your blood sugar at your target levels, you may delay or even prevent it. Often you wont have symptoms until youve developed the problem, so get regular eye exams. These new tests and treatments will help address problems early.
Can Vision Loss From Diabetes Be Prevented
Yes, in a routine eye examination, your optometrist can diagnose potential vision threatening changes in your eye that may be treated to prevent blindness. However, once damage has occurred, the effects are usually permanent. It is important to control your diabetes as much as possible to minimize your risk of developing retinopathy.
Which Specialties Of Doctors Treat Diabetic Eye Disease
Ophthalmology is the specialty of medicine that deals with the diagnosis and treatment of eye disease. The ophthalmologist is the appropriate person to both diagnose and treat diabetic eye disease.
Some ophthalmologists limit their practice to diseases of the retina. A general ophthalmologist can decide whether or not the specific patient requires an evaluation by a subspecialist in retinal disease.
People with diabetes also will be cared for by their family doctor or internal medicine specialist and other subspecialists as needed.
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Swelling Of The Eye Lens
Another potential effect from diabetes is swelling of the eye lens, leading to blurry vision. If your blood sugar levels change quickly from low to normal, the shape of your eyes lens can be affected and your vision can be blurred. Your vision goes back to normal after your blood sugar stabilizes. If youre getting eyeglasses, make sure your blood sugar levels are controlled before your exam so that you can get the most accurate glasses prescription, says Cai.
Whats The Treatment For Diabetic Retinopathy And Dme
In the early stages of diabetic retinopathy, your eye doctor will probably just keep track of how your eyes are doing. Some people with diabetic retinopathy may need a comprehensive dilated eye exam as often as every 2 to 4 months.
In later stages, its important to start treatment right away especially if you have changes in your vision. While it wont undo any damage to your vision, treatment can stop your vision from getting worse. Its also important to take steps to control your diabetes, blood pressure, and cholesterol.
Injections. Medicines called anti-VEGF drugs can slow down or reverse diabetic retinopathy. Other medicines, called corticosteroids, can also help.
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Maintain Your Eye And Vision Health With Diabetes Latest Ada Standards Of Care
Having diabetes puts you at risk for problems with your eyes and vision. Learn about the steps you can take, as recommended in the latest ADA Standards of Care, to maintain the health of your eyes and prevent damage.
People with diabetes are at increased risk compared to the general population of developing eye problems including: retinopathy, macular edema, cataracts and glaucoma. And diabetes continues to be the leading cause of new-onset blindness in people aged 18 to 64 years of age.
Learn how to maintain the health of your eyes based on guidance from the American Diabetes Associations Standards of Care.
Diabetic Retinopathy Can Cause Permanent Vision Loss
Many people are surprised to learn that diabetic retinopathy is the most common cause of vision loss for people with diabetes. Hereâs a quick primer.
Diabetes is a disease that affects the small blood vessels throughout the body, including the delicate blood vessels in the back of your eye. These blood vessels are just like pipes: When they become damaged, they weaken and start to leak. Over time, these tiny blood vessels drip blood and plasma onto your retina. This causes retinal tissue to swell, which leads to cloudy or blurred vision. This also causes damage that results in less oxygen and other nutrients getting to your retina.
Sometimes, your body tries to correct the problem by making new blood vessels. But these blood vessels are fragile and can burst and bleed, or form scar tissue that pulls your retina off of your eye wall. All of these scenarios may ultimately lead to blindness.
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When To Get An Eye Exam
You should get an eye exam once a year, unless your ophthalmologist or optometrist has suggested something different. The risk of vision loss can be greatly reduced with regular checks. Remember, you may not be aware of changes to your vision and many problems can be treated when caught early.
If you notice any of the following changes to your vision, go see an eye doctor immediately:
- blurred vision
- flashes of light in the field of vision
- sudden loss of vision
- blotches or spots in vision
Diabetic retinopathy can worsen in pregnancy, so if you have diabetes you should have a diabetic eye exam before getting pregnant and while pregnant.
How Is Diabetic Retinopathy Diagnosed
An eye doctor can diagnose diabetic retinopathy during a simple exam.
- Visual acuity: Acuity refers to how clearly you can see.
- Intraocular pressure to make sure there are no signs of glaucoma.
- Eye muscle function: Muscle function refers to how well you can move your eyes.
- Peripheral vision: Peripheral vision is seeing from the sides of your eyes.
- Pupil response: This assessment looks at how your pupils react to light.
Then, your eye doctor will put drops into your eyes. The drops dilate your pupils .
During this exam, the doctor looks for:
- Abnormal blood vessels.
- Bleeding in the center of your eye.
- Growth of new blood vessels.
- Retina swelling.
- Visual acuity.
In the early stages of the disease, your healthcare provider may use a wait-and-see approach especially in the setting of good vision. During this phase, you have regular eye exams but donât need further treatment. Some people need eye exams every two to four months.
Other treatment options include:
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Whats The Connection Between Diabetes And Dry Eyes
Dry eye syndrome is a common complication of both type 1 and type 2 diabetes. It happens because of high blood sugars.
When your blood sugar is high, it can cause nerve damage in your eyes which, in turn, can lead to decreased tear production.
Additionally, high blood sugar can cause inflammation throughout your body. This inflammation makes it harder for your lacrimal glands the glands in your eyes that produce tears to function.
Over time, if left untreated, dry eye may lead to:
- eye pain
- corneal scarring
- vision loss
Fortunately, managing your blood sugar and keeping it within a healthy range can lower your risk of dry eye syndrome.
Eye drops and other treatments can also help relieve dry eye symptoms and prevent complications while you work with a healthcare professional to manage your diabetes.
Do I Need To Follow Up With My Doctor After Being Diagnosed With Diabetic Eye Disease
If you or someone you know has diabetes and mild diabetic eye disease, follow-up examinations with an ophthalmologist every year may be all that is necessary.
If the person has a more serious disease, more frequent follow-up appointments with an ophthalmologist are required based on the severity of the disease.
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Signs Of Hearing Loss
Hearing loss can happen slowly, so it can be hard to notice. Often, friends and family members will notice your hearing loss before you do.
Signs of hearing loss include:
- Often asking others to repeat themselves.
- Trouble following conversations with more than one person.
- Thinking that others are mumbling.
- Problems hearing in noisy places, such as busy restaurants.
- Trouble hearing the voices of small children and others with quiet voices.
- Turning up the TV or radio volume too loud for others who are nearby.
Problems with your inner ear may also affect your balance.
Does Diabetes Increase The Chance Of Vision Loss
For those living with diabetes, symptoms can be a daily challenge combined with the thought of losing your eyesight, it becomes easy to be concerned.
Did you know that diabetes is the leading cause of vision loss in adults? This is a frightening aspect to the disease, as most of us take our eyesight for granted. People with Type 1 and Type 2 diabetes do have a heightened risk for eye complications and blindness.
Sight loss with diabetes, however, is not inevitable. Increasing your knowledge about vision health and learning preventative steps to take can preserve your eyesight for many years to come.
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How Can Diabetes Affect Your Eyes
Diabetes occurs when your body does not properly process food as energy. When you have diabetes, your body either does not respond to or does not produce insulin, which is a hormone that delivers glucose to the cells in your body. Having too much glucose in the bloodstream, outside the cells where it belongs, can lead to damage of the blood vessels and nerves that run throughout your body, including to the eyes.
Types Of Diabetic Retinopathy
- Non-proliferative retinopathy is an early form of the disease, where the retinal blood vessels leak fluid or bleed.
- Macular oedema is a swelling of the macula, caused by the leakage of fluid from retinal blood vessels. It can damage central vision.
- Proliferative retinopathy is an advanced form of the disease and occurs when blood vessels in the retina disappear and are replaced by new fragile vessels that bleed easily, and that can result in a sudden loss of vision.
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Know Your Blood Sugar Levels
Consistently high blood sugar levels make you more at risk of diabetes complications, including serious eye problems.
Knowing what your target levels are and regularly checking your blood sugars can help you keep on top of them. This means checking your blood sugar levels at home and getting a doctor to check your HbA1c levels regularly too.
Your healthcare team should help you set your targets. The closer you get, the lower your risk of developing eye problems.
If youre finding it difficult to keep your blood sugar levels to your target range, speak to your healthcare team for advice. Or you can call our helpline for more information and support.
How Does Diabetes Affect The Retina
The retina is the light-sensing component located in the back of the eye. It is composed of blood vessels, nerve cells , and specialized cells called photoreceptors that are involved in directly sensing light. The ability of the retina to sense light requires energy, which is dependent on the oxygen supplied by blood circulating through blood vessels.
In diabetes, elevated blood sugar levels damage the blood vessels of the retina. These damaged blood vessels leak fluid, bleed, and do not provide adequate oxygen to the retina, leading to retinal ischemia. As a result, retinal cells begin to die and the retina is unable to function properly. In addition, diabetes also damages the neurons of the retina directly. Together, these effects cause diabetic retinopathy.
Vision loss associated with diabetic retinopathy may initially affect central vision due to a condition called diabetic macular edema. This swelling of the macula, a portion of the retina responsible for sharp, central vision, can lead to blurry vision and distortion of images.
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How To Protect Your Ears
You cant reverse hearing loss, but you can follow these tips to help protect your ears:
- Keep your blood sugar as close to your target levels as possible.
- Get your hearing checked every year.
- Avoid other causes of hearing loss, including loud noises.
- Ask your doctor whether any medicines youre taking can damage your hearing and what other options are available.
You should have your hearing tested by an audiologistexternal icon when you first find out you have diabetes and then every year after. Make it part of your diabetes care schedule. If you think you have hearing loss, talk to your doctor. They can help you decide if you should see an audiologist.
Hearing loss can be frustrating for you and your family, and it can affect your social life. There are many reasons to keep your blood sugar in your target rangeprotecting your hearing is just one of them. Plus, youll feel better and have more energy while you do it!
How To Prevent Reverse And/or Delay Diabetes
Regular follow up
If theres no evidence of retinopathy or other problems after one or more exams, then screening should be done every year by an ophthalmologist or optometrist.
If you are told you have evidence of retinopathy or other eye problems, you should see a specialist for that problem as often as recommended by the specialist.
In closing, the ADA now recommends a comprehensive approach to prevent and/or delay most long-term diabetes complications. Some of the actionable steps you can take to prevent eye problems or other complications includes:
Get regular exams to check for any complications such as retinopathy, heart disease, kidney disease, etc.
Report any physical changes in your body or symptoms to your diabetes care providers.
Take action as soon as possible to get the recommended treatment for a detected problem.
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Diabetes And Hearing Loss
Get your hearing tested every year if you have diabetes.
Over time, blood sugar levels that are too high or too low can damage nerves that affect your hearing. Learn how you can help prevent hearing loss if you have diabetes.
Hearing loss happens for many reasons. You probably know that it can happen as you age or if you spend too much time around loud noises. You may not know that having diabetes puts you at risk for hearing loss. Managing your blood sugar is a critical part of your diabetes care. It can also help protect your hearing.
Read more about the signs of hearing loss and how you can help prevent it if you have diabetes.
Risk Factors For Diabetes
The risk factors for diabetic retinopathy include:
- Type 1, type 2, or gestational diabetes , and prediabetes. The longer the person has diabetes, the more likely they are to develop diabetic retinopathy.
- High blood pressure, blood sugar levels, or cholesterol.
- Being of a certain race or ethnicity: Black, of Latin American descent, and Indigenous peoples have higher risks.
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How To Detect And Treat Vision Loss From Diabetic Eye Disease
The eyes may be windows to the soul, but for people with diabetes, looking deep into the retina can also reveal a diabetes-related eye disease.
Two of the most common types of vision loss related to diabetes are macular edema and retinopathy. Both are under the scope of diabetic eye disease, which includes all the retinal changes caused by diabetes. Diabetes can also make you more likely to have other eye conditions, including cataracts and glaucoma.
The good news: Advances in testing are catching problems before serious retinal changes occur. This is an important step since eye damage may have no symptoms at first. And if you already have diabetes-related eye disease, advances in treatment can save your sight.
When To See Your Doctor
If youre experiencing sudden blurred vision together with eye pain, you should go see your doctor and have your eye checked
If your vision has become blurred over time, it could be a sign of an underlying condition, which could be diabetes amongst other possible causes.
Your doctor should be able to help distinguish why your vision may have worsened.
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Complications Of Diabetic Retinopathy
Diabetic retinopathy complications can result in serious vision problems, including:
Vitreous haemorrhage: It occurs when new blood vessels start to bleed into the vitreous fluid. When this complication is minor, you may see floaters. However, in severe haemorrhage, blood fills the vitreous cavity and temporarily blocks the vision completely. This complication takes a few weeks or months to clear unless the retina is damaged.
Glaucoma: Diabetic retinopathy causes new blood vessels to grow in the front of the eye as well. This results in a buildup of eye pressure and interference with the normal fluid flow. Glaucoma can damage the optic nerve and can lead to permanent blindness.
Retinal detachment: When damaged blood vessels pull the retina away from the support tissue, retinal detachment occurs. In this condition, you may observe floaters and flashes of light initially and then complete obscuration of vision.
When To See A Doctor For Diabetic Eye Disease
Even if the person is not experiencing any symptoms due to diabetes, the person should have an annual eye examination by an ophthalmologist . If the ophthalmologist notices any significant signs of diabetic eye disease or if the person requires treatment, exams may need to be scheduled more frequently than annually.
If the person notes any significant changes in vision other than a mild temporary blurring, they should contact an ophthalmologist immediately.
Questions to ask the doctor about diabetes and eye problems
- Are there any signs of permanent damage to my eyes from diabetes?
- Is there any significant loss of vision? If so, is this loss of vision permanent?
- Are there any signs of cataracts or glaucoma?
- Do I need any treatment at this time for any problems with my eyes?
- How often do I need to be examined?
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Other Types Of Diabetic Eye Disease
Diabetic retinopathy is the most common cause of vision loss for people with diabetes. But diabetes can also make you more likely to develop several other eye conditions:
- Cataracts. Having diabetes makes you 2 to 5 times more likely to develop cataracts. It also makes you more likely to get them at a younger age. Learn more about cataracts.
- Open-angle glaucoma. Having diabetes nearly doubles your risk of developing a type of glaucoma called open-angle glaucoma. Learn more about glaucoma.