Type 2 Diabetes And Eyes

Can You Reverse Diabetic Eye Problems

Its not possible to completely reverse retinopathy, macular edema, and glaucoma. But there are treatments that can help them from getting worse. This might include medications and surgery.

Cataract surgery can remove cataracts and restore vision. Once a healthcare provider removes a cataract, they put a clear lens in its place, which allows you to see more clearly. Sometimes treatment for other eye conditions like glaucoma or diabetic macular edema is more effective after removing a cataract.

Keep On Top Of Your Cholesterol And Blood Pressure

High blood pressure and a lot of fat in your blood will increase your chances of getting eye problems. This is because your blood vessels can get damaged or blocked, so the blood cant move around your eye properly.

We have advice and information to help you manage your blood pressure and cholesterol. Your healthcare team will also be able to support you with this.

Other Eye Problems To Be Aware Of

Thereâs another type of diabetic retinopathy which is a little different from the three stages above, known as diabetic maculopathy. While those first three can affect all parts of the retina, diabetic maculopathy is specific to the middle part of your retina, the macula, which is responsible for your central vision. A build-up of fluid in this part of your eye, known as a diabetic macula oedema, can seriously disrupt your day-to-day life as it could prevent you from doing things like driving or reading.

Diabetic retinopathy is the development of sight loss directly related to diabetes, but people living with type 2 diabetes are also at an increased risk of developing other eye problems. Having diabetes can mean youâre one and a half times more likely to develop glaucomaâwhich is when fluid builds up in your eyesâand two times as likely to develop cataracts. Cataracts can cause your vision to go cloudy. Both glaucoma and cataracts, if left untreated, can lead to blindness.

Fortunately, diabetic eye screenings will help identify all these problems early and help protect you from diabetic retinopathy, cataracts, and glaucoma.

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Symptoms Of Diabetic Eye Disease

Diabetic retinopathy causes blood vessel damage in the retina. Left untreated, it can cause vision loss and can develop into DME.

Approximately 40% to 45% of patients with diabetes have symptoms of diabetic retinopathy, though many don’t notice it. Symptoms can include:

• Blurry vision
• Floaters
• Faded, washed out appearance of colors
• Blank or dark areas in your field of vision

Diabetic macular edema is a build-up of fluid in the center of the retina, or the macula. This part of the eye is responsible for sharp vision and most of our color vision. Symptoms can include:

• Blurry or wavy vision in the center of your field of vision
• Floaters
• Noticing colors appear faded or washed out

Both forms of diabetic eye disease are treatable. Types of treatment and effectiveness depend on the severity of the condition.

At UT Southwestern, we take a multidisciplinary approach to diagnose and treat diabetic eye disease. If we detect diabetes-related eye symptoms and you have been diagnosed with diabetes, we can recommend that you follow up with your endocrinologist or primary care doctor.

If we see signs of eye damage but you have not been diagnosed with diabetes, we can refer you to a diabetes expert at UT Southwestern. The ophthalmology team works closely with our endocrinology doctors and nurses to make sure you have the treatment and information you need to reduce your risks.

What Eye Problems Can Diabetes Cause

Over time, high blood sugar may damage the blood vessels and lenses in your eyes. This can lead to serious diabetic eye problems which can harm your vision and sometimes cause blindness. Some common diabetes eye problems include:

• Diabetic retinopathy, which is the leading cause of blindness in American adults. It affects blood vessels in the retina . The blood vessels may swell and leak fluid into your eye. If it’s not treated, it can cause serious problems such as vision loss and retinal detachment, where the retina is pulled away from its normal position at the back of your eye.
• Diabetic macular edema , which happens when blood vessels in the retina leak fluid into the macula . This usually develops in people who already have other signs of diabetic retinopathy.
• Glaucoma, a group of eye diseases that can damage the optic nerve . Glaucoma from diabetes happens when the blood vessels in the front of your eye are damaged, and new blood vessels grow near the iris . The blood vessels block the space where fluid drains from your eye. This causes fluid to build up and pressure to increase inside your eye.
• Cataract, which happen when the clear lens in the front of your eye becomes cloudy. Cataracts are common as people age. But people with diabetes are more likely to develop cataracts younger and faster than people without diabetes. Researchers think that high glucose levels cause deposits to build up in the lenses of your eyes.

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What Are The Types Of Diabetic Retinopathy

Diabetes can cause blood vessels in the retina to become blocked, to leak or to grow incorrectly. The type of diabetic retinopathy you have depends on how badly your blood vessels are affected by diabetes. There are different types of retinopathy:

• Background diabetic retinopathy: Background retinopathy does not usually affect your sight, but your eyes will need to be monitored carefully to make sure your retinopathy doesnt become worse.
• Proliferative diabetic retinopathy: If background retinopathy gets worse, many of the retinal blood vessels become damaged or blocked. When these changes affect a large area of your retina, blood supply to the retina is reduced. The body tries to fix this by growing new blood vessels on the retinal surface or into the vitreous gel. Unfortunately, these new vessels are weak, and they bleed very easily, which may affect your vision.
• Diabetic maculopathy and diabetic macular oedema: Diabetic maculopathy is when your macula is affected by retinopathy. If the blood vessels near the macula are leaky, fluid can build up at the macula and cause macular swelling. This is called diabetic macular oedema and it can cause vision to be blurred and distorted, as well as making colours appear washed out.

Is Blurry Vision With Diabetes Temporary

Blurry vision can result from both short-term and long-term complications of diabetes.

Long-term eye problems stem from blood vessel damage in the retina of one or both eyes due to high blood sugar levels over the course of many years. These complications are not temporary, but treatment can slow their progression.

Short-term blurriness, due to high or low blood sugar levels, is temporary and will resolve when blood sugar levels return to normal.

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How Do I Get A Diabetes Eye Check

Usually your doctor or nurse will refer you to the local retinal screening service. However, you are the most invested in looking after your eyesight, so make sure to check each year whether your eye check is due and make sure you get to your appointment.

• If your last retinal eye check was normal, make sure it is done every 2 years.
• If you have early, mild or advanced diabetic eye disease, make sure you understand what treatment is needed and anything you can do to slow down the damage to your eyesight.

Common Eye Diseases Among People With Diabetes

• Retinopathy causes small blood vessels in the retina to get weak and possibly leak blood. This disease can cause blindness if not treated. This disease has no symptoms when it starts, so its important to get your eyes checked regularly.
• Cataracts cause a clouding of the lens of the eye, which makes vision blurry. People with diabetes are more likely to get cataracts.
• Glaucoma causes pressure in the eye. If not treated, glaucoma can cause vision loss or blindness.

Ask your health care team to help you set and reach goals to manage your blood sugar, blood pressure, and cholesterol and stop smokingalso known as the ABCs of diabetes.

• A1C : The goal set for many people is less than 7% for this blood test, but your doctor might set a different goal for you.
• Blood pressure: High blood pressure causes heart disease. The goal is less than 140/90 mmHg for most people but check with your doctor to see what your goal should be.
• Cholesterol: LDL or bad cholesterol builds up and clogs your blood vessels. HDL or good cholesterol helps remove the bad cholesterol from your blood vessels. Ask your doctor what your cholesterol numbers should be.
• Smoking: If you smoke or use other tobacco products, take steps to quit. Call 1-800-QUIT-NOW for support.

Teach your family about your diabetes and the ABCs so they can help you.

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How Diabetes Can Affect The Eyes

The retina is the light-sensitive layer of cells at the back of the eye that converts light into electrical signals. The signals are sent to the brain which turns them into the images you see.

The retina needs a constant supply of blood, which it receives through a network of tiny blood vessels.

Over time, a persistently high blood sugar level can damage these blood vessels in 3 main stages:

• background retinopathy tiny bulges develop in the blood vessels, which may bleed slightly but do not usually affect your vision
• pre-proliferative retinopathy more severe and widespread changes affect the blood vessels, including more significant bleeding into the eye
• proliferative retinopathy scar tissue and new blood vessels, which are weak and bleed easily, develop on the retina this can result in some loss of vision

However, if a problem with your eyes is picked up early, lifestyle changes and treatment can stop it getting worse.

• eye pain or redness
• difficulty seeing in the dark

These symptoms do not necessarily mean you have diabetic retinopathy, but it’s important to get them checked out.

Do not wait until your next screening appointment.

How Does A Diabetic Eye Exam Work

A diabetic eye exam can occur two ways:

Getting dilated eye examinations are so important, says Cai. This allows your doctors to identify issues early and offer you treatments if you need them to prevent vision loss from diabetes.

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What Is Diabetic Eye Disease

Diabetic eye disease is a group of eye problems that can affect people with diabetes. These conditions include diabetic retinopathy, diabetic macular edema, cataracts, and glaucoma.

Over time, diabetes can cause damage to your eyes that can lead to poor vision or even blindness. But you can take steps to prevent diabetic eye disease, or keep it from getting worse, by taking care of your diabetes.

The best ways to manage your diabetes and keep your eyes healthy are to

• manage your blood glucose, blood pressure, and cholesterol, sometimes called the diabetes ABCs
• If you smoke, get help to quit smoking
• have a dilated eye exam once a year

Often, there are no warning signs of diabetic eye disease or vision loss when damage first develops. A full, dilated eye exam helps your doctor find and treat eye problems earlyoften before much vision loss can occur.

How Does Diabetes Develop

Researchers arent sure about the exact cause of type 1 diabetes. However, type 2 diabetes is much more well known. Insulin is a hormone that the body produces which allows the sugar in your blood to access the cells in your body. Sugar is necessary for your cells to create energy, and insulin resistance usually occurs after a specific cycle develops.

First, a person is, for whatever reason, unable to make enough insulin to cover all the glucose that they eat. The body tries to make extra insulin to make up for the shortfall. The pancreas is unable to keep up with the increased need for insulin, and excess sugar floats throughout the blood doing damage instead of being absorbed by cells to create energy.

Eventually, insulin becomes less effective at helping glucose enter the cells and blood sugar levels rise ever higher. This effect is known as insulin resistance, and in type 2 diabetes it takes place gradually. Due to the gradual nature of insulin resistance, doctors recommend certain lifestyle changes to either slow the advance of the disease or halt its progress altogether.

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Diabetic Eye Disease And Diabetic Retinopathy

Diabetic retinopathy is the most common type of diabetic eye disease. The longer you have diabetes, the more likely you are to have some degree of diabetic retinopathy. How bad it will be depends on how well you control your blood sugar.

High blood sugar levels damage blood vessels throughout your body, including the ones in your retina. This thin layer of light-sensitive tissue lines the back of the eye and sends light to your brain. Thatâs what allows you to see.

There are 2 types:

1. Background or non-proliferative diabetic retinopathy : This is the earliest stage. Damaged blood vessels begin to leak into the retina. NPDR can cause changes in the eye including:

• Macular edema: Blood vessels in the retina leak fluid into the macula and it swells. Located in the center of your retina, itâs what gives you your pinpoint vision. This wonât lead to blindness, but it can cause blurred vision. It can get better once you get your blood sugar and blood pressure under control. If it doesnât improve, lasers or medications injected directly into your eye may help.
• Macular ischemia: This loss of blood flow results when small blood vessels in your retina close up. Your vision blurs because the macula no longer gets enough blood to work like it should.

Reducing Your Risk Of Developing Diabetic Retinopathy

It all sounds a bit scary, but if youâre on the path to managing, or even reversing, your type 2 diabetes then youâre already doing all the right things to reduce your risk of eye damage. Itâs something youâll hear a lot, but the single most useful thing you can do to take care of your bodyâand your eyes!âas someone with type 2 diabetes, is to monitor and regulate your blood sugar levels. Itâs definitely easier said than done, but hereâs some food for thought on reducing your risk of eye disease:

Watch your blood sugar, blood pressure, and cholesterol levels

Monitoring your levels regularly will help you notice when things change, for better or worse. High blood glucose and high blood pressure are the two big things to look out for when it comes to your eye health. A quick guide for what you should be seeing is:

If you check your blood sugar at home, it should be 4 to 7mmol/l, and you should try and check at different times throughout the day

• GP blood sugar tests take an average from the past few weeks and most people with diabetes should be looking for 48mmol/mol or 6.5%
• As someone with diabetes you should aim for your blood pressure reading to be no more than 140.80mmHg, and no less than 130/80mmHg but if youâve been given alternative guidance by your GP, you should follow that
• A healthy total cholesterol level is below 4mmol/l and can be measured with a blood test by your GP

Get regular screenings

Live a healthy lifestyle

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Looking After Your Eyes

Keeping your eyes in good health is vital for preventing conditions such as diabetic retinopathy and maintaining your eyesight. If you have diabetes, it is very important to control your blood sugar and cholesterol, and keep your blood pressure as close to normal as possible. Effective management of diabetes will reduce your risk of having problems.

Other steps you can take to help prevent retinopathy include:

• Informing your GP or diabetes care team of any changes to your vision
• Losing weight and maintaining a healthy weight
• Eating a healthy, balanced diet and keeping fit through regular exercise
• Quitting smoking
• Sticking to your prescribed medication plan

How Will My Eye Doctor Check For Diabetic Retinopathy

Eye doctors can check for diabetic retinopathy as part of a dilated eye exam. The exam is simple and painless your doctor will give you some eye drops to dilate your pupil and then check your eyes for diabetic retinopathy and other eye problems.

If you have diabetes, its very important to get regular eye exams. If you do develop diabetic retinopathy, early treatment can stop the damage and prevent blindness.

If your eye doctor thinks you may have severe diabetic retinopathy or DME, they may do a test called a fluorescein angiogram. This test lets the doctor see pictures of the blood vessels in your retina.

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What Other Problems Can Diabetic Retinopathy Cause

Diabetic retinopathy can lead to other serious eye conditions:

• Diabetic macular edema . Over time, about 1 in 15 people with diabetes will develop DME. DME happens when blood vessels in the retina leak fluid into the macula . This causes blurry vision.
• Neovascular glaucoma. Diabetic retinopathy can cause abnormal blood vessels to grow out of the retina and block fluid from draining out of the eye. This causes a type of glaucoma .