Get Your Eyes Screened
Eye screening is a way of spotting eye problems before you notice any changes to your sight.
Everyone whos over 12 years old and living with diabetes is entitled to an NHS diabetes eye screening once a year. Its one of your 15 Healthcare Essentials and a vital diabetes health check.
Diabetic retinopathy can become quite advanced before it starts affecting your sight, so that’s why it’s important to go to your regular eye screening appointments. That way, you can get the righttreatment in time.
Weve also got more information about what happens during an eye screening, so you can feel prepared going to your appointment.
How Does Diabetes Cause Diabetic Retinopathy
Diabetes mellitus causes abnormal changes in the blood sugar that your body ordinarily converts into energy to fuel different bodily functions.
Uncontrolled diabetes allows unusually high levels of blood sugar to accumulate in blood vessels, causing damage that hampers or alters blood flow to your bodys organs including your eyes.
Diabetes generally is classified as two types:
Type 1 diabetes: Insulin is a natural hormone that helps regulate the levels of blood sugar needed to help feed your body. When you are diagnosed with Type 1 diabetes, you are considered insulin-dependent because you will need injections or other medications to supply the insulin your body is unable to produce on its own. When you dont produce enough of your own insulin, your blood sugar is unregulated and levels are too high.
Type 2 diabetes: When you are diagnosed with Type 2 diabetes, you are generally considered non-insulin-dependent or insulin-resistant. With this type of diabetes, you produce enough insulin but your body is unable to make proper use of it. Your body then compensates by producing even more insulin, which can cause an accompanying abnormal increase in blood sugar levels.
With both types of diabetes, abnormal spikes in blood sugar increase your risk of diabetic retinopathy.
Eye damage occurs when chronically high amounts of blood sugar begin to clog or damage blood vessels within the eyes retina, which contains light-sensitive cells necessary for good vision.
What Are The Symptoms Of Diabetes Eye Problems
Vision problems related to diabetes usually occur in both eyes at the same time. Here are some of the most common early symptoms:
Presence of floaters
Difficulty seeing at night or in dim lighting
Changing vision quality
If these eye problems are not treated properly, more serious symptoms can happen, including:
Darkened or empty spots in your field of vision
Loss of side or peripheral vision
Partial or total blindness
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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.
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.
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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.
How Can I Reduce The Risks
If your diabetes is well controlled, youre less likely to have problems, or they may be less serious. However, some people with diabetes do have serious sight loss because of their retinopathy. You can reduce your risk of developing retinopathy, or help to stop it from getting worse, by:
- Keeping your blood glucose or blood sugar level within normal levels.
- Tightly controlling your blood pressure.
- Controlling your cholesterol levels.
- Keeping fit and maintaining a healthy weight.
- Giving up smoking. Nerve damage, kidney and cardiovascular disease are more likely in smokers with diabetes. Smoking increases your blood pressure and raises your blood sugar level, which makes it harder to control your diabetes.
- Having regular retinal screening. The most effective thing you can do to prevent sight loss due to diabetic retinopathy is to go to your retinal screening appointments. Early detection and treatment can stop you from losing sight.
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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.
How Are These Eye Conditions Treated
Unfortunately, once you develop any of these diabetes-related eye problems, they cannot be reversed. Doctors can only try to prevent them from getting worse. Many times, they require surgery.
Treating cataracts depends on how bad they are. If your cataracts arent bothering you much, you can ease symptoms by having your eyeglass prescription adjusted. When your cataracts begin to prevent you from performing your normal activities, they can be surgically removed.
Diabetic retinopathy, glaucoma, and macular edema are a bit more difficult to manage. Eye drops are used to help keep the pressure and swelling to a minimum, but one of the following may also need to be done:
. This is a type of laser surgery to help treat retina problems and macular edema. It involves sealing the blood vessels around your retina that are most likely to start leaking.
Vitrectomy. If the blood vessels in your retina are leaking a lot of fluid, your doctor may recommend this procedure to remove blood from inside your eye as well as any scar tissue on your retina.
Injectable eye medications. These are an option for those with glaucoma or macular edema. There are a few injectable medications for glaucoma , and they stop your eye from making new blood vessels that can leak more fluid into your eye and increase eye pressure. For macular edema, injectable medications include steroids and anti-inflammatories that help reduce and control swelling.
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Prevent Or Delay Eye Diseases
You can protect your vision and lower your chance for vision loss with these steps:
- Get a dilated eye exam at least once a year so your eye doctor can spot any problems early when theyre most treatable.
- Keep your blood sugar levels in your target range as much as possible. Over time, high blood sugar not only damages blood vessels in your eyes, it can also affect the shape of your lenses and make your vision blurry.
- Keep your blood pressure and cholesterol levels in your target range to lower your risk for eye diseases and vision loss. Also good for your health in general!
- Quit smoking. Quitting lowers your risk for diabetes-related eye diseases and improves your health in many other ways too.
- Get active. Physical activity protects your eyes and helps you manage diabetes.
- Ask your doctor for a referral to diabetes self-management education and support services. People who receive less diabetes education are twice as likely to get diabetic retinopathy as people who receive more education.
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.
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Blood Sugar And Vision Problems
Blurred vision could just be a temporary problem that develops rapidly and is caused by high blood sugar levels. High blood sugar causes the lens of the eye to swell, which changes your ability to see. Changing the shape of the lens naturally throws off vision. This can be a chronic, 24/7 kind of problem, or it can occur only after a high-carb meal, when glucose is way up.
The Harvard Medical School Family Health Guide says that after-meal blurriness can be prevented by avoiding high-carb meals. The cure for chronic, all-the-time blurriness is to get blood glucose down to normal range before meals. It may take as long three months of relatively normal blood glucose levels before vision returns to your baseline normal.
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.
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Eye Exam Assistance Programs
If you have diabetes and cannot afford an eye exam, there are programs available to help you obtain the eye care you need. Examples include:
VISION USA. Administered by the Optometry Cares The AOA Foundation, this program provides free eye exams to uninsured, low-income workers and their families. For more information about VISION USA, visit the AOA Foundation website.
EyeCare America. This public service program of the Foundation of the American Academy of Ophthalmology provides free eye exams for qualifying seniors. Eligible individuals receive a comprehensive medical eye exam and up to one year of care for any disease diagnosed during the initial exam at no out-of-pocket cost. To determine if you or a senior family member or friend qualify for this program, visit the EyeCare America website.
Lions Clubs International. This organization provides financial assistance to individuals for eye care through its local clubs. You can find a local Lions Club by using the club locator feature on the organization’s website.
When Do Eye Checks Start
- For type 2 diabetes, eye checks start from the time of diagnosis. This is because some people may already have signs of diabetes eye disease by this time.
- For type 1 diabetes, eye checks tend to start 5 years after diagnosis, but this can vary depending on your age when first diagnosed.
- Pregnant women with known diabetes before should have eye checks in the first trimester.
- If you have no damage to your retina , you will be offered an eye screen every 2 years.
If there are any signs of eye disease, the eye team will explain what further tests, treatment and follow up is needed. You may also need eye checks more often than every 2 years.
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What Can Be Done For Me If I Have Eye Damage From Diabetes
Your ophthalmologist can perform laser procedures to stop progression of the disease and reduce swelling. Medications may also be injected straight into the eye to help reduce swelling. Surgery is a later resort to clear out blood and remove scar tissue that may be causing the retina to swell or detach.
Diabetes Treatment And Blurriness
For people who take medication to increase insulin in the body, changing the timing of food or a change in activity levels can result in low blood sugar levels.
Blurriness from low blood sugar does not result from changes in the eye. Instead, it is due to the way hypoglycemia affects the brain.
Vision that changes in this way will return to normal after glucose levels return to normal.
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Who Is More Likely To Develop Diabetic Eye Disease
Anyone with diabetes can develop diabetic eye disease. Your risk is greater with
- high blood glucose that is not treated
- high blood pressure that is not treated
High blood cholesterol and smoking may also raise your risk for diabetic eye disease.
Some groups are affected more than others. African Americans, American Indians and Alaska Natives, Hispanics/Latinos, Pacific Islanders, and older adults are at greater risk of losing vision or going blind from diabetes.
If you have diabetes and become pregnant, you can develop eye problems very quickly during your pregnancy. If you already have some diabetic retinopathy, it can get worse during pregnancy. Changes that help your body support a growing baby may put stress on the blood vessels in your eyes. Your health care team will suggest regular eye exams during pregnancy to catch and treat problems early and protect your vision.
Diabetes that occurs only during pregnancy, called gestational diabetes, does not usually cause eye problems. Researchers aren’t sure why this is the case.
Your chances of developing diabetic eye disease increase the longer you have diabetes.
Reducing Your Risk Of Diabetic Retinopathy
To prevent retinopathy or prevent it from getting worse, keep your blood sugar, blood pressure, and blood cholesterol within a healthy range.
Follow the ABCDEs of staying healthy with diabetes to reduce the risk of eye damage.
A A1C Most people should aim for an A1C of 7%* or less by managing blood sugars well. A1C is a blood test that is a measure of your average blood sugar level over the past 120 days.
B Blood pressure Control your blood pressure to less than 130/80* mmHg.
C Cholesterol The LDL cholesterol target is less than 2.0* mmol/L.
D Drugs to protect your heart Speak with your health-care team about medications.
E Exercise & Eating Regular physical activity, healthy eating, and maintain a healthy body weight.
S Screening for complications Ask your health-care team about tests for your heart, feet, kidneys, and eyes.
S Smoking cessation Stop smoking and seek support for help with quitting.
S Self management, stress, and other barriers Set goals for yourself to reach the targets and live well with diabetes, such as managing stress effectively.
* Discuss your target values with your health-care team. Note that A1C targets for pregnant women, older adults and children 12 years of age and under are different
For more information about diabetic retinopathy, visit the Canadian National Institute for the Blind .
To find a CAO optometrist in your area, visit the Canadian Association of Optometrists.
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What Can I Do To Prevent Diabetic Retinopathy
Managing your diabetes is the best way to lower your risk of diabetic retinopathy. That means keeping your blood sugar levels in a healthy range. You can do this by getting regular physical activity, eating healthy, and carefully following your doctors instructions for your insulin or other diabetes medicines.
To make sure your diabetes treatment plan is working, youll need a special lab test called an A1C test. This test shows your average blood sugar level over the past 3 months. You can work with your doctor to set a personal A1C goal. Meeting your A1C goal can help prevent or manage diabetic retinopathy.
Having high blood pressure or high cholesterol along with diabetes increases your risk for diabetic retinopathy. So controlling your blood pressure and cholesterol can also help lower your risk for vision loss.